| 摘要: | 本研究主要目的在探討台灣精神藥物使用盛行率的演變及影響精神藥物使用的相關因素。本研究之資料來源為國民健康局之「2005年國民健康訪問調查」及國家衛生研究院之「全民健康保險研究資料庫」，研究樣本由國民健康訪問調查中選出，並排除未滿18歲之兒童青少年，樣本數為12,287，再串聯健保資料庫取得精神藥物利用情況。
本研究之依變項共有兩個，其一為樣本是否有使用精神藥物，其二為樣本的精神藥物使用量(衡量單位為定義每日劑量)；自變項為教育程度、就業狀況、職業類別與家戶收入；控制變項包含人口學特性(年齡、性別、種族、居住地區、居住地都市化程度)、健康行為(吸菸、喝酒、運動)、健康狀態(自述精神疾病狀態、肥胖、自覺健康狀態)以及社會支持(婚姻狀況、同住情形、子女個數)。本研究使用廣義估計方程式作為統計分析方法。
研究結果指出教育程度越高者及有工作者，其精神藥物的使用盛行率較低，但有工作者的抗焦慮劑使用量較無業、失業者來的高，職業類別和家戶所得對精神藥物使用盛行率/使用量的影響則不明顯。另外，女性、高齡者、滴酒不沾者及子女個數越多的人比較傾向會使用精神藥物，使用量方面則是男性、年齡層較低者及無運動者使用量較高。
透過研究結果可以發現，教育程度、就業狀況等社會決定因素是會對精神藥物的使用情況造成影響的，而年齡、性別這類基本的人口學變項或吸菸、喝酒等等健康行為亦或多或少影響了精神藥物的使用。由於台灣精神醫療的蓬勃發展、藥物使用的快速成長，政策制定者及醫療提供者必須投入更多的心力來監督精神藥物的利用，杜絕資源的浪費，並確保有需求者都能得到妥善的照護。
The purpose of this study is to explore the changing of prevalence of psychotropic drug and correlates of psychotropic drug use in Taiwan. The data sources of this study are National Health Interview Survey conducted by Bureau of Health Promotion in 2005 and National Health Insurance Research Database from National Health Research Institutes. Study sample is selected from National Health Interview Survey that excluded those whose age is less then eighteen, the sample size is 12,287. And these data are combined with National Health Insurance Research Database to get the situation of drug use.
There are two dependent variables in this study, whether the respondent used psychotropic drug or not and the volume of use (measured by defined daily dose). The independent variables are education, employment, job, and income. Control variables include socio-demographic variables (gender, age, race, region, and urbanicity), health behavior (smoking, drinking, and exercise), health status (mental illness, obesity, and self-perceived health status), and social support (marrage, company, and number of child). Generalized estimating equation was applied for analyses.
Results indicated that people who had higher education level and being employed had lower prevalence of psychotropic drug, but people who had job comsumed much more volume of anxiolytics. Besides, job and income had no influence in psychotropic drug use. Moreover, female, elder, people never drink, and people who have more child are tend to use psychotropic drug. Male, young, and people who have no regular exercise consumed higher volume of psychotropic drug.
The result of this study implied that social determinants such as education and employment can affect the use of psychotropic drug, and socio-demographic like gender, age, health behavior like smoking, drinking also have some influences in psychotropic drug use. Because of the vigorous development of psychiatric medication and rapid growth of psychotropic drug use, policy makers and health care providers should put more efforts into the monitoring of these drugs, so that the waste chould be eliminated, and people who have mental problem can get proper medication. |
