台灣不同族群老人之健康不平等與全民健保

ASIA unversity > 醫學暨健康學院 > 健康產業管理學系 > 健康管理組 > 國科會研究計畫 > Item 310904400/9413

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題名:	台灣不同族群老人之健康不平等與全民健保
作者:	董和銳
貢獻者:	健康學院健康產業管理學系
關鍵詞:	台灣老人族群全民健保健康不平等 Health disparities, Ethnicity National Health Insurance Elderly, Taiwan.
日期:	2009
上傳時間:	2010-05-07 03:14:43 (UTC+0)
摘要:	90/12/21 修訂十一、研究計畫中英文摘要：請就本計畫要點作一概述，並依本計畫性質自訂關鍵詞。（一）計畫中文摘要。（五百字以內）計畫名稱：台灣不同族群老人之健康不平等與全民健保計畫摘要全民健保是台灣第一個根據公民身份將全民都納入的健康保險制度，在1995 年開辦之後對台灣民眾醫療的可近性（accessibility）及醫療利用（utilization）的提升是非常顯著的。有研究顯示健保的實施對於台灣健康不平等的縮小有正面影響。但這些研究用的都是地區集體層次（area-level or aggregate-level）的資料，而且是直接比較健保前後的死亡率，而從二十世紀初到現在，人類死亡率的長期趨勢（Secular Trend）都是下降的。單單比較健保前後的全國死亡率的差距是很難將這些差距完全歸因於全民健保的開辦。因此，本研究將利用具全國代表性的調查樣本，進一步了解全民健保的實施對台灣社會族群間的醫療照顧與健康不平等現象產生了什麼樣的影響？本研究將利用「臺灣地區老人保健與生活問題長期追蹤研究調查」與衛生署之死亡檔之連結後的資料檔案，針對台灣三大族群（外省、閩南及客家籍）間的健康不平等情形做下面的分析：（一）分析健保實施前後，不同世代（cohort）的台灣老年人口族群、社經地位與死亡情形三者之間的互相關聯，進一步釐清「全民健保」在其中所扮演的角色。（二）全民健保實施前後，不同族群或社經地位的老人在可預防之死亡（preventable deaths）方面的差異。（三）實施全民健保之後不同族群老人的主要死因疾病與醫療照顧品質之間的關聯。 90/12/21 修訂十一、研究計畫中英文摘要：請就本計畫要點作一概述，並依本計畫性質自訂關鍵詞。（二）計畫英文摘要。（五百字以內） Ethnic Health Disparities and the National Health Insurance Abstract Health disparities research has long documented that women live longer than men, infant mortality is higher among the lower socioeconomic status (SES), and African Americans suffer markedly higher rates of death and disease than American whites. In recent years, this line of research has shifted from documenting different patterns of disparities to focusing more on identifying the underlying causes of health disparities and it has been argued that the access, utilization, and quality of health care might explain, in a great part, why ethnic health disparities persist. In Taiwan, the launch of National Health Insurance (NHI) has greatly improved the accessibility and utilization of health care services, especially for the newly insured elderly population. However, it is not clear if the program’s impacts on reducing ethnic mortality differentials across three major ethnic groups of elders in Taiwan. By taking advantage of a longitudinal data from the Survey of Health and Living Status of the Elderly in Taiwan and linking the survey data to the biomarkers collected by researchers from the Georgetown University and Princeton University, this study proposes to conduct the following analyses: 1. By analyzing ethnic mortality differentials before and after NHI and across successive cohorts, I will be able to clarify the role NHI has played in explaining the ethnic health disparities among the elderly in Taiwan. 2. By linking the survey data to the National Death Index file, I will identify what are the major causes of death that lead to the observed ethnic mortality differentials. Plus, I will also examine the strength of associations between mortality and preventable deaths to further understand the impacts of NHI on ethnic health disparities in Taiwan. 3. By linking the survey data to the Social Environmental Biomarkers of Aging Study (SEBAS) in Taiwan, I will be able to examine the associations between care quality and ethnic distributions of risk factors.
顯示於類別:	[健康管理組] 國科會研究計畫

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