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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 張慶國(Chin-Kuo Chang) | |
dc.contributor.advisor | 張慶國(Chin-Kuo Chang | chinkuochang@ntu.edu.tw | 0000-0002-8338-7196), | |
dc.contributor.author | Elisabeth Gilmore | en |
dc.contributor.author | 黃恩慈 | zh_TW |
dc.date.accessioned | 2023-03-19T22:06:39Z | - |
dc.date.copyright | 2022-07-01 | |
dc.date.issued | 2022 | |
dc.date.submitted | 2022-06-29 | |
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Do low-income coronary artery bypass surgery patients have equal opportunity to access excellent quality of care and enjoy good outcome in Taiwan? International Journal for Equity in Health, 13(1), 64. https://doi.org/10.1186/s12939-014-0064-8 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/84226 | - |
dc.description.abstract | 在台灣,無家可歸(homelessness)仍是一個尚待深入研究的領域。雖然國外的許多研究已經指出:無家者(people experiencing homelessness, PEH)在醫療保健服務獲得上,面臨著許多障礙;但台灣全民健康保險制度提供了一個獨特的研究機會,在大幅降低了取得醫療服務的財務障礙之後,是否仍存在著其他未知的醫療保健服務取得障礙。本研究旨在探討無家者取得醫療保健服務的公共衛生議題,以橫斷式調查研究探索他們的一般健康狀況和醫療保健利用特性,並與一般社區民眾進行比較。本研究使用信度、效度均已確立之中文化問卷做為測量工具:十二項目健康生活品質短表(Short form-12 items health survey, SF-12)調查和2013年衛福部所設計之國民健康訪問調查問卷。這些問卷由台北地區的成年無家者和年齡、性別頻率配對之社區對照組自行填寫。本研究結果顯示:與社區對照者比較,我們發現就算控制了干擾因素,無家者的一般生理健康仍顯著較差,無家者在過去一年住院的風險也顯著較高。同時無家者在過去三年間接受新冠肺炎疫苗、季節性流感疫苗與免費的癌症篩檢服務也都顯著較少。因此,雖然台灣的全民健康保險給付涵蓋範圍廣泛,大幅降低了醫療保健服務取得的財務障礙,但對無家者而言,仍然存在著其他取得障礙。本調查研究的結果,將為台灣公共衛生當局提供實證,針對無家者等弱勢群體的需求,發展出一套獨特公共衛生政策與介入計劃,並為降低弱勢族群獲取適當醫療服務障礙的全球政策,提供深入見解。 | zh_TW |
dc.description.abstract | Homelessness in Taiwan is an under-investigated research field. While studies in other countries have demonstrated that people experiencing homelessness (PEH) face barriers to accessing healthcare, Taiwan’s universal healthcare system provides a unique opportunity to study barriers to accessing care when healthcare is almost completely financially covered. The following study aims to establish that homelessness is a public health issue, investigating the health status and healthcare utilization of people experiencing homelessness compared to the general Taiwanese population. A 24-item cross-sectional survey was administered assessing general health status and healthcare utilization to a target group of people experiencing homelessness in Taipei and a group of counterparts for comparison from the general population. Compared to the community residents, the self-reported physical health of PEH was significantly worse, but their mental health did not differ significantly. PEH were more likely to have been hospitalized in the past year than community residents, and less likely to have received any COVID-19 vaccine, seasonal flu vaccine, or a free cancer screening in the past three years. These differences in healthcare utilization patterns under a universal healthcare coverage system suggest that PEH face non-financial barriers to accessing care, especially when the need is not urgent. Further research identifying and addressing barriers to accessing healthcare for people experiencing homelessness is imperative in order to reach true universal healthcare access for all. | en |
dc.description.provenance | Made available in DSpace on 2023-03-19T22:06:39Z (GMT). No. of bitstreams: 1 U0001-2806202212043900.pdf: 2996697 bytes, checksum: 8380bc46f8ebc63eb5289269905c0f9a (MD5) Previous issue date: 2022 | en |
dc.description.tableofcontents | Acknowledgement ii 中文摘要 iv Abstract v List of Figures and Tables viii Chapter 1: Introduction 1 Literature Review 3 People Experiencing Homelessness (PEH) 3 Overview of Health and Homelessness Globally 5 Taiwan: Access to Healthcare 9 Taiwan: History of Homelessness 11 Taipei: Picture of Homelessness Today 15 Taiwan: Health and Healthcare for PEH 19 Conceptual Frameworks for Healthcare Utilization 21 Study Aims 22 Hypotheses 23 Chapter 2: Methods 24 Research Approach 24 Survey Design 25 Predisposing and Enabling: Demographics 26 Need: 12-Item Short-Form Health Survey (SF-12) 27 Health Behavior: Healthcare Utilization 27 Sampling Process for Participants 28 Survey Implementation 30 Ethical Considerations 31 Data Analysis Method 33 Chapter 3: Results 35 Basic Characteristics of Study Population 35 Health Status of People Experiencing Homelessness and Community Residents 38 Comparing Acute Healthcare Utilization between PEH and Community Residents 42 Comparing Preventative Healthcare Utilization between PEH and Community Residents 48 Predisposing Factors in People Experiencing Homelessness 54 Chapter 4: Discussion and Conclusion 71 Discussion 71 Physical and Mental Health Status 71 Healthcare Utilization 72 Length of Homelessness 74 Impetus for Policy Change 74 Advantages and Limitations 75 Ethical Considerations 77 Conclusions 77 References 79 Appendix A: Community-Based Participatory Research Phases 95 Appendix B: IRB Approval 96 Appendix C: Paper Survey for People Experiencing Homelessness 97 | |
dc.language.iso | en | |
dc.title | 台北無家者健康狀況與醫療利用:橫斷式訪問調查 | zh_TW |
dc.title | Health Status and Healthcare Utilization of People Experiencing Homelessness in Taipei: A Cross-Sectional Survey | en |
dc.type | Thesis | |
dc.date.schoolyear | 110-2 | |
dc.description.degree | 碩士 | |
dc.contributor.author-orcid | 0000-0003-4702-4686 | |
dc.contributor.advisor-orcid | 張慶國(0000-0002-8338-7196) | |
dc.contributor.oralexamcommittee | 林先和(Hsien-Ho Lin),郭年真(Raymond Kuo) | |
dc.contributor.oralexamcommittee-orcid | 林先和(0000-0002-7481-6016) | |
dc.subject.keyword | 無家者,街友,醫療服務獲得,醫療服務利用,醫療服務取得障礙,全民健康保險,十二項目健康生活品質短表,安德森醫療服務利用行為架構, | zh_TW |
dc.subject.keyword | homelessness,access to healthcare,healthcare utilization,barriers to accessing healthcare,universal healthcare,SF-12,Andersen Framework,Taiwan, | en |
dc.relation.page | 100 | |
dc.identifier.doi | 10.6342/NTU202201172 | |
dc.rights.note | 同意授權(限校園內公開) | |
dc.date.accepted | 2022-06-29 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 全球衛生碩士/博士學位學程 | zh_TW |
dc.date.embargo-lift | 2022-07-01 | - |
顯示於系所單位: | 全球衛生學位學程 |
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