臺灣六十五歲以上榮民住院之相關因素分析

An Analysis of Factors Associated with Hospital Utilization for Senior Veterans in Taiwan

10.6288/TJPH2004-23-04-05

朱慧凡(Hui-Fan Chu)；吳肖琪(Shiao-Chi Wu)

六十五歲以上榮民 ； 住院利用 ； 兩部門模式 ； senior veterans ； hospital utilization ； two-part model

台灣公共衛生雜誌

23卷4期（2004 / 08 / 01）

297 - 304

繁體中文

目標：探討六十五歲以上榮民之住院利用情況及其影響因素，以提供相關單位制定榮民醫療政策之參考。 方法：以六十五歲以上榮民為研究對象，連結88年健保住院申報資料，採兩部門模式（two－part model）分析影響榮民是否住院與住院次數之因素。 結果：88年六十五歲以上榮民住院使用率為24%，每百人住院人次為45人次，迴歸分析發現男性、年齡較大、有重大傷病、投保類別為第五類、教育程度較低、退伍軍階較低、內住就養、與未婚之榮民在是否住院與住院次數上皆顯著較高。 結論：榮民持續老化將使住院醫療需求快速增加，建議衛生署與退輔會應加強提供榮民服務並規劃長期照護，確實了解榮民就醫之需求，以提升榮民的照護品質。

Objectives: To explore the factors of hospital utilization in senior veterans as a reference for medical policy to be used by the government. Methods: Using veteran population files and national health insurance inpatient claim data to analyze the factors associated with hospital utilization. A two-part model was used to examine the factors leading to hospitalization and the number of hospitalizations. Results: In 1999, the user rate was 24 per 100 veterans, and the discharge rate was 45 per 100 veterans. The regression results indicated that senior veterans who were male, unmarried, category 5 beneficiaries, having severe illness, lower educated, lower military rank, and living in nursing home, have a significantly higher rate and number of hospitalization. Conclusions: With the aging of senior veterans, the Department of Health and the Veterans Affairs Commission should reinforce the supply of medical services and long-term care for senior veterans.

1. Ashton Cm,Petersen NJ,Souchek J(1999).Geographic variations in utilization rates in Veterans` Affairs hospitals and clinics.N Eng J Med,340,32-39.
2. Ashton CM,Weiss TW,Petersen NJ,Wray NP,Menke TJ,Sickles RC(1994).Changes in VA hospital use 1980-1990.Medical Care,32,447-458.
3. Centers for Disease Control Vietnam Experience Study(1988).Health status of Vietnam veterans.JAMA,259,2701-14.
4. Grootendorst PV(1995).A Comparison of alternative models of prescription drug utilization.Health Econ,4,183-198.
5. Hakkinen U(2002).Change in determinants of use of physician services in Finland between 1987 and 1996.Soc Sci Med,55,1523-37.
6. Hoff RA,Rosenhenk RA(1998).The use of VA and non-VA mental health services by female veterans.Medical Care,36,1524-33.
7. Hoff RA,Rosenhenk RA(1998).Female veterans` use of Department of Veterans Affairs health care services.Medical Care,36,1114-9.
8. Horgan C,Taylor A,Wilensky G(1983).Aging veterans: Will they overwhelm the VA medical care system?.Health Affairs,2,77-86.
9. O` Toole BI,Marshall RP,Grayson DA(1996).The Australian Vietnam Veterans Health Study.Int J Epidemiol,25,307-340.
10. Randall M,Kilpatrick KE,Pendergast JF,Jones KR,Vogel WB(1987).Differences in patient characteristics between veterans administration and community hospitals: Implication for VA planning.Medical Care,25,1099-1104.
11. 內政統計資訊服務網
12. 行政院國軍退除役官兵輔導委員會(1998)。中華民國八十六年統計年鑑。
13. 行政院國軍退除役官兵輔導委員會(1998)。臺閩地區青壯榮民狀況調查報告（八十六年）。
14. 行政院國軍退除役官兵輔導委員會(2000)。我們的服務－榮民輔導工作簡介。
15. 行政院國軍退除役官兵輔導委員會(1998)。簡析國軍退除役官兵輔導制度。
16. 行政院國軍退除役官兵輔導委員會輔導統計
17. 吳肖琪(1997)。全民健康保險各類被保險人住院醫療利用評估。中央健康保險局八十六年度委託研究計畫報告(DOH86-NH-020)。
18. 杜明勳(1996)。南部某榮民安養之家住家榮民健康狀況調查。中華衛誌，15，97-107。
19. 胡台麗(1990)。芋仔與番薯－臺灣榮民的族群關係與認同。中央研究院民族學研究所集刊，69，107-132。

1. 楊昭恂、黃東波、洪世欣、李偉強(2007)。應用ACG病例組合系統評量榮民疾病負荷與校正醫療利用。醫務管理期刊，8(1)，67-84。