反思課程介入對護專學生核心能力成效探討

The Efficacy of Reflective Program for Enhancing Core Competency of Nursing Students

目的：探討健康資本對低所得國家經濟成長的影響方向與程度，是否端賴醫療保健支出占GDP比率超過某一特定門檻值而不同。方法：本研究以1995年至2011年低所得國家的人均所得成長資料，並以縱橫資料(panel data)形式，應用Gonzälez, Teräsvirta, & van Dijk(2005)所提出的縱橫平滑移轉迴歸模型(Panel Smooth Transition Regression Model ,PSTR)，以醫療保健支出占GDP比率、公共醫療支出占醫療保健支出比率和預期壽命為健康資本衡量指標，藉由醫療保健支出占GDP比率作為移轉變數的實證研究，找出醫療保健支出占GDP比率的門檻值。結果：實證結果顯示，健康資本對低所得國家經濟成長確實存在不對稱門檻關係，當醫療保健支出占GDP比率超過6.0631%門檻值時，公共醫療支出占醫療保健支出比率和預期壽命對經濟成長有正向影響，醫療保健支出占GDP比率對經濟成長則有負向影響；當醫療保健支出占GDP比率低於4.9027%門檻值時，醫療保健支出占GDP比率和預期壽命對經濟成長有顯著正向影響，公共醫療支出占醫療保健支出比率對經濟成長則有負向影響。結論：是故，非線性模型更能捕捉低所得國家健康資本對經濟成長之影響效果。不僅提供其他國家相關單位之參考，更可作為國內當局修訂政策的重要依據。

Purposes: This study discusses the ways and extents that health capital influences economic growth in low-income countries, and whether there is a threshold value of health care expenditure (HCE) to GDP. Methods: This research uses the data of per capita income from low-income countries from 1995 to 2011 as panel data, and applies the Panel Smooth Transition Regression Model (PSTR) from González et al. (2005). The following measures of health are used as the index of health capital in this study: the ratio of HCE to GDP, the ratio of public health care expenditure (PHCE) to HCE, and life expectancy. By analyzing taking the ratio of HCE to GDP as a transition variable, this study identifies the threshold value of HCE to GDP. Results: The results of this study reveal a nonlinear asymmetric threshold relationship between health capital and economic growth. When the ratio of HCE to GDP is more than 6.0631%, then the ratio of PHCE to HCE and life expectancy has positive influences on economic growth. However, the ratio of HCE to GDP has a negative influence on economic growth. When the ratio of HCE to GDP is lower than 4.9027%, the ratio of HCE to GDP and life expectancy has significant positive influence on economic growth, while the ratio of PHCE to HCE shows significant negative influence on economic growth. Conclusions: In conclusion, the non-linear model provides a clear analysis of how health capital influences economic growth in low-income countries. This is not only a reference for other countries but also an important reference for domestic policy reforms.