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    题名: 重大傷病醫療費用推估與健康生命表之建構
    作者: 劉明昌
    贡献者: 黃泓智
    余清祥


    劉明昌
    关键词: 重大傷病
    醫療費用推估
    疾病負荷
    日期: 2002
    上传时间: 2009-09-18
    摘要: 摘要
    平均壽命因死亡率下降而延長以及主要死因轉變為中老年疾病或慢性病，尤其中老年疾病與慢性病必須長期治療且不易根治的特性，使得高齡化社會對於醫療保健的需求將逐漸上升。基於上述背景本文以全民健保資料庫重大傷病資料研究台灣地區在壽命延長以及死因轉變之下醫療需求以及疾病負荷，其中醫療需求研究是以保險精算的方式推估未來台灣地區醫療需求金額以及每人平均門診醫療費用成本；疾病負荷研究是以生命表的方式計算因疾病損失年數與健康餘命分別以死因除外的方式以及健康餘命佔平均餘命的比例分析死因轉變對於國民壽命與健康存活時間的影響。研究中發現醫療需求有以近似線性方式上升的可能，醫療費用成本也隨之逐漸上升，醫療費用的上升趨勢將形成商業醫療健康保險的挑戰；在壽命延長以及死因轉變之下因疾病損失年數有上升的趨勢，並且若中老年與慢性疾病發生率持續不變健康存活時間佔平均壽命的比例將逐漸下降。
    Abstract
    The health care demand becomes larger and larger in the aging society result from the improvement of mortality and the geriatric and chronic diseases become major dead causes now. Under this circumstance, we aim to evaluate the future health care demand and the burden of disease in Taiwan by using critical illness and injury data among National Health Insurance database. In this research, we evaluate the future health care demand amount and outpatient expenditure per capita in Taiwan in actuarial way and evaluate the burden of disease by calculating the year lost due to disease and health life expectancy. According to research result, we argue that the demand of health care is increasing in almost linear way and the increase of health care cost becomes the important challenge to commercial health insurance. In additional, the year lost due to disease is increasing and the proportion of health life expectancy to life expectancy is decreasing result from life becomes longer and longer and the change of major dead causes.
    參考文獻: 參考文獻
    中文部分
    1､余清祥 (1997), 修勻—統計在保險的應用, 雙葉書廊, 台北, 台灣
    2､陳紹馨 (1979), 台灣的人口變遷與社會變遷, 聯經出版社, 台北, 台灣
    3､曾奕翔 (2002), 台灣地區死亡率推估的實證方法之研究與相關年金問題之探討, 政治大學風險管理與保險學研究所碩士論文
    4､黃意萍 (2002), 台灣地區的人口推估研究, 政治大學統計研究所碩士論文
    英文部分
    1､C. J. L. Murray, A. D. Lopez, (1996), The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, Harvard University Press (Global Burden of disease and Injury Series, Vol. 1).
    2､C. Mathers, T. Vos, C. Stevenson(1999), The burden of disease and injury in Australian. Australian Institute of Health and Welfare, Canberra: AIHW
    3､D. P. Rice(1966), Estimating the cost of illness. PHS Publication NO. 947-6. Washington , D.C.: Government printing office,
    4､D, F. Sullivan (1971), A single index of mortality and morbidity. HSMHA Health reports, 86, p347-p354
    5､E. M. Crimmins, Y. Saito, D. Ingegneri(1989), Changes in life expectancy and disability-free life expectancy un the United States Population and Development Review 15 No.2 p.235-p.255
    6､E. M. Crimmins, M. D. Hayward, Y. Saito (1994), Changing mortality and morbidity rates and the health status and life expectancy of the older population Demography Vol.31 No.1 p.159-p.175
    7､E. Pitacco (1994), LTC insurance. From the multistatemodel to practical implementations, XXV, ASTIN, p.437-p.452
    8､ H. D. Tolley, K. Manton, E. Stallard. (1982), Compartment model methods in estimating cancer costs Transactions of Society of Actuaries Vol.34 p.399-p.413
    9､ H. H. Panjer (1988), AIDS: Survival analysis of persons testing HIV+, Transactions of Society of Actuaries Vol.40 p.517-p.530
    10､ H. D. Tolley, K.G.. Manton (1991), Intervention effects among a collection of
    risk, Transactions of Society of Actuaries Vol.43 p.443-p.468
    11､ New Zealand Ministry of Health (2002), Modeling Diabetes: The mortality burden. Public Health Intelligence Occasional Bulletin No 8
    12､ New Zealand Ministry of Health (2002), Modeling Diabetes: A Multi-state life table model. Public Health Intelligence Occasional Bulletin No 9
    13､ New Zealand Ministry of Health (2002), Modeling Diabetes: Forecasts to 2011. Public Health Intelligence Occasional Bulletin No 10
    14､ R. L. Brown (1993), Introduction to the mathematics of demography 2nd Ed. ACTEX, Winsted, Connecticut, USA
    15､ S. B. Laditka D. A. Wolf (1998), New methods for analyzing active life expectancy Journal of aging and health p.214-p.241
    16､ S. Bennett, C. Choi(2002), Australian Health,2002. Australian Institute of Health and Welfare, Canberra: AIHW
    描述: 碩士
    國立政治大學
    風險管理與保險研究所
    90358020
    91
    資料來源: http://thesis.lib.nccu.edu.tw/record/#G0090358020
    数据类型: thesis
    显示于类别:[風險管理與保險學系] 學位論文

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