| 摘要: | 本文將分析影響腦血管疾病就診率之消費或居住型態等因素，並以全民健保體系之永續發展為目的，引出政策建議。期望透過控制這些因素，降低腦血管疾病之罹病風險，同時降低健保體系長期以來對腦血管疾病的龐大支出成本。
本文之研究年度為民國九十三年到民國一零三年；共十一個年份。以台灣經五都改制後之18個縣市再下分兩組性別及四組年齡層作為觀察點單位。其解釋變數係利用國發會提供之各縣市教育程度、財富狀況、消費內容、人口密度等資料，整合全民健保資料庫提供的該疾病各縣市就診資料，分析經濟生活的改變以及居住分布的改變，對於罹患腦中風因素的影響。本研究為追蹤資料，以兩階段最小平方法及最小平方法之迴歸分析來探討經濟及消費型態的變化，在控制了性別、年齡及其他控制變數後，對於腦中風就診率的影響。
由迴歸結果得知，經濟發展程度與腦血管疾病就診率並不顯著相關，而人口密度、平均可支配所得與高血壓人口比例亦不顯著相關影響；醫療資源則為負相關，表示醫療資源的挹注將有助於改善腦中風疾病的就診率；不良的飲食習慣則具正相關影響，而個體之社經地位則是負相關。另由迴歸結果得知，性別及年齡是影響腦中風就診率的決定性因素；男性風險高於女性。另外個體年齡越高，就診率越大。區域的部分，其腦血管疾病就診率排名依序為：中部地區、東部地區、南部地區最後則是北部地區。
對於相關政策，首先建議課徵較重之飲料稅額，且須轉嫁至消費者身上才具降低飲料消費量的效力。其二建議針對中部地區加強腦血管疾病之治療，或挹注醫療資源於中部地區以改善腦血管疾病之情形。期望透過這些政策，達到降低健保體系對於腦血管疾病支出成本之果。;Abstract
This research focus on finding out economic factors, consumer behaviors, and conditions of living would affect the treatment rate of brain disease. By observing how these factors affected stroke treatment rate, we can provide some suggestions for our government about what policies should be implemented in order to cut down the burden of National Health Insurance.
In this research, we used 18 cities in Taiwan and allocated their citizens into 2 gender groups and 4 age groups. The scale of this research was from 2004 to 2014, so we had 1584 observations in our panel data. The explanatory variables we used were provided by National Development Council, including the level of education, wealth conditions, citizen consumptions, and the level of urbanizations in different cities. Next, we integrated these variables with the brain stroke treatment data provided by the National Health Insurance Research Database,so we can analyze how the differences of residence and the economic conditions can affect the brain disease treatment rate.
About the regression, we used multi-regression in two stages least square or least square to analyze the factors that affect stroke treatment rate by controlling age, gender, and other controlling variables to find the relations of these factors and brain stroke treatment rate.
According to our results, we found that the economic development and level of urbanization had nothing to do with treatment rate of brain disease. However, the availability of medical resources had a negative effect on treatment rate of brain disease. The bad dietary habits had positive effects on brain stroke. About the social status, level of education had a negative effect on stroke in no doubts, but the level of disposable income had nothing to do with treatment rate of stroke. Additionally, our statistical results showed that gender and age were also two crucial factors that explained the treatment rate of brain stroke. Generally, male had more risks of being infected due to stroke than female, and if one individual was older, he/she was more likely to be infected. About the district factor, the central district has the strongest brain stroke treatment rate, and the eastern district is in the second place, southern district is in the third place, finally, the last one would be northern district.
To reduce the treatment rate of our citizens, we proposed some suggestions based on our findings. Firstly, we should impose more taxes on beverages consuming and the taxes must transfer to consumers. Secondly, we assert that about the brain stroke issue, we should focus on the central district. For example, we could higher the medical resource in central district in order to bring down the treatment rate. By implementing the policy suggested above, we can cut down the treatment rate due to brain stroke therefore, to reach the goal that reduce the expenditure of Health Insurance. |
