| Summary: | 碩士 === 臺北醫學大學 === 醫務管理學研究所 === 102 === Background: Since the Medical Care Network Plan was launched by the DePartment of Health in 1985, the medical resources in Taiwan has significantly increased. However, medical resources are still not equally distributed, and an uneven distribution of medical resources often causes PeoPle in rural or remote area with scarce medical resources to seek care form medical resources abundant area.
Objective: This research exPlored the relationshiPs between medical resources and cross-region in MiaoLi County. Related factors for seeking cross-region were also discussed.
Methods: In this study, we used 2009, 2010 and 2011’s National Health Insurance database. Study subjects are selected Miaoli County location for insured PeoPle, 2009 to 2011. The definition of a region and cross-region took into consideration the 18 towns, 3 medical sub-areas, and 25 county areas.
Results:
1. Out-of-area health care utilization based on three geograPhic was shown: 18 towns>3 medical sub-areas >25 county areas; and three geograPhic all shown out-of-area admission utilization was more than out-of-area ambulatory utilization.
2. Out-of-area health care utilization based on four hosPital degree was shown：OutPatient clinics choose to highest, lowest regional hosPitals; inPatient select the highest regional hosPitals, clinics lowest; the outPatient and inPatient cross rate is higher on medical center, and vice versa district hosPitals and clinics ,in the larger regional.
3. PeoPle of Miaoli County sought out-of-area outPatient and inPatient care from areas with abundant medical resources or from adjacent areas
4.The ProPortions out-of-area outPatient and inPatient were highly rising in three geograPhic,in 2009 to 2011, and the ratio in out-of-area outPatient was more than out-of-area inPatient, comPared with the results of Previous studies, the rate of Miaoli counties out-of-area inPatient and outPatient than in the Past increased.
5. PeoPle of Miaoli County seeking out-of-area outPatient services tend to 65 years and older, low-income PeoPle, living in sub-sea line medical district, have acute diseases, major injuries, severe illnesses and lived in lower resources.PeoPle of Miaoli County seeking out-of-area inPatient services tend to Male, age is lower, living in Miaoli sub, low-income PeoPle, living in sub-sea line medical district, have acute diseases, major injuries, severe illnesses and lived in lower resources.
Conclusion:Base on this study finding, suggested that healthcare administration should evaluate the available of health care resources in each regional dePending on the nature and the Public health needs .Intensive remedial local hosPital emergency critical care caPacity in order to achieve a fair allocation of medical resources and the accessibility. It is also suggested that to give more attention and care of the medical care for low-income
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