新醫院的成立對當地民眾就醫行為之影響－－以北部某地區為例

Impact of a Newly-opened Hospital on Residents’ Behavior in Seeking Healthcare

本研究為探討新醫院的成立是否會影響當地居民的就醫行為變化，及瞭解民眾不同就醫選擇因素對於就醫行為之影響。研究方法採橫斷式研究，針對汐止地區20歲以上之人口進行問卷調查，依每里戶數比例分配樣本數，共訪查2,105位民眾，回收有效樣本1,477份，回收率70.17%。回收之問卷以描述性統計、卡方檢定、單因子變異數分析及羅吉斯迴歸進行分析。研究結果發現，民眾就醫選擇因素中最重視醫療服務品質因素，且新醫院的成立確實會影響民眾之就醫行為並增加民眾就醫的方便性。影響就醫行為因素包含經濟因素、社會心理因素、年齡、婚姻、有無慢性病及自覺健康狀態等皆會對就醫行為造成影響。新醫院的成立確實會改變民眾的就醫行為，特別的是其中慢性病患者至醫院就醫的意願雖有增加，但每年就醫次數卻呈現減少或沒有影響，應與慢性病患者的就醫習慣與當地尚無其他大型醫院有關。本研究建議主管機關可針對尚無醫院設立之地區評估醫院設立可能性，及後續研究者可利用健保資料庫對醫療利用進一步分析，作為現行逐步建構整合式照護模式之醫療體系參考。

This study has two aims: 1) to explore the difference in behavior of seeking healthcare of local residents’ before and after the establishment of a new hospital, 2) to find and understand which decision factors can affect this behavior. This study is a cross study targeted at adults over 20 years of age from 46 neighborhoods in Sijhih. A total of 2,105 adults were surveyed and 1,477 questionnaires were collected; the return rate was 70.17%. This study uses the SPSS statistical software package and conducts descriptive statistics, chi-square test, one-way ANOVA, and Logistic regression. The results show that the residents’ decision factors in their decision of choice in healthcare were most influenced by quality of care. The behavior of seeking healthcare transitioned once a new hospital was established. Other decision factors which influenced choice in healthcare include: economical, socio-psychological, age, marital status, having chronic disease, selfperceived health. A newly-opened hospital does indeed affect local residents’ behavior in seeking healthcare as it increases convenience. Especially, even though willingness to seek healthcare at a hospital in chronic disease patients has increased, hospital usage has either decreased or has been unaffected. The reason should relate to the behavior in chronic disease patients and no substitutive hospital locally. Governments can evaluate the possibility of setting up hospitals in regions which have no hospitals. Future research may use National Health Insurance Research Database to analyze medical utility for further as a framework reference to make up the hospital integrated care system structure.