醫療與社區：以臺中醫院社區醫學暨健康部前進臺中市南區　探討癌症篩檢與惡性腫瘤死亡率之成效分析

Medicine and Community: The Effectiveness Analysis of Cancer Screening and Malignant Tumor Mortality Performed by Department of Community Medicine and Health, Taichung Hospital for Taichung South District

黃君琪(Chun-Chi Huang)；安慧貞(Huei-Jhen An)；賴仲亮(Chung-Liang Lai)；李孟智(Meng-Chih Lee)；許碧珊(Pi-Shan Hsu)

社區關懷據點 ； 癌症篩檢 ； 惡性腫瘤死亡率 ； Community care center ； Cancer screening ； Malignant tumor mortality

醫學與健康期刊

6卷2期（2017 / 09 / 01）

95 - 105

繁體中文

為了維護及增加民眾在健康與智能的提升，與社區緊密結合；民眾藉由預防保健並達到降低健康風險，進而促進身心健康之目的。本專案為瞭解社區民眾在臺中醫院社區服務提供的認知與利用之障礙，共分為三階段實施，第一階段以里長面對面訪談、參照專家意見後設計出結構式問卷，再進行隨機抽樣發放前測問卷確認信效度；第二階段以結構式問卷進行社區民眾之調查，最後採魚骨圖歸納分析問題特性要因並做對策實施與檢討；第三階段由上述分析結果調整社區篩檢民眾的方式與作法，增加健康智能的提升。在臺中醫院努力下臺中市南區2015年惡性腫瘤死亡率呈現下降趨勢，且下降比例7.9%，分別高於全國2.2%；高於臺中市2%；另2013年至2016年南區篩檢人數上升2.06倍；初診人數提升2.84倍；初診就診人數提升3.12倍，呈現逐年上升趨勢顯示臺中醫院前進南區之成效性。未來，藉由本專案介入措施與方案成效能提供醫院前進社區之參考依據，落實照顧社區民眾之健康。

Taichung Hospital connects with the community to maintain and improve their health and knowledge. The goal is to reduce the health risks and improve mental and physical health through implementing preventive healthcare. This project is divided into three stages to better understand the community barriers to obtaining a better understanding of the community barriers to obtaining better healthcare services provided by Taichung Hospital. The first stage is to design a structured questionnaire that is based on expert suggestions and interviews with the chief of village of Taichung's South District. The validity of the questionnaire is reviewed before a stratified random sampling. The second stage is to study the community results from the questionnaire for cause and effect factors via fishbone diagram and then implementing countermeasures. The third stage is to apply analyzed results and make improvements to both the communities' health knowledge and the process of health examinations. Under the guidance of Taichung Hospital, Taichung South District mortality rates due to malignant tumors have shown a downward trend in 2015, with a decline ratio of 7.9% higher than the entire country and Taichung city, being 2.2% and 2% respective. The number of screenings increased by 2.06% from 2013-2016, with the number of first visits increasing by 2.84% and revisits by 3.12%. The rates continuously increased with each year, showing the effectiveness of Taichung Hospital in the South District. These results can be used as references with designing and implementing interventions and projects of Taichung Hospital to ensure the health and well-being of the residents in the community.

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