影響住院病患跨區利用之因素

The objectives of this study were to describe the utilization pattern of patients seeking hospitalization services outside their medical regions and to explore factors influencing cross-regional hospitalization behavior. Method: This study adopted the National Health Insurance enrollment and claims data of the year 2000 provided by the National Health Research Institute. A representative sample of 89,814 beneficiaries was analyzed. This study identified cross-regional hospitalization by comparing patients' residential locations and the locations of the hospitals they were admitted to. Multivaraite logistic regressions were used. Results: For the year 2000, about 21% of hospitalized patients were from medical regions outside the regions of the hospital that they were admitted to. The highest cross-regional hospitalization rates were observed in Yunlin County (57%) and Nantou (49%). The lowest rates were observed in Taipei (8%) and Kaohsiung (9%). Multivariate results showed that children under the age of four, high-incomer individuals, surgical patients, cancer patients, the mentally ill, other catastrophic illness patients, and citizens residing in areas with poorer medical resources had higher cross-region hospitalization rates. Conclusion: It was not only the sufficiency of medical resources that had a significant influence on cross-region hospitalization, but also the patient's personal characteristics and the attributes of disease. The planning and allocation of future medical resource should take patient characteristics and the attributes of their diseases into consideration.