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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 傅祖壇 | |
dc.contributor.author | Hsiao-Fen Tseng | en |
dc.contributor.author | 曾筱芬 | zh_TW |
dc.date.accessioned | 2021-06-13T03:34:05Z | - |
dc.date.available | 2006-07-28 | |
dc.date.copyright | 2006-07-28 | |
dc.date.issued | 2006 | |
dc.date.submitted | 2006-07-26 | |
dc.identifier.citation | 參考文獻
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/32152 | - |
dc.description.abstract | 摘 要
由於經濟成長生活水準提升以及飲食文化與生活習慣,當前國人主要罹病之型態已轉為以慢性疾病為主,其中心臟疾病與腦血管疾病對國人之生命健康影響甚大,自民國89年以來心臟血管疾病與腦血管疾病之死亡人數便高居我國國人十大死因之第二、三名,此外由於心臟血管疾病之病程長,故其所耗費之各項醫療費用與社會成本亦相當龐大,為能更有效利用有限醫療資源,預防心臟血管疾病之效益評估實為重要議題。由於動脈硬化是心臟血管疾病風險因子引起心臟血管疾病的重要機轉,而高血壓相對於其他心臟血管風險因子而言,其與動脈硬化間較具有一致性的相關,故本文擬以高血壓改善進行心臟血管疾病預防之效益評估。 過去的文獻多以條件評估法來衡量消費者對於心臟血管疾病預防之願付價值,然條件評估法是透過假設市場的建立以假設性問題進行效益之評估,所衡量之效益可能有較多的偏誤,故本文擬改以實際醫療需求狀況更精確評估效益,與一般醫療需求研究不同的是,本文乃應用旅行成本法以消費者就醫時所需支付之掛號費、醫藥費用之部分負擔、交通成本以及時間成本設算醫療價格,以之建構TCM醫療需求並與僅考慮醫藥費用之一般醫療需求比較,此外本文考量不同健保身分對醫療需求之影響假設醫療需求為異質性,利用此一異質性醫療需求以消費者剩餘估算不同健保身分下心臟血管疾病預防之效益,並利用最小顯著差異法進行群間差異性分析以瞭解影響效益之因素,並將估計結果與其他評估方式進行比較。 透過TCM醫療需求模型估算高血壓由目前水準改善至一般正常值(110mmHg)時,本文發現以不同的時間估算方式所得的各組效益不盡相同,但整體的平均效益則相當接近,其中根據『勞工請假規則』估算時間成本者,高血壓改善之總效益為每人每年8690元,以工資之1/3估算時間成本者則為每人每年8192元,而工資之1/4估算時間成本者則為每人每年7527元。 利用最小顯著差異法進行群間差異性分析結果發現,在消費者效益的部分主要以健康知識指數、血壓、高血壓用藥情況以及健保身分為顯著影響因素;在健保效益的部份以地區、性別、年齡、教育、工作狀況、血壓、高血壓用藥情況中風家族病史以及健保身分為顯著因素;至於總效益的部分的則以地區、性別、年齡、教育、工作狀況、健康知識指數、血壓、高血壓用藥狀況、中風家族病史以及健保身分為顯著影響因素。 最後,將TCM醫療需求模型所估得之效益與其他效益評估方式進行比較發現,條件評估法與群體歸因風險模式所估得之結果均高於以TCM醫療需求所估算之效益,此乃因為條件評估法所估得之效益包含心理層面等無法透過實際醫療需求變動反映的部分,而群體歸因風險模式則是以二元虛擬變數表示高血壓改善之狀況,因此其可能會高估或低估效益;而以TCM醫療需求進行高血壓改善之效益評估乃是以連續變數──血壓變動所引起的醫療需求變動進行效益估算,故所估算之效益僅涵蓋能透過醫療需求變動反映者。 | zh_TW |
dc.description.provenance | Made available in DSpace on 2021-06-13T03:34:05Z (GMT). No. of bitstreams: 1 ntu-95-R93627005-1.pdf: 634730 bytes, checksum: 081ae5c763d9dbdaad8859d2d397c4d3 (MD5) Previous issue date: 2006 | en |
dc.description.tableofcontents | 目 錄
頁次 第一章 緒論…………………………………..…………….…..1 第一節 研究動機………………..…….…………………….….1 第二節 研究目的………………..…….…………………….….3 第三節 研究方法………………..…….…………………….….3 第四節 研究對象與資料來源………….…………………….….4 第五節 論文架構……………………….…………………….….5 第二章 文獻回顧……………………….…………………….….6 第一節 心臟血管疾病風險因子之相關文獻與代表性指標.……6 第二節 健康之效益衡量與旅行成本法之相關文獻………….…8 第三節 醫療需求之相關文獻………………………………..…12 第四節 部分負擔之相關文獻……………………………………15 第五節 本章結論…………………………………………………16 第三章 理論模型……………………………….….…………..18 第一節 效益評估指標………………….…..………………….18 第二節 TCM醫療需求之理論基礎…………...…………………21 第四章 資料來源與變數說明…………………………………..26 第一節 樣本資料來源與內容……………………………………26 第二節 變數定義說明與資料分析………………………………30 第五章 實證模型與結果…………………………………………42 第一節 實證模型建構與變數說明………………………………42 第二節 實證結果說明與分析……………………………………50 第三節 效益估計與群間差異性分析……………………………58 第四節 不同效益評估方式之比較………………………………69 第六章 結論…………………………………….........…...71 第一節 研究結果…………………………………………………71 第二節 建議……………………………………………………..73 第三節 研究限制…………………………………………………73 參考文獻……………………………………………………………75 附錄一……………………………………………………........84 附錄二…………………………………………………………....86 附錄三………………………………………………………......87 表 目 錄 頁次 表1-1 臺灣地區主要死亡原因……………………...........1 表4-1 心臟血管疾病之認知……………………………………27 表4-2 樣本各項特徵之次數分配統計表………………………32 表4-3 變數定義與變數特徵之說明………………………....33 表4-4 樣本健康狀況與社會經濟變數統計表…………………35 表4-5 樣本之門診利用狀況與費用……………………………37 表4-6 樣本之跨縣市與各級院所門診次數統計表…………..38 表4-7 各項醫藥費用統計表……………………………………39 表4-8 消費者自行支付之各項費用與醫療價格統計表………41 表5-1 各項變數定義與統計值……………………………....47 表5-2 醫療需求實證估計結果(以『勞工請假規則』估算時間成本)………….........................................52 表5-3 醫療需求之價格彈性(以『勞工請假規則』估算時間成本)……………...........................................53 表5-4 其他成本估算方式之實證估計結果……………………56 表5-5 其他成本估算方式之價格彈性…………………………57 表5-6 高血壓改善之效益評估(以『勞工請假規則』估算時間成本)……...……......................................60 表5-7 其他成本估算方式之高血壓改善效益評估(以工資之1/3)............................................62 表5-8 其他成本估算方式之高血壓改善效益評估(以工資之1/4估)............................................62 表5-9 樣本地區年度總效益(以『勞工請假規則』估算時間成本)………...……........................................63 表5-10 樣本地區年度總效益(以工資之1/3為單位時間價格)…………………….....................................63 表5-11 樣本地區年度總效益(以工資之1/4為單位時間價格)…………………….....................................64 表5-12高血壓改善效益之群間分析(以『勞工請假規則』估算時間成本)....…...........................................66 表5-13高血壓改善效益之群間分析(以工資之1/3為單位時間價格)……….....…........................................67 表5-14高血壓改善效益之群間分析(以工資之1/4為單位時間價格)………... .…........................................68 表5-15 不同效益評估模式之比較……….…...............70 圖 目 錄 頁次 圖3-1 消費者剩餘之概念…………………………………… 18 圖3-2 補償變量與消費者剩餘……………………………….19 圖3-3 對等變量與消費者剩餘……………………………...20 圖3-4 健康特徵改善之效益衡量圖………………………...23 圖3-5 異質性需求下健康改善之效益衡量圖……………...24 圖4-1 各項醫療支出說明圖……………………………. ….28 圖4-2 樣本資料說明圖………..…….………………………30 圖5-1 醫療需求之價格彈性(以『勞工請假規則』估算時間成本)….…………….......................................53 圖5-2(a)其他時間成本估算方式之價格彈性(以工資之1/3估算)……………...……...................................57 圖5-2(b)其他時間成本估算方式之價格彈性(以工資之1/4估算)………………........................................58 | |
dc.language.iso | zh-TW | |
dc.title | 血壓改善之心臟血管疾病預防效益評估 | zh_TW |
dc.title | Valuing the Benefits of Cardiovascular Disease Prevention Through the Improvement of Blood Pressure | en |
dc.type | Thesis | |
dc.date.schoolyear | 94-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 吳珮瑛,劉錦添 | |
dc.subject.keyword | 醫療需求,效益,心臟血管, | zh_TW |
dc.subject.keyword | medical demand,benefit,Cardiovascular Disease, | en |
dc.relation.page | 88 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2006-07-28 | |
dc.contributor.author-college | 生物資源暨農學院 | zh_TW |
dc.contributor.author-dept | 農業經濟學研究所 | zh_TW |
顯示於系所單位: | 農業經濟學系 |
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