影響民眾選擇自費健康檢查因素之研究

Influential Factors in Choosing Self-Paid Health Examination Services

目的：本研究的目的是探討影響民眾選擇自費健康檢查（健檢）的因素。有效的健檢能早期發現疾病，改善國民健康；醫院透過發展自費健檢產品，亦可減輕財務壓力。本研究參照Andersen提出之健康服務模式並做部分修正，將影響利用健康服務的因素區分為環境、人格特質（包括前傾、使能與需要因素）、健康行為與預後因素。方法：本研究以中部某區域醫院自2009年2月16日至3月26日間之門診病患為研究對象，共計取得266個40歲以上之樣本，並應用Tobit模型分析影響自費健檢利用次數的因素。結果：年齡愈輕、本身教育程度較差、子女教育程度愈高、個人年所得愈高、可接受健檢費用愈高、曾使用過全民健保成人健檢、有嚼食檳榔習慣與有施打預防針習慣者均較傾向利用一次以上的自費健檢服務。結論：影響民眾健檢利用的因素包括前傾因素、使能因素、需要因素與健康行為，環境因素與預後因素的影響並不顯著。瞭解利用自費健檢民眾之特質，有助醫院設計適當健檢產品，研究結果亦可與利用健保免費健檢的民眾特性作比對。

Objective: This study investigated the determinants in choosing self-paid health examination services. Effective health examinations can help in early detection of diseases and improvement in citizens' health. Self-paid examination services could also help alleviate financial burdens on hospitals. We modified the health behavior model proposed by Andersen (1995) and reclassified the determinants into four categories: environmental, individual characteristics (predisposing components, enabling components, and need components), health behaviors, and prognostic factors. Methods: The study subjects were outpatients from a regional hospital in central Taiwan during the period of 2009/2/16 to 2009/3/26. Judgment sampling was conducted and 266 valid samples were collected. Tobit regression models were used to examine the factors related to self-paid health examinations. Results: Individuals who were younger, had a low level of education, had offspring with higher education, had a higher personal income, were open to higher health examination costs, had utilized the national health insurance adult examination service, chewed betel nut, or regularly receive shots were more likely to use self-paid health examination services more than once. Conclusions: The determinants significantly influencing self-paid health examination included predisposing factors, enabling factors, need factors and health behaviors. Environmental and prognostic factors were not significant. The study results could help in the development of health examination services tailored to the characteristics of the clientele. In addition, the factors affecting the use of self-paid health examinations found in this study can be compared with those affecting the use of health examinations covered by National Health Insurance.