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| Title: | 不同年度COVID-19流行期間影響門診就醫行為的相關因素探討 |
| Other Titles: | A study on the factors affecting outpatient medical behavior during different COVID-19 epidemic periods |
| Authors: | 呂曉瑄
LU, XIAO-XUAN |
| Contributors: | 廖宏恩
Liao, Hung-En
健康產業管理學系健康管理組碩士在職專班 |
| Keywords: | 嚴重特殊傳染性肺炎;就醫行為;健康信念模式;照護可近性
COVID-19;Access to Care Behavior;Health Belief Model;Accessibility of Care |
| Date: | 2023 |
| Issue Date: | 2023-11-22 02:03:03 (UTC+0) |
| Abstract: | 背景：自2019年末中國武漢爆發新冠肺炎以來，至今已造成全世界大流行，臺灣初次疫情爆發時期是在2021年5月初，此次疫情的爆發是由傳染力較弱但病毒性較強且死亡率也較高的病毒為主，而2022年第二波的疫情則變為傳染力較強但病毒性較弱且死亡率較低的病毒為主，以至於第二波爆發雖大多屬於輕症，但確診病例數卻比去年高出100萬例以上。民眾在疫情期間擔心在公共場所增加被傳染的風險而選擇待在家中，減少外出的機會，連帶著生活型態與就醫行為也跟著改變，疫情期間民眾會因為小病至小診所就醫，大型醫學中心不再每天擠滿人，讓醫療資源有效發揮於急重症病人。而兩波疫情中皆因為疫情的升溫，民眾防疫措施更加完善且擔心至醫療院所增加受感染的風險，其醫療就醫行為也大幅降低。目的：本研究主要目的為探討在嚴重特殊傳染性肺炎（COVID-19）疫情期間民眾至門診就診的意願以及民眾的就醫行為在疫情前後是否有差異，進而分析在疫情期間影響民眾門診就醫行為改變的因素。方法：本研究係屬回溯性研究設計，應用「健康信念模式」為架構，針對20歲以上成年人在網路社團發放具信效度線上問卷，最終有效問卷共438份，以描述性統計及成對樣本T檢定分析2021及2022年醫院收治COVID-19確診病人時，民眾至門診就醫的意願，並採用二元邏輯斯迴歸分析民眾在COVID-19不同時期影響其就醫行為改變的相關因素。結果：COVID-19流行在2021年第一波疫情比2022年第二波疫情對民眾至醫院就診的意願衝擊較大（p<0.05）；而在疫情前較高比例的民眾（52.3%）平均每月就醫次數為1~2次，2021年降為0次（54.3%），2022年則恢復為1~2次（49.5%），且不同時期（i.e., 疫情前、2021年、2022年）民眾平均每月就醫次數皆有顯著差異（p<0.05）；在2021年影響民眾就醫行為的原因為「住家距離醫院的路程」，距離醫院越近越有可能去醫院就診（p<0.05）；而2022年則是「年齡」與「住家距離醫院的路程」，40~54歲比20~39歲族群就醫的可能性低（p<0.05），距離醫院越近越有可能去醫院就診（p<0.05）。結論：相較於平時，2021年（低感染率、高死亡率）比2022年（高感染率、低死亡率）疫情對於民眾就醫意願與行為有較大的衝擊，然而年齡與路程可近性，在上述不同情境依然扮演影響民眾就醫的重要因素。
Background：The first outbreak in Taiwan was in early May 2021, and this outbreak was dominated by a less infectious but more virulent virus with a higher mortality rate, while the second wave in 2022 was dominated by a more infectious but less virulent virus with a lower mortality rate. Although most of the cases in the second wave are mild, the number of confirmed cases is more than 1 million higher than last year. During the epidemic, people chose to stay at home and go out less because they were worried about the increased risk of infection in public places, and this led to a change in lifestyle and medical behavior. In both waves of the epidemic, as the epidemic heated up, people took better precautions and were concerned about the increased risk of infection at medical facilities, and their medical visits were significantly reduced.Objective：The main purpose of this study was to investigate the willingness of people to visit the outpatient clinics during the outbreak of severe and specific infectious pneumonia (COVID-19) and whether there were differences in people's behavior before and after the outbreak, and to analyze the factors that influenced changes in people's behavior during the outpatient clinics during the outbreak.Method：The study was designed as a retrospective study. Using the Health Belief Model as a framework, 438 validated online questionnaires were distributed to adults aged 20 years or older in online societies, and descriptive statistics and paired sample t-testing were used to analyze people's willingness to go to outpatient clinics in 2021 and 2022 when they were admitted to hospitals with confirmed COVID-19 patients.Result：The first wave of COVID-19 epidemic in 2021 had a greater impact on people's willingness to visit hospitals than the second wave in 2022 (p<0.05); while a higher proportion of people (52.3%) made one to two visits per month on average before the epidemic, which decreased to zero in 2021 (54.3%) and returned to one to two visits in 2022 (49.5%). In 2021, "distance from home to hospital" was the reason affecting people's medical behavior, and the closer to the hospital, the more likely they were to go to the hospital (p<0.05); while in 2022, "age" and "distance from home to hospital" were the reasons affecting people's medical behavior. In 2022, it is "age" and "distance to hospital", 40~54 years old are less likely to go to the hospital than 20~39 years old (p<0.05), and the closer to the hospital, the more likely to go to the hospital (p<0.05).Conclusion：The 2021 (low infection rate, high mortality rate) epidemic will have a greater impact on the willingness and behavior of people to seek care than the 2022 (high infection rate, low mortality rate) epidemic, but age and accessibility still play important roles in influencing people's access to care in these different scenarios. |
| Appears in Collections: | [健康管理組] 博碩士論文
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