| Summary: | 碩士 === 臺中健康暨管理學院 === 健康管理研究所 === 91 === Due to the rapid change of Taiwan’s society, public health management has transformed from mere epidemic prevention to more diverse and complicated issues. In addition, the needs and wants of the public vary according to the public health condition and the composition of the population in individual city or county. The “Community Health Diagnosis” can play a prominent role in achieving effective and efficient health promotion and disease prevention under limited resources. This study evaluates the public’s health condition in three counties and one city in central Taiwan. The results of the study are expected to become the basis for the Fourth-Phase Plan of Medical Care Net: The New Century Health Passport, a plan to incorporate diverse resources and advance the quality of medical care.
The research on Community Health Diagnosis is conducted from three dimensions. The first dimension is to establish indicators for the public health. The data used include public mortality data from the Department of Health (DOH), age and gender distributions of the population in Taiwan in 2001, the national insurance data from the National Health Research Academy and a health survey about the population in the three counties and one city in Taiwan’s central regions. The second dimension is to gain community information using statistical data from DOH and the Department of Interior (DOI). The third dimension is to analyze the health problems among the population in the four studied regions using national insurance data from the National Health Research Academy, age and gender distributions of the population in Taiwan in 2001, and the estimates of medical care and social service utilization from DOH.
The results show that Taichung City has relatively lower mortality and morbidity rates, lower numbers of living-alone elderly and people with physical and mental disability, and lower rate of domestic abuse. On the other hand, Taichung City has the highest population growth rate, society growth rate, birth rate of women older than 35, marriage rate, crime rate, non-occupied housing rate, migration rate, urbanization rate, and medical utilization rate. Taichung City also ranks the highest in medical resources and the numbers of social welfare organizations. Taichung County has the best self-reported health condition and public safety. Moreover, its sizes of the county population and dependent population are the largest and the natural rate of population growth is the highest. Changhwa County has the highest birth and pregnancy rates, but it also has the lowest migration rate, medical care utilization rate, and the lowest number of clinics and hospital beds per 100,000 population. Nantao County has the highest mortality, morbidity and domestic abuse rates, the highest number of abused children, people with physical and mental disability, living-alone elderly, the highest dependent ratio and the proportion of people older than 65. In addition, the county has the lowest social welfare utilization rate, and the lowest numbers of hospitals, doctors, doctors of Chinese medicine, and dentists per 100,000 population.
Among the four counties, Taichung City enjoys the best public health condition, and has the advantage of prevalent medical care, social welfare resources, and urbanization. On the other hand, its considerable fluctuations in population growth, migration and marital stability of the population, and relatively poorer self-reported health condition and public safety are the disadvantages. The Tauchung County has the best public safety and self-reported health. Changhwa County has the lower number of clinics and hospital beds per 100,000 population and medical utilization rate. Nantao County has the worst public health condition and highest dependent ratio. And to make the situation worse, the county has lacked the medical care and social welfare resources and has a low rate of social service utilization
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