請用此 Handle URI 來引用此文件：
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/8669完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 賴美淑(Mei-Shu Lai) | |
| dc.contributor.author | Yin-Chao Chang | en |
| dc.contributor.author | 章殷超 | zh_TW |
| dc.date.accessioned | 2021-05-20T19:59:32Z | - |
| dc.date.available | 2011-10-03 | |
| dc.date.available | 2021-05-20T19:59:32Z | - |
| dc.date.copyright | 2011-10-03 | |
| dc.date.issued | 2011 | |
| dc.date.submitted | 2011-08-23 | |
| dc.identifier.citation | 1. Christoph E B, Andrea F, Massimo M. Hepatoma—Resection or Transplantation. Surg Clin N Am 2004;84:495–511.
2. 衛生署衛生統計。 3. El-Serag. Epidemiology of Hepatocellular Carcinoma. Clinics in Liver Disease 2001;5(1):1-16. 4. Zoli M, Magalotti D, Bianchi G, Gueli C, Marchesini G, Pisi E. Efficacy of a Surveillance Program for Early Detection of Hepatocellular Carcinoma. Cancer 1996;78:977-85. 5. Bruix J, et al. Clinical Management of Hepatocellular Carcinoma. Conclusions of the Barcelona-2000 EASL Conference. J Hepatol 2001;35:421-30. 6. Huo TI, Lin HC, Hsia CY, et al. The Model for End-Stage Liver Disease Based Cancer Staging Systems are Better Prognostic Models for Hepatocellular Carcinoma: a Prospective Sequential Survey. Am J Gastroenterol 2007;102(9):1920-30. 7. Broelsch CE, Frilling A, Malago M. Hepatoma- Resection or Transplantation. Surg Clin N Am 2004;84:495-511. 8. Hu RH, Lee PH, Chang YC, Ho MC, Yu SC, et al. Treatment of Centrally Located Hepatocellular Carcinoma with Central Hepatectomy. Surgery 2003;133:251–6. 9. Cance WG, Stewart AK, Menck H. The National Cancer Data Report on Treatment Pattern for Hepatocellular Carcinomas. Improved Survival of Surgically Resected Patients, 1985–1996. Cancer 2000;88:912–20. 10. Bruix J, Sherman M. Management of Hepatocellular Carcinoma. Hepatol 2005;42(5):1208–36. 11. 蔡樹榮、陳銘仁、張文熊、施壽全、王鴻源、王蒼恩：肝癌術後早期復發的危險因子的探討。中華癌醫會誌 (J Chinese Oncol. Soc.) 2009；25(2)：114-22。 12. McLafferty S, Wang F. Rural Reversal? Rural-Urban Disparities in Late-stage Cancer Risk in Illinois. Cancer 2009;115(12): 2755–64. 13. 台灣癌症登記資料庫Taiwan Cancer Registry Database 2006-2008.行政院衛生署國民健康局。 14. Rosenstock IM, Strecher VJ, Becker MH. Social Learning Theory and the Health Belief Model. Health Educ Quarterly 1988;15(2):175-83. 15. 張苙雲：醫療與社會―醫療社會學的探索。一版。台北：巨流圖書，1998；83-113。 16. Aday LA, Andersen RM. A Framework for the Study of Access to Medical Care. Health Serv Res 1974;9:208-20. 17. Cunningham P J, Cornelius L J. Access to Ambulatory Care for American Indians and Alaska natives: the Relative Importance of Personal and Community Resources. Social Sci and Med 1995;40(3):393-407. 18. Stock R. Distance and the Utilization of Health Facilities in Rural Nigeria. Social Sci and Med 1983;17(9):563-70. 19. Oleson JJ, Breheny PJ, Pendergast JF, Ryan S, Litchfield R. Impact of Travel Distance on WISEWOMAN Intervention Attendance for a Rural Population. Prev Med 2008;47:565-9. 20. Payne S, Jarrett N, Jeffs D. The Impact of Travel on Cancer Patients’ Experiences of Treatment: a Literature Review. Eur J Cancer Care 2000;9:197-203. 21. Lin G, Allan DE, Penning MJ. Examining Distance Effects on Hospitalizations Using GIS : a Study of Three Health Regions in British Columbia Canada. Environment and Planning A 2002;34:2037-53. 22. Anneke T S, David RB, Maria D K, William AK, Craig LS. Impact of Patient Distance to Radiation Therapy on Mastectomy Use in Early-Stage Breast Cancer Patients. J Clin Oncol.2005:23(28):7074-80. 23. French J, McGahan C, Duncan G, Lengoc S, Soo J, Cannon J. How Gender, Age, and Geography Influence the Utilization of Radiation Therapy in the Management of Malignant Melanoma. Int J Radiation Oncol Biol Phys 2006;66:1056-63. 24. Sauerzapl VA, Jonesa AP, Haynesa R, Crawfordb SM, Formanc D. Travel Time to Radiotherapy and Uptake of Breast-conserving Surgery for Early Stage Cancer in Northern England. Health & Place 2008;14:424–33. 25. Cosford P, Garrett C, Turner K. Travel Times and Radiotherapy Uptake in Two English Counties. Public Health 1997;111(1):47-50. 26. Newacheck PW, Brindis CD, Cart CU, Marchi, K, Irwin CE. Adolescent Health Insurance Coverage: Recent Changes and Access to Care. Pediatrics 1999;104(2):195-202. 27. Fossett JW, Perloff JD, Kletke PR. Peterson JA. Medicaid and Access to Child Health Care in Chicago. J Health Politics, Policy and Law 1992;17(2):273-98. 28. Adersen, R. Health Status Indices and Access to Medical Care. Am J Pub Health 1978;68(5):458-63. 29. Joyce TJ. The Demand for Health Inputs and their Impact on the Black Neonatal Mortality Rate in the U.S. NBER Working Paper 1986.No. 1966. 30. Yantzi N, Rosenberg MW, Burke SO, Harrison MB. The Impacts of Distance to Hospital on Families with a Child with a Chronic Condition. Social Science & Medicine 2001;52:1777-91. 31. Jones AP, Benthan G, Horwell C. Health Service Accessibility and Deaths from Asthma. Intl J Epid. 1998;28:101-5. 32. Williams R. Meningitis and Unpaved Roads. Social Science and Medicine. 1987; 24(2):109-15. 33. 胡幼慧、林芸芸、吳肖琪：台灣地區社會流行病學之分佈：六項死因 之小區域分析。人口學刊1990；13：83-106。 34. Grossman M. On the Concept of Health Capital and the Demand for Health. The Journal of Political Economy.1972;80(2): 223-55. 35. Liao HS. Spatial Accessibility to Health Care Service and Health Outcome for People with Disability. GIS in Humanities and Social Sciences 2009, Session 1: Exemplar projects that have developed GIS in the Humanities or Social Sciences-1;1-22. 36. Dunne P, Patterson C, Kilmartin M, Sladden M. Health Service Provision in Rural and Remote Areas: a Need Analysis. The Medical Journal of Australia. 1994;161(18): 160-62. 37. Penchansky R, Thomas JW. The Concept of Access: Definition and Relationship to Consumer Satisfaction. Med Care 1981;19(2):127-40. 38. Ruger JP, Kim HJ. Global health inequalities: an international comparison. J Epi Community Health 2006;60:928-36. 39. Luo W, Wang F. Measures of Spatial Accessibility to Health Care in a GIS Environment: Synthesis and a Case Study in the Chicago Region. Environment and Planning B: Planning and Design 2003;30:865-84. 40. Luo W. Using a GIS-based floating catchment method to assess areas with shortage of physicians. Health Place 2004;10:1-11. 41. Guagliardo MF. Spatial Accessibility of Primary Care: Concepts, Methods and Challenges. Int J Health Geographics 2004;3:3. 42. Khan AA. An integrated approach to measuring potential spatial access to health care services. Soc Eco Plan Sci 1992;26:275-87. 43. Sherman JE, Spencer J, Preisser JS, Gesler WM, Arcury TA. A Suite of Methods for Representing Activity Space in a Healthcare Accessibility Study. Int J Health Geographics 2005;4:24. 44. Luo W, Qi Y. An Enhanced Two–Step Floating Catchment Area (E2SFCA) Method for Measuring Spatial Accessibility to Primary Care Physicians. Health & Place 2009;15:1100-07. 45. Stratmann WC. A Study of Consumer Attitudes About Health Care: The Delivery of Ambulatory Aervices. Medical Care 1975;13(7):537-48. 46. Yoram W, Lawrence KS. Analytic Approach to Marketing Decisions in Health-Care Organizations. Operations Research 1976;24(5):973-90. 47. Javalqi RG, Rao SR, Thomas EG. Choosing a Hospital: Analysis of Consumer Tradeoffs. J Health Care Mark 1991;11(1):12-22. 48. Anonymous. Health care without (European) borders [Editorial]. Lancet 2008;372:87. 49. Hanlon N, Skedgel C. Cross-District Utilization of General Hospital Care in Nova Scotia: Policy and Service Delivery Implications for Rural Districts. Soc Sci & Med 2006;62:145-56. 50. Basu J, Friedman B. Preventable illness and out-of-area travel of children in New York counties. Health Econ 2001;10:67-78. 51. Liu J, Bellamy G, Barnet B, Weng S. Bypass of local primary care in rural counties: effect of patient and community characteristics. Ann Fam Med 2008;6:124–30. 52. 陳珮青、楊銘欽、江東亮、鄭守夏：病人跨區住院與醫療區資源分佈之探討。台灣衛誌 2003；22：27-32。 53. 洪維河、鄭守夏、張睿詒、江東亮：台灣醫療區跨區住院比例之變遷，1985-1995。中華衛誌 1998；17：388-94。 54. 張笠雲、謝幸燕：就醫流向的長期變遷。中華公共衛生雜誌 1994；13(1)：54-76。 55. 潘奇：台北醫療區域中有關台北縣醫療資源分佈及民家求醫流向之探討。台中：私立中國醫藥學院醫務管理研究所碩士論文，1991。 56. 林維娟：跨區醫療利用及其影響因素分析。台北：國立陽明大學醫務管理研究所碩士論文，2003。 57. 黃鼎鈞：台灣精神疾病跨區住院比例之變遷，1997與2001。台中：台中健康暨管理學院健康管理研究所碩士論文，2004。 58. 章殷超、溫在弘、賴美淑：利用地理資訊系統探討肝癌病患就醫地理可近性與醫院選擇間之相關性。台灣衛誌 2009；28(6)：517-29。 59. Tam DT, Trottier H, Mery LS, Morrison HI, Barr RD, Greenberg ML, Franco EL. Delay in Diagnosis and Treatment Among Children and Adolescents with Cancer in Canada. Pediatr Blood Cancer 2008;41:468-74. 60. Bouche G, et al. Determinants of Variability in Waiting Times for Radiotherapy in the Treatment of Breast Cancer. Radiotherapy and Oncol 2010;97:541-7. 61. Kiwuwa MS, Charles K, Harriet MK. Patient and Health Service Delay in Pulmonary Tuberculosis Patient Attending a Referral Hospital: a Cross-Sectional Study. BMC Public Health 2005;5:122. 62. Moser DK, et al. Reducing Delay in Seeking Treatment by Patients With Acute Coronary Syndrome and Stroke-A Scientific Statement From the American Heart Association Council on Cardiovascular Nursing and Stroke Council. Circulation 2006;114:168-182. 63. Solomon Y, Gunnar B, Getu A. Diagnostic and Treatment Delay Among Pulmonary Tuberculosis Patients in Ethiopia: a Cross Sectional Study.BMC Infectious Diseases 2005;5:112. 64. Liam CK, Tang BG. Delay in the Diagnosis and Treatment of Pulmonary Tuberculosis in Patients Attending a University Teaching Hospital. Int J Tuberc Lung Dis 1997;1(4):326-332. 65. The NHS Cancer Plan. 2000. 66. Sharpe D, Williams RN, Ubhi SS, Sutton CD, Bowrey DJ. The “Two-Week Wait” Referral Pathway Allows Prompt Treatment but Does not Improve Outcome for Patients with Oesophago-Gastric Cancer. EJSO 2010;36:977-81. 67. Potter S, et al. Referral Patterns, Cancer Diagnoses, and Waiting Times After Introduction of two Week Wait Rule for Breast Cancer: Prospective Cohort Study. BMJ 2007;335;288. 68. O’Rourke1 N, Edwards R. Lung Cancer Treatment Waiting Times and Tumor Growth. Clin Oncol 2000;12:141–4. 69. Jensena AR, Nellemannc HM, Overgaarda J. Tumor Progression in Waiting Time for Radiotherapy in Head and Neck Cance. Radiotherapy and Oncol 2007;84:5–10. 70. Crawford SC, et al. The Waiting Time Paradox: Population Based Retrospective Study of Treatment Delay and Survival of Women with Endometrial Cancer in Scotland. BMJ 2002;325;196. 71. Jensen AR, Mainz J, Overgaard J. Impact of Delay on Diagnosis and Treatment of Primary Lung Cancer. Acta Oncol 2002;41(2):147–52. 72. Bartona MB, Morgana G, Smeeb R, Tivera KW, Hamilton C, Gebski V. Does Waiting Time Affect the Outcome of Larynx Cancer Treated by Radiotherapy? Radiotherapy and Oncol 1997;44:137-41. 73. Terhaar sive Droste JS, et al. Dose Delay in Diagnosing Colorectal Cancer in Symptomatic Patients Affect Tumor Stage and Survival? A Population-Based Observational Study. BMC Cancer 2010;10:332. 74. Noel G, Quetin P, Heymann S, Karamanoukian D, Schott Waiting Times do not Negatively Modify Outcome of Patients With Multiform Glioblastoma. Cancer Radiotherapy 2009;13:17-23. 75. Phillips JJ, Hall MC, Lee WR, Clark PE. Does a Delay in Initiating Definitive Therapy Affect Biochemical Recurrence Rates in Men with Clinically Localized Prostate Cancer? Urol Oncol 2007;25:196-200. 76. Jack RH, Davies EA, Robinson D, Sainsbury R, Moller H. Radiotherapy Waiting Times for Women With Breast Cancer; a Population-Based Cohort Study. BMC Cancer 2007;7:71. 77. Sanchez CJ, et al. Influence of Timing of Initiation of Adjuvant Chemotherapy over Survival in Breast Cancer: a Negative Outcome Study by The Spanish Breast Cancer Research Group (GEICAM). Breast Cancer Res Treat 2007;101:215-23. 78. Hershman D, et al. Timing of Adjuvant Chemotherapy Initiation After Stage III Colon Cancer. 79. Chen WT, Fernandes ML, Lin CC, Lin SM. Delay in Treatment of Early –Stage Hepatocellular Carcinoma Using Radiofrequency Ablation May Impact Survival of Cirrhotic Patients in a Surveillance Program. J Surg Oncol 2011;103:133-9. 80. Rendell EG, Johnson CB. Guidelines for Federally Designated Health Care Shortage Areas. HD0414. Pennsylvania: Department of Health, 2006; 36. 81. 劉介宇、洪永泰、莊義利、陳怡如、翁文舜、劉季鑫、涼賡義：台灣地區鄉鎮市區發展類型應用於大型健康調查抽樣設計之研究。健康管理學刊 2006； 4(1)：1-22。 82. Onega T, Duell EJ, Shi X, Wang D, Demidenko E, Goodman D. Geographic access to cancer care in the U.S. Cancer 2008;112:208-20. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/8669 | - |
| dc.description.abstract | 前言：地理資訊系統(Geographic Information System)運用在公共衛生領域的角色日漸重要，本論文運用地理資訊系統所之空間資訊，進行醫療資源評估、並探討醫療資源與肝癌病患診斷及求醫行為之關聯。
方法：以「二階段浮動可近區位法」建立台灣鄉鎮「基層醫療資源地理可近性」；以「重力模式」建立「肝癌治療資源地理可近性」。以國家癌症登記資料庫之肝細胞癌(Hepatocellular Carcinoma)病患為例，進行醫療資源地理可近性與肝癌病患之早期診斷、跨區就醫與治療延遲之關聯性。 結果：地理可近性修正後之「基層醫療資源地理可近性」與傳統之評估方式有顯著的差異；肝癌病患居住鄉鎮之「基層醫療資源地理可近性」等級越高，病患診斷為早期肝癌之勝算比越大(OR=1、1.15、1.14、1.27)；早期肝癌病患居住鄉鎮之「肝癌治療資源地理可近性」等級與跨區就醫呈現非線性相關(OR=1、1.84、0.32、0.07)；早期肝癌病患居住鄉鎮之「肝癌治療資源地理可近性」等級、是否跨區就醫與治療延遲無關。 結論：提升鄉鎮基層醫療資源對於肝癌之早期診斷與防制有正面之效果；病患因醫療資源不足與追求醫療照護品質而選擇跨區就醫，對於早期肝癌病患跨區就醫所選擇醫院之治療預後，需進一步深入評估。 | zh_TW |
| dc.description.abstract | Preface: The role of geographic information system is increasingly important in the field of public health. The study tries to use detailed spatial information to identify the relationships among Geographic accessibility of healthcare resources, the diagnosis of HCC and health-seeking behaviors of patients with HCC.
Method: Using 'two-step floating catchment area method' to establish the 'geographic accessibility of primary care', and 'gravity model' to the 'geographic accessibility of HCC specific treatment' of townships in Taiwan. Take patients with HCC for example to identify the relationships among geographic accessibility of medical resources, early diagnosis of HCC, cross district health seeking and treatment delay. Results: The 'geographic accessibility of primary care' of townships presents a lot of differences from traditional method. Higher rank of the 'geographic accessibility of primary care' of patients with HCC has higher possibility to be patients with early HCC (odds ratio=1, 1.15, 1.14, and 1.27). There is non-linear relationship between the 'geographic accessibility of HCC specific treatment' of patients with early HCC and cross-district health seeking behavior (odds ratio=1, 1.84, 0.32, and 0.07). However no relationship found between treatment–delay and spatial barriers of hospital-seek behavior in patients with early HCC. Conclusion: This study employed GIS-based accessibility approach. We identify the geographic accessibility of medical resources significantly affected the stage diagnosed and hospital-seeking behavior of patients with HCC. Treatment patterns, treatment qualities and outcomes of cancer hospitals need to be considered further to explain cross-district hospital-seeking behavior more comprehensively. | en |
| dc.description.provenance | Made available in DSpace on 2021-05-20T19:59:32Z (GMT). No. of bitstreams: 1 ntu-100-F88845204-1.pdf: 2247463 bytes, checksum: fb465c5fd5ef07d4202f0e5c22293e11 (MD5) Previous issue date: 2011 | en |
| dc.description.tableofcontents | 第一章 前言1
第二章 文獻探討 4 第一節 肝癌的文獻回顧4 第二節 台灣癌症登記資料庫 (Taiwan Cancer Registry database) 7 第三節 醫療可近性與地理資訊系統運用在醫療資源評估與醫療照護之文獻回顧 9 第四節 跨區就醫與治療等候時間之文獻回顧 14 第五節 研究目的與內容 17 第六節 研究假設 19 第三章 材料與方法 20 第一節 研究流程 20 第二節 資料庫來源21 第三節 資料庫之建立流程 22 第四節 建立鄉鎮「基層醫療資源地理可近性」25 第五節 建立鄉鎮「肝癌治療資源地理可近性」29 第六節 研究變項定義 30 第七節 研究架構與統計方法 33 第四章 結果 35 第一節 鄉鎮「基層醫療資源地理可近性」與「肝癌治療資源地理可近性」之建立 35 第二節 不同「基層醫療資源地理可近性」病患之早期肝癌差異性分析 49 第三節 不同「肝癌治療資源地理可近性」早期肝癌病患之「跨區就醫」差異性分析 53 第四節 早期肝癌病患之「治療延遲」差異性分析 59 第五章 討論 62 第一節 台灣鄉鎮之基層醫療資源與肝癌病患之就醫地理障礙 62 第二節 肝癌早期診斷與「基層醫療資源地理可近性」等級的關聯 66 第三節 早期肝癌病患「跨區就醫」之探討69 第四節 早期肝癌病患「治療延遲」之探討 73 第五節研究限制 75 第六章 結論 77 參考文獻 78 附錄 86 附錄1 台灣地區359個鄉鎮市區都市化分層研究結果表 86 | |
| dc.language.iso | zh-TW | |
| dc.title | 肝細胞癌病患之醫療資源地理可近性與診斷、求醫行為之關聯性研究 | zh_TW |
| dc.title | Identification of the Relationships among Geographic Accessibility of Healthcare Resources, the Diagnosis of HCC and Health-Seeking Behaviors of Patients with HCC | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 99-2 | |
| dc.description.degree | 博士 | |
| dc.contributor.coadvisor | 溫在弘(Tzai-Hung Wen) | |
| dc.contributor.oralexamcommittee | 季瑋珠(Wei-Chu Chie),鍾國彪,劉俊人 | |
| dc.subject.keyword | 地理資訊系統,二階段浮動可近區位法,重力模式,肝細胞癌,跨區就醫,治療延遲, | zh_TW |
| dc.subject.keyword | Geographic Information System,Two Step Floating Catchment Area Method,Gravity Model,Hepatocellular Carcinoma,Cross District Health Seeking Behavior,Treatment Delay, | en |
| dc.relation.page | 89 | |
| dc.rights.note | 同意授權(全球公開) | |
| dc.date.accepted | 2011-08-23 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 流行病學與預防醫學研究所 | zh_TW |
| 顯示於系所單位： | 流行病學與預防醫學研究所 | |
文件中的檔案：
| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| ntu-100-1.pdf | 2.19 MB | Adobe PDF | 檢視/開啟 |
系統中的文件，除了特別指名其著作權條款之外，均受到著作權保護，並且保留所有的權利。