Morbidity Status and Medical Utilization Among Physicians

• Main Authors: Chung, Hsin-Ju, 鍾欣如
• Other Authors: Lee, Mei-Wen
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/60756083213981155471

碩士 === 中臺科技大學 === 醫療暨健康產業管理系碩士班 === 102 === Background and Purpose: Doctors play an important part in the care and maintenance of public health. It is worth investigating whether the work styles and work related diseases of doctors affect their lives and work, thereby resulting in a loss of manpower of doctors or a negative impact on their meeting of patients’ needs. This study was to analyze doctors’ utilization of medical services, and the factors effecting this utilization. Methods: The research data was taken from the National Health Insurance Research Database(NHIRD) of the years 2007 to 2011. Using a panel study, 31,168 doctors were selected in the year 2007 and observed until 2011. Negative binomial regression with generalized estimating equations was used to explore utilization of medical services among doctors. Results: Doctors made outpatient appointments, sought medical attention, and utilized medical services on an average of 0.00 to 2.41 times between the years 2007 and 2011. Among the seventeen categories of outpatient services, the three most commonly sough were digestives disease, respiratory diseases, and circulatory diseases services. Predisposing factors include sex and age; Enabling factors include insurance salary; need factors include the suffering of chronic diseases and catastrophic illness; workplace traits include hospital ownership, hospital accreditation level, and branch of bureau of NHI. These factors have a significant effect on the frequency of utilization of digestive, respiratory, and circulatory diseases related medical services. After control of the statistical models, an analysis of factors influencing the utilization of digestive diseases related medical services shows that utilization correlates positively with increase of age and negatively with increase of insurance salary. Those who suffered chronic diseases and catastrophic illness utilized such medical services significantly more. Those who work at medical centers, regional hospitals, or district hospitals utilized such medical services significantly less than those who work at clinics. Those who work at public hospitals and nonprofit hospitals utilized such medical services significantly less than those who work at private hospitals. Those who work in the Taipei region, the northern Taiwan region, the Kaohsiung-Pingtung region,and the eastern Taiwan region utilized medical services significantly less than those who worked in the central Taiwan region. Conclusions: After adjusting for predisposing factors and need factors, the enabling factors of doctors: insurance salary and workplace traits (e.g. hospital ownership, accreditation level of hospital, and branch of bureau of NHI), are shown to significantly affect medical service utilization. This study shows that financial status and the accessibility of medical services are significant factors in anticipating doctors’ suffering from diseases. The training of doctors is difficult, and this study hopes to remind doctors to pay attention to their health, and to provide doctors with suitable information on medical care, thus decreasing the loss of manpower of doctors.