北部某大學學生的求醫行為：中西醫之選擇

Behavior of Seeking Treatment in Students from a University: Comparing the Choice between Chinese and Western Medical Care

全民健保開辦多年，中西醫均納入給付，又一些大型醫院也有中醫診療部，在醫療保險及醫療可近性均滿足後，國人在中西醫之選擇行為是如何呢？本研究刻意選擇北部某大學具中西醫學系及其附屬醫院具中西醫門診之大學學生為研究族群，探討不同病症在中西醫求診選擇，單複向求醫行為，及科系上的差異。於民國88年5月份進行抽樣問卷調查。抽出447人，回收問卷305份，回收率為68.23%，有效問卷共有298份。統計結果顯示：「肌肉關節酸痛、關節炎」，「肌肉扭傷、關節脫臼、骨折」較傾向中醫；而「鼻塞、流鼻水、咳嗽、感冒」、「胃及十二指腸潰瘍」、「高血壓」、「糖尿病」、「心臟病」、「腦中風」、「癌症」等較傾向看西醫。而醫學系及中醫系比較，除了「胃及＋二指腸潰瘍」、「牙痛」、「癌症」此三種疾病外，醫學系皆傾向向西醫求診、而中醫系則傾向向中醫求診。就醫學院其他科系、工學院、管理學院三學院之學生相比較，則僅有「過敏性鼻炎、蕁麻疹」、「氣喘、支氣管炎」、「婦科疾病、月經異常」等項目，學院別對於中西醫選擇出現明顯差異，有些學院傾向中醫、有些學院傾向西醫。而單複向求醫行為方面則與科系有關，醫學系較傾向單向求診西醫、中醫系則是以複向求診佔絕大部份、其他科系亦多傾向複向求診中西醫。又大學生的親友在不同病症選擇中西醫醫療體系與本人情況相似。

Health insurance coverage and accessibility of both Chinese and weatern medical care have been increased after the implementation of National Health Insurance (NHI), What is the choice of the use of Chinese and western medical care is essential to study. A survey was conducted to address the above question in students from a university which is located in north Taiwan, and has departments of Chinese medicine and western medicine. The study university also has a western-style teaching hospital with Chinese medicine clinics.A survey with random cluster sampling was conducted on May 1999. A valid sample of 298 was used with 68.2% of response rate. Higher proportion of students sought treatment from Chinese medicine for symptoms of ”Muscle-skeletal soreness, medicine. Symptoms of ”nasal congestion, rhinorrhea (running nose), coughing, fever”, ”gastric and duodenal ulcer”, ”hypertension”, ”diabetes mellitus”, ”cardiac disease”, ”stroke” and ”cancer” tended to show high proportion of using western medical care compared with that using Chinese medicine. When comparing the use of Chinese and western medical care between Chinese medical students and western medical students, except for ＂gastric and duodenal ulcer”, ”toothache” and ”cancer”, western medical students tended to seek treatment from westrn medicine and Chinese medical students tended to seek treatment from Chinese medicine. Only the symptoms of ”allergic rhinitis, urticaria”, ”asthma, bronchopneumonia” and ”gynecological or menstrual disorder” show difference in use of Chinese or western medical care among three different schools. Regarding single or dual use of medical care, majority of western medical students sought treatment solely from western medicine and majority of students from Chinese medicine and other departments were mixed-care users. When their relatives or friends were sick, the choice of Chinese and western medical service were similar to the students' own pattern.