剖析台灣民眾的就醫流動：利用引力模式評估就醫距離與醫療資源分布的影響
Journal
台灣公共衛生雜誌
Journal Volume
2
Journal Issue
35
Pages
136-151
Date Issued
2016
Abstract
Objectives: Township-level physician-to-population and hospital bed-to-population ratios have been widely adopted as indicators of health care accessibility in Taiwan; however, these indicators cannot reflect actual healthcare-seeking behaviors of patients. Therefore, the aims of this study were to establish actual patient flow for seeking healthcare and to clarify the factors influencing preferences for seeking healthcare. Methods: We estimated the residence and collected the locations of healthcare visits for each patient from the nationwide Longitudinal Health Insurance Database in 2010 to establish an origin-destination matrix. The patient flow among townships could be conducted from the matrix. The weighted travel distance of healthcare visits was developed as a new indicator of accessibility. The gravity model was then used to analyze the patient flow and assess the influences of travel distance and healthcare resources. Results: Using the weighted travel distance, eastern Taiwan and the coastal areas of Yunlin and Chiayi were identified as the poorest accessibility for healthcare resources. The results of the gravity model showed that travel distance was the major factor correlated negatively with the volumes of outpatient and inpatient/emergency flow; however, the abundance of healthcare resources positively influenced the preference of inpatient/emergency patients from their residence to neighborhood regions for seeking healthcare. Conclusions: The weighted travel distance could properly reflect the access of healthcare. We conclude that travel distance is the major factor which influences patient flow for seeking healthcare. In contrast, people tend to choose the healthcare facilities with abundant resources for seeking inpatient/emergency healthcare.
Type
journal article