國民出國旅遊健康照護需求之研究－台大旅醫中心之服務創新模式

Abstract

國人出國旅遊人數有逐年增加的趨勢，個人與環境因素導致旅遊時的疾病與意外傷害風險增加，因此出國旅遊者更需要預防保健與醫療照護並重的健康照護網。本研究主要目的是探討出國旅遊民眾對於旅遊時健康照護服務內容的認知與使用經驗，並提出以醫院為基礎提供出國旅遊時健康照護服務的創新模式。研究對象為年齡≥18歲至台大旅遊醫學中心門診就診即將出國旅遊的民眾，以問卷調查的方法，了解其基本資料、旅遊相關內容、9項旅遊醫療保險內容的認知及使用經驗等。結果發現共397人納入分析研究，平均年齡36.5±13.9歲，40歲以下民眾居多佔66.4%，68%受訪者將至開發中國家地區，女性比男性(31% vs. 19%)有較多比例安排潛水、高山活動與泛舟等特殊活動，也有較多感染疾病或發生其他醫療事件的經驗(25% vs. 15%)。民眾都知道旅遊當中大部份醫療保險服務項目，也認為這些服務重要，但卻較少使用，較多人知道且認為重要的服務項目為24小時緊急電話諮詢、緊急醫療轉送、協助安排就醫、返國推薦醫師、推薦當地醫療院所及預約看診等，且年齡、性別、教育程度等變項與知道旅遊當中醫療保險服務項目無關，大多數的變項也與服務內容的重要性無關，個人收入及年齡、性別、教育程度等變項與合理的收費範圍無關，而平均合理的費用約為648元。以台灣去年出國旅遊的人數估算，潛在市場超過60億元。未來規劃旅遊時健康照護內容依序為24小時緊急電話諮詢、緊急醫療轉送、推薦當地醫療院所及預約看診、協助安排就醫、即時通訊、醫療翻譯與病歷傳送、推薦特約醫師診療、返國推薦醫師、住院期間醫療人員訪視，並使用價值網分析，建立出國旅遊健康創新服務之模式，再以SWOT矩陣策略分析此服務模式之外部環境的機會與威脅、內部環境的優勢與劣勢，以作為未來發展此事業的策略參考。

The number of Taiwanese traveling abroad is increasing and it has been noted that greater risk for travel-related illness and injury is found during travel due to personal and environmental factors. Therefore, a health care network comprising services of prevention and medical care can not be over-emphasized for the abroad travelers. The study aimed to investigate the awareness and experiences of health care services during travel abroad. Based on the results, we proposed an innovative model of hospital based health care for the travelers. Participants aged greater than 18 years of the travel clinic at National Taiwan University Hospital, planning to travel abroad, were recruited into the study with a three-part questionnaire administered. The questionnaire included the items of socio-demographic characteristics, travel itineraries, awareness and experiences of 9 health care services provided by travel insurances. A total of 397 participants, mean age =36.5 ±13.9 years, were recruited. Among them, 66.4% were under 40 years and 68% planning to the developing country areas. The females were more likely to arrange special activities, such as scuba diving, mountain climbing, and river rafting than males (31% vs. 19%). The females also had more experiences of travel-related infectious diseases and other medical events (25% vs. 15%). People were aware of most health care services of travel insurance and also considered the services important. However, they seldom used the services. The better known services which were also recognized important were as follows: 24-hour telephone medical advice, emergency medical repatriation, arrangement for hospital admission, arrangement for appointments of doctors after travel, and arrangement for appointments of nearby hospitals. There was no difference between age, sex, educational level and other variables with awareness and importance of health care services by travel insurance during travel. There was no association between age, sex, educational level, and personal income with willingness to pay for those services. The willingness to pay was about 648 NT dollars and the potential market was over 6 billions according to the number of Taiwanese travelers going abroad last year. The future plan of items of the health care services by travel insurance during travel is as the following order: 24-hour telephone medical advice, emergency medical repatriation, arrangement for hospital admission, instant messaging of medical advice, medical records translation and transfer, arrangement for appointments of doctors, arrangement for appointments of doctors after travel, and monitoring medical condition during hospitalization. Using value net analysis, we then established an innovative model of health care service during travel abroad. Furthermore, the strategy of future development was supported by the SWOT matrix analysis consisting of opportunities and threats of environment, and internal forces of strength and weakness.