Department of Economics, College of Social Science, National Cheng Kung University, Tainan, Taiwan.
Int J Health Plann Manage. 2019 Apr;34(2):572-582. doi: 10.1002/hpm.2717. Epub 2018 Dec 5.
In Taiwan, although the implementation of the National Health Insurance (NHI) program reduced financial barriers and enhanced accessibility for individuals to utilize health care services, an unequal distribution of medical care resources still exists. This paper is focusing on analyzing factors that are associated with unmet health care needs among the middle-aged and elderly under the NHI in Taiwan.
Statistical analysis from the 2007 Survey of Health and Living Status of the Elderly in Taiwan. We firstly adopted latent class analysis to classify individuals' observable reasons for feeling unwell but not seeing a doctor within the last 3 months into three latent perceived barriers classes. We further used a multinomial probit regression model to analyze factors that are associated with each perceived barrier class to the access of health care service.
Results indicate relative to the "relatively no barriers" class, individuals with a high level of educational attainment tend to more likely to be in the "accommodation barriers" class, and individuals live in the most developed areas with the densest medical facilities tend to less likely to be in the "accessibility barriers" class.
We identified possible risk factors for each perceived barrier, which could provide important insights for health authorities and medical providers when targeting policies and interventions to efficiently assist people in need.
在台湾，尽管实施了全民健康保险（NHI）计划，降低了个人获得医疗服务的经济障碍，提高了可及性，但医疗资源的分配仍存在不平等。本文重点分析了在台湾的全民健保下，中年和老年人未满足的医疗需求与哪些因素有关。
利用 2007 年台湾老年人健康与生活状况调查的统计数据。我们首先采用潜在类别分析，将过去 3 个月内因感觉不适但未就医的个体的可观察原因分为 3 个潜在的感知障碍类别。然后，我们进一步使用多项概率回归模型，分析与每个感知障碍类别相关的医疗服务获得因素。
结果表明，与“相对无障碍”类别相比，教育程度较高的个体更有可能属于“适应障碍”类别，而居住在医疗设施最发达、密度最大地区的个体则不太可能属于“可及性障碍”类别。
我们确定了每个感知障碍的可能风险因素，这为卫生当局和医疗服务提供者在制定政策和干预措施以有效帮助有需要的人时提供了重要的见解。
