台灣外籍勞工住院醫療利用特性與影響因素

The Features and Influencing Factors of In-patient Utilization of Foreign Labors in Taiwan

本研究以Aday和Andersen第二階段「醫療服務利用行為模式」為基準，運用預測相關性之研究設計，分析外籍勞工個人型態（傾向因素、能用因素、需求因素）和外部醫療資源（地區人數醫師數比與地區人數病床數比）對其住院醫療服務利用之影響。方法：資料來源為1998年至2000年全民健康保險研究資料庫之住院醫療費用清單明細檔、承保檔與行政院衛生署衛生統計資訊網公佈之人口病床數及醫師數，並利用t檢定、皮爾森積差相關、複迴歸與邏輯斯迴歸探究各自變項對於住院醫療服務利用情形的預測力。研究的三年期間外籍勞工投保人數分別為236,432人、259,508人和219,520人，平均投保年齡為29.5歲、29.4歲與29.2歲，男女比例由2：1漸趨於1：1；而每年住院人數則為4,097人、4,239人及3,540人。就醫科別以外科為主，診斷與手術多為腸胃道方面之疾病。另外，需求因素是預測外籍勞工使用住院醫療服務利用之最佳因子。而在衡量整體外籍勞工利用住院醫療服務時，只有傾向因素之性別有一致性之結果：男性利用住院醫療服務約為女性的2倍。在評估住院外籍勞工之住院醫療服務利用時，應考量其本身生理狀況，而若衡量整體外籍勞工住院傾向則可從性別之角度切入。建議外勞之醫療利用情形宜持續觀察，未來學者的研究方向可考慮社會脈絡之因素。

Based on the health behavior model of Aday and Andersen, the researcher examined the effectof individual characteristics(predisposing component, enabling component, and need component)andhealth care resources on in-patient utilization of foreign labors by using a predictive correlational researchdesign. Two sets of secondary sources were used. The first part of database including “in-patientexpenditures by admissions” and “registry for beneficiaries” from 1998 to 2000 was retrieved from theNational Health Research Institute (NHRI) database. The second one was adopted the information about“the density of physician” and “hospital-bed ” from the National Annual Statistics Information Service bythe Department of Health from 1998 to 2000. Inferential analyses including t-test, Pearson’s correlation,multiple regression, and multivariate logistic regression were conducted to examine the relationshipbetween individual characteristics and health care resources and in-patient utilization of foreign labors.The insured numbers of foreign labors from 1998 to 2000 were 236,432, 259,508, and 219,520,respectively. The average age of these people from 1998 to 2000 were 29.5, 29.4, and 29.2, respectively.The proportion of gender (male/female) was from 2:1 to near 1:1. The numbers of using hospital servicesfrom 1998 to 2000 were 4,097, 4,239, and 3,540, respectively. Surgery was the major reason of admission,and the terms of diagnosis and operation were mostly related to gastrointestinal disease. Need componentwas the significant predictor of hospitalization. Overall, gender, one of the predisposing components, wasconsistently and significantly associated with the use of hospital service. For instance, the rate of usinghospital service of male labors was twice as much as female labors. The physical status must take intoconsideration while predicting in-patient utilization for foreign labors. Gender is the significant factor forpredicting the use of hospital services. For further research, health care utilization among foreign labors isworthy of continuous investigation. Besides, social contexts should be considered in future study.