從重視健康之民眾觀點探索地方政府衛生施政結果相關性研究──多元邏輯斯迴歸分析應用

Multiple Logistic Regression Analysis of the Association between People's Expectations of Their Health Status and the Governmental Public Health Policies

目的：政府的施政必須能反應地方民眾需求，衛生施政成果亦為縣市首長被評比項目之一，經調查資料發現「身體健康」已經為民眾期待提升生活品質的最優先希望的項目，因此本研究目的為瞭解各地方政府在衛生施政上結果與期待「身體健康」的地區民眾間的相關性，作為推動衛生政策時參考。方法：本研究資料來源為使用內政部「108年國民生活狀況意向調查」之釋出資料，有效樣本4,050人，另結合各縣市衛生施政之重要統計指標取作為施政層次指標，將其合併後進行分析。方法採多元邏輯迴歸模式統計，比較以「身體健康」做為第一優先意願的民眾族群中，對地方政府衛生相關施政指標的感受程度。
結果：根據調查結果發現對生活品質滿意度得分最高之縣市為新竹市，滿意度最低則為花蓮縣，不同縣市民眾對其生活品質滿意度呈現有顯著差異。另以滿意度最高的的新竹市來看，其民眾認為在改善生活品質上列為最優先的項目為「身體健康」為最多(13.7%)；再以行政區域觀察，重要都市如新北市、臺北市、桃園市民眾也都認為「身體健康」為改善生活品質上最優先項目。
再針對重視「身體健康」之民眾再進行多元邏輯斯迴歸分析後發現各縣市在衛生施政的指標中的「成人預防保健利用率」會有顯著的相關，另在個人因素層面則跟年齡、性別與教育程度相關。
結論：經本研究的資料實證，在各縣市衛生施政的成果中有關成人預防保健的推動狀況會跟在生活品質要求身體健康的民眾呈現顯著相關性，進而影響其生活滿意度。從考量健康促進的觀點上，各縣市政府應著重在投入如預防保健、健康檢查等相對需投資資源較少但對民眾感受性高及有機會促進影響其健康行為之政策作為上，用以提升民眾的健康素養。此外，身體健康已為民眾在生活品質上關心的首要項目，更應參考WHO「健康融入所有政策」(Health in all policies)的作法，衛生部門應可檢視其他與健康相關政策指標納入跨部門施政協調參考，以加強健康治理達成城市永續與民眾滿意之目標。

Aim: Governmental policies should respond to people’s expectations. This study analyzed the association between the implementation of health policies in various local administrations and people’s expectations, with a view to providing insights for the development of future public policies.
Method: Data were collected from the“2019 Citizens Living Conditions Survey in Taiwan.”A total of 4050 valid samples were selected. These data were then correlated with statistics on core health policies within different local administrations across Taiwan. Multiple logistic regression analysis was performed to examine the expectations of individuals who prioritize health to enhance their quality of life.
Results: In Hsinchu City, 13.7% of the survey respondents considered“personal health”their top priority for improving their quality of life. Similar trends were discovered in New Taipei City, Taipei City, and Taoyuan City. After conducting multiple logistic regression analyses on people who prioritized ''health issues,'' this study found that each county and city's utilization rate on ''adult preventive health care facilities'' was significantly related to the governance indicator of public health policy. In addition, at the personal factor level, it is related to age, gender, and education level.
Discussion: The findings indicate that local administrations should pay more attention to policies that promote disease prevention, health check-ups, and public education to modify people’s behavior concerning preventable diseases. In addition, health-related concerns have become a primary focus for many individuals seeking to enhance their quality of life. The WHO’s concept of“Health in all policies”can serve as the basis for future investments and policy design, interdepartmental communications, and goals for ensuring public satisfaction.