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| 題名: | 歐洲16國女性就業率與健康支出之關係 |
| 作者: | 崔翔 |
| 貢獻者: | 公共衛生學研究所 |
| 日期: | 2010 |
| 上傳時間: | 2010-10-20 11:20:39 (UTC+8) |
| 摘要: | 研究背景：近年來，各國的健康支出已經超過經濟的成長。雖然已有許多研究調查造成健康支出的影響因素，但對於女性就業率與健康支出之間的關係卻少有著墨。
研究目的：以國家層級資料，了解女性就業率是否與國家健康支出有關。控制了其他影響健康支出的因子後，女性就業率與國家健康支出之間的關係以及相關程度。藉此可提供健康福利規劃一些建議。
研究方法：本研究將使用取自OECD健康統計的二手資料來進行1970-2007年的跨國縱貫性研究，以福利制度較為明確的歐洲16個國家作為主要研究對象。統計分析則進行重複測量資料的迴歸分析。
結果：在調查1970年至2007年，歐洲16國的女性就業率與總健康支出、公共健康支出以及私人健康支出都有顯著的正向相關，其中又以影響公共健康支出較多。放入供給面後女性就業率在總健康及私人健康支出方面仍有顯著正向影響，但在公共健康支出方面則未有顯著，可能原因在於1990年代以後，公共健康支出受到供給因子的影響較女性就業率來的大，因此才呈現沒有顯著的情況。在利用福利制度分類後，女性就業率在自由主義、普及主義以及男性養家福利制度的國家中，都與總健康支出有顯著的正向影響；在公共健康支出方面，則是只有普及主義福利制度國家的女性就業率與其有顯著相關；私人健康支出在不同的福利制度下，女性就業率都與其沒有統計上的顯著相關。放入了供給因子作控制後發現，在總健康支出的部分，女性就業率仍是與自由主義、普及主義以及男性養家福利制度國家的總健康支出有著顯著的正向影響；在公共健康支出方面，則是除了普及主義福利制度外，自由主義福利體制的國家其女性就業率與公共健康支出有統計上顯著的正向相關；私人健康支出在不同福利分層下控制了年代、需求因子及供給因子後，在自由主義、普及主義以及男性養家福利制度的國家中，女性就業率與私人健康支出都有顯著的正向影響。
結論：女性就業率在控制了其他干擾因子後，確實與健康支出有關，但在不同的健康支出項目，其影響的程度也有所不同。研究歸納其影響原因有三：(一)女性就業後可獲得的資源增加，因此造成使用醫療保健資源的門檻較低，使健康支出成長；(二)女性就業後對於自身健康風險暴露增加，因此女性能受到來自於政府或是雇主的照護也會越多，以降低健康風險並保障其健康狀況；(三)家庭照護者的角色漸漸被專業照護人員取代，女性仍在大多數的社會中負擔家庭照護者的角色，女性孕育生命養育小孩的天職，在女性就業後受到衝擊，因此當女性有能力聘請專業的育嬰及照護人員，其健康支出也會隨之上升。
BACKGROUND: In recent years, growth in health expenditure has outpaced economic growth in developed countries. While past studies have identified various macro factors associated with health expenditure, none has focused on the effects of female employments on health expenditure.
OBJECTIVE: To assess the relationship between female employment rates and health expenditure in 16 European countries.
METHODS: Country-level data from 1970 to 2007 were obtained from the Organization for Economic Co-operation and Development dataset. Variables used in this study included total health expenditures, public health expenditures, private health expenditure, welfare factors, demand and supply factors, and female employment rate (FER). We estimated the relationship between FER and health expenditures by using repeated measurement linear mixed model regression. All controlled variables were country level factors.
RESULTS: FER proved to be a correlate of health expenditure from 1970 to 2007 in this sample of nations, even when controlling for the effects of other variables likely to impact health expenditure. FER is positively associated with total and private health expenditure in Anglo-Saxon, Scandinavian, and Bismarckian welfare states, while associated with public health expenditure in Anglo-Saxon, Bismarckian, and Southern welfare states.
CONCLUSIONS: FER is significantly associated with health expenditure in the countries studied. We speculate that FER may affect health expenditure through the following mechanism: the increased available resources for women to spend on health care, the increased exposure to occupational health risks, and the heavier reliance on formal care. These three reasons may lead to higher health expenditure. |
| 關聯: | 74頁 |
| 描述: | 第一章. 緒論 1
第二章. 文獻探討 3
第一節. 女性就業率的意涵及現況 3
第二節. 女性就業與健康之間關係 7
第三節. 福利國家體制對女性就業相關政策 14
第四節. 健康支出定義及現況 18
第五節. 影響健康支出因子的相關研究 20
第三章. 研究方法 25
第一節. 研究資料來源 25
第二節. 研究設計與分析 26
第三節. 研究變項說明 29
第四章. 研究結果 32
第一節. 樣本描述 32
第二節. 相關性分析 43
第三節. 模式分析 46
第四節. 分層分析 53
第五章. 討論與建議 66
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