28卷6期

• Link 公衛論壇 Public Health Forum
• 觀光賭場與賭博合法化帶來的公衛衝擊觀光賭場與賭博合法化帶來的公衛衝擊
• 鄭雅文
  Ya-Wen Cheng
• 無
  none
• 無
  none
• 455 - 458
• 10.6288/TJPH2009-28-06-01

• Link 綜論 Review Article
• 職災補償制度之國際比較及台灣制度之改革方向An International Comparison of Workers' Compensation Schemes for Occupational Injuries and Diseases and Suggestions for Policy Reform in Taiwan
• 林依瑩、 鄭雅文、王榮德
  Yi-Ying Lin, Ya-Wen Cheng, Jung-Der Wang
• 職災補償 ； 職業災害 ； 社會安全制度 ； 國際比較 ； 政策改革
  workers' compensation ; occupational injuries ; social security ; international comparison ; policy reform
• 社會安全制度旨在確保人民的基本生存權，其中，職災補償救濟乃是先進國家中最早出現的社會安全制度之一。為瞭解職災補償制度的核心精神，以釐清台灣職災補償制度的問題與改革方向，本文回顧國際間職災補償制度之發展歷史以及國際勞工組織相關公約，並選取特定國家，比較其法源依據、行政組織、涵蓋人口範圍、財源、給付內容與給付方式等。從國際比較分析可發現，台灣職災補償制度的問題包括：相關法規分散、缺乏專責於職災保護制度的主管機構、職災補償制度未涵蓋所有受僱者、保險費率偏低、給付不足、健保代辦職災醫療給付而造成部份的職災門診醫療被全民健保吸收。我們建議，台灣職災社會保險制度應獨立立法且應設置獨立的業務專責機關；此外，職災保險應涵蓋所有受僱者、應強化職災預防之誘因機制、應適當提昇給付額度與範圍，並應與健保醫療照顧制度作適度區隔。
  The purpose of social security is to ensure people's basic right to existence. In the developed countries, workers' compensation is one of the oldest types of social security system. To better comprehend the problems of the current workers' compensation system in Taiwan, we reviewed the historical development of workers' compensation systems worldwide, as well as the related conventions adopted by the International Labor Organization. In addition, we compared workers' compensation schemes in selected countries with regard to legislative framework, administrative organization, coverage of workforce, source of funds, and content and means of delivery of benefits. Based on international comparative analyses, we concluded that the problems with the workers' compensation system in Taiwan include: a complicated legislative framework with multiple laws and regulations, lack of an administrative authority specializing in workers' compensation, exclusion of some employees from the coverage, low premium rates, insufficient benefits, and inadequate coordination with the national health services and other social security systems. We suggest that changes in the legislative framework and administrative infrastructure should be the priorities in policy reform. In addition, the workers' compensation system should cover all salaried employees, incentive mechanisms for prevention should be strengthened, benefits provided should be adjusted and the benefit levels raised, and a clear line should be drawn between medical care services offered by the workers' compensation system and the National Health Insurance.
• 459 - 474
• 10.6288/TJPH2009-28-06-02

• Link 原著 Original Article
• 運用eHealth科技系統提升國民中學健康教學者之健康專業能力與健康生活型態Enhancing Professional Competency and Healthy Lifestyles of Middle School Health Educators Through eHealth Technology
• 劉潔心、晏涵文、 邱詩揚、廖梨伶
  Chieh-Hsing Liu, Han-Wen Yen, Shy-Yang Chiou, Li-Ling Liao
• eHealth科技系統 ； 國民中學 ； 健康教學者 ； 健康專業能力 ； 健康生活型態
  eHealth technology ; middle school ; health educators ; professional competency ; healthy lifestyles
• 目標：本研究旨在運用eHealth科技系統之同儕支持社群、量身訂作教學、及專業促進與支持等介入方式，以改善國民中學健康教學者之健康生活型態及健康專業能力。方法：以準實驗研究設計之實驗組對照組前後測設計，選取95年度教育部核定健康促進示範縣市國民中學健康教學者為研究對象，共53名教師為實驗組對象（有效樣本回收率為70.67%）；而對照組對象則為65名（有效樣本回收率為86.67%），完全不予介入。兩組皆於介入前完成前測問卷，介入期兩個月，介入後同步進行後測。結果：本介入計畫在「工作感受」上，於控制前測得分的前提下，實驗組於「工作感受」、「健康信念」、「生活技能」、「自我效能」、及「健康行為意向」顯著較對照組表現良好。結論：本研究所發展之eHealth科技系統具良好介入成效，此一克服時間與空間的障礙，且低成本高效率的介入方式，值得做為未來健康教學者健康促進計畫中的重要參考工具。
  Objectives: This study aims to establish the eHealth technology program and to evaluate its effectiveness in middle school health educators. It is hoped that this intervention can strengthen professional competency and encourage healthy behaviors and lifestyles in the target population. The eHealth intervention is based on health behavior theories and models, and it also incorporates the functions and strategies of the eHealth interactive technology, including the use of peer support communities, tailored education, and professionally facilitated education and support programs. Methods: Subjects were from health-promoting schools selected by the Ministry of Education in the Academic Year 2005. A nonequivalent control group design was used. The experimental group (n=53) received the eHealth intervention for two months, while the control group (n=65) received nothing. The outcomes were evaluated using a close-ended questionnaire. Results: The eHealth intervention improved perception of working conditions, health beliefs, life skills, and self-efficacy, and encouraged the adoption of healthy behaviors among middle school health educators. Conclusions: This intervention can provide a valuable reference for those public health policy-makers and health researchers who seek to implement the health educators' health promotion program through eHealth technology.
• 475 - 490
• 10.6288/TJPH2009-28-06-03

• Link 原著 Original Article
• 台灣鄉鎮市區因子對青少女生育率的影響Effects of township-level Characteristics on Teenage Birth Rates in Taiwan
• 洪瑋薇、莊坤洋、莊媖智
  Wei-Wei Hung, Kun-Yang Chuang, Ying-Chih Chuang
• 青少女生育率 ； 鄉鎮市區因子 ； 時間遲滯
  Teenage birth rate ; township-level characteristics ; time-lagged model
• 目標：主要探討台灣地區從1980年開始到2005年為止，359個鄉鎮市區因子和鄉鎮層次青少女生育率的相關性，及鄉鎮市區因子可否預測五年及十年後的青少女生育率。方法：資料來源為台閩地區人口統計、縣市要覽以及戶口及住宅普查資料。樣本為台灣地區359個鄉鎮市區，從1980年到2005年，每五年抽樣一次，共計2,154個樣本。分析方法使用雙變項分析、重複測量的混合模型(Mixed Model)分析以及時間遲滯模式(Time-lagged Model)。本研究的區域因子包含人口組成（人口密度、原住民人口百分比、65歲以上人口百分比和離婚率）、社經地位（高等教育人口百分比）、社會醫療福利服務（每萬人口醫師數和社會福利支出）以及其他因素（遷徙率）。結果：在同年模式中，人口密度越低、每萬人口醫師數越低、高等教育人口百分比越低、65歲以上人口百分比越高、原住民人口百分比越高的地區，青少女生育率是越高的。區域因子影響青少女生育率也有出現時間遲滯的情形，也就是說，在控制了當年青少女生育率後，區域的人口密度、65歲以上人口百分比、原住民人口百分比、高等教育人口百分比這四個變項，可穩定預測五年及十年後的青少女生育率；而區域的離婚率則是要經一段時間才能影響青少女生育率，以十年的效果最大，離婚率愈高，青少女生育率愈高；遷徙率只有在五年及十年時間遲滯模式中有達到顯著，遷徙率愈高則青少女生育率愈高。結論：影響青少女生育率的因子，以社會結構層面因子較為明顯，像是人口密度、65歲以上人口百分比、原住民人口百分比、高等教育人口百分這四個區域因子，都跟當年的青少女生育率有關，也可穩定預測五年後及十年後的青少女生育率。未來政策制訂者應該要看每個影響因子背後所帶有的意義，也應該要努力去達到地區平均發展機會。
  Objectives: This study examined the relationship between township-level factors and teenage birth rates from 1980 to 2005 in 359 townships in Taiwan. We also examined whether township-level factors were associated with five-year and ten-year teenage birth rates. Methods: The data came from Taiwan Demography, The City and County Statistics, and Census. The study used repeated measures of township-level characteristics every 5 years from 1980 to 2005 (N=2154). We conducted bivariate analyses and used mixed models with repeated measurements and time-lagged models to analyze the data. The variables included population composition (population density, the percentage of aborigines, the percentage of people over 65 years old, and divorce rates), socioeconomic status (the percentage of people with college degrees), medical and social services (the number of physicians per 10,000 people and social welfare spending), and other factors (residential mobility). Results: In the contemporary model, population density, the percentage of physicians, and the percentage of college educated people were negatively associated with teenage birth rates, whereas the percentage of elderly and the percentage of aborigines were positively associated with teenage birth rates. In the time-lagged models, after controlling for current teenage birth rates, population density, the percentage of college educated people, the percentage of elderly, and the percentage of aborigines were associated with five-year and ten-year teenage birth rates. The relationship between the percentage of divorced people and teenage birth rates was strongest in the 10-year model. Residential mobility was not significant in the contemporary model, but was significant in the 5-year and 10-year models in which higher residential mobility predicts higher teenage birth rates. Conclusions: These findings suggest that township-level social structural characteristics have more significant effects on teenage birth rates than do other township-level characteristics. Population density, the percentage of elderly, the percentage of aborigines, and the percentage of college educated people were associated with teenage birth rates in the contemporary model, the 5-year model, and the 10-year model. Future policy should focus on examination of the theoretical meaning of each township factor and improvement in regional equity as well as fulfillment of regional needs.
• 491 - 502
• 10.6288/TJPH2009-28-06-04

• Link 評論 Commentary
• 評論：台灣鄉鎮市區因子對青少女生育率的影響Commentary: Effects of township-level Characteristics on Teenage Birth Rates in Taiwan
• 李孟智
  Meng-Chih Lee
• 無
  none
• 無
  none
• 503 - 503
• 10.6288/TJPH2009-28-06-05

• Link 評論 Commentary
• 作者回應：台灣鄉鎮市區因子對青少女生育率的影響Response: Effects of township-level Characteristics on Teenage Birth Rates in Taiwan
• 洪瑋薇、莊坤洋、莊媖智
  Wei-Wei Hung, Kun-Yang Chuang, Ying-Chih Chuang
• 無
  none
• 無
  none
• 504 - 504
• 10.6288/TJPH2009-28-06-06

• Link 原著 Original Article
• 樂觀偏誤及預防行為：台灣民眾對禽流感的反應Optimistic Bias and Precautionary Behavior: The General Public's Response to Avian Influenza in Taiwan
• 吳宜蓁、盧鴻毅、侯心雅
  Yi-Chen Wu, Hung-Yi Lu, Hsin-Ya Hou
• 禽流感 ； 樂觀偏誤 ； 風險知識 ； 憂慮 ； 預防行為
  Avian influenza ; optimistic bias ; risk knowledge ; worry ; precautionary behavior
• 目標：本研究以2006年3月台灣地區面臨的禽流感威脅情境為例，檢視台灣民眾對此未知風險是否存有樂觀偏誤的心理，並探討影響樂觀偏誤及預防行為的因素為何。方法：透過電話系統隨機抽樣調查法，本研究於2006年3月下旬完成822份有效樣本，回應率為67.5%。結果：本研究發現，面對禽流感爆發的威脅，受訪民眾存有樂觀偏誤心態；此外，憂慮顯著地預測樂觀偏誤及預防行為，風險知識則顯著地預測預防行為，但其對樂觀偏誤則不具有顯著的預測能力。結論：面對禽流感，樂觀偏誤心理依然存在，但偏誤程度不大。本研究建議，提高民眾的風險危機意識有助減低樂觀偏誤並促使民眾採取預防行為。
  Objectives: The current study sought to investigate the phenomenon of optimistic bias regarding the possible deadly threat of avian influenza (AI) in Taiwan. This study also explored the determinants of optimistic bias and precautionary behaviors. Methods: A telephone survey was employed using a systematic random sample of 822 respondents (response rate of 67.5%). Results: The findings of this study indicated that respondents perceived that others were more likely to be infected with AI than themselves (optimistic bias phenomenon). In addition, worry was found to be negatively predictive of optimistic bias and positively predictive of precautionary behavior, while risk knowledge was positively predictive of precautionary behavior, but was not significantly predictive of optimistic bias. Conclusions: While facing the threat of AI, an optimistic bias phenomenon is present among Taiwanese, but is not salient. This study suggests that riskarousal will eliminate the optimistic bias phenomenon and enable respondents to take precautionary actions.
• 505 - 516
• 10.6288/TJPH2009-28-06-07

• Link 原著 Original Article
• 利用地理資訊系統探討肝癌病患就醫地理可近性與醫院選擇間之相關性Using Geographic Information Systems (GIS) to Identify the Association between Geographic Accessibility and hospital-seeking Behavior by Hepatocellular Carcinoma Patients in Taiwan
• 章殷超、溫在弘、賴美淑
  Yin-Chao Chang, Tzai-Hung Wen, Mei-Shu Lai
• 區位分析 ； 就醫行為 ； 健康不平等 ； 地理資訊系統 ； 癌症診斷資料庫
  Location analysis ; hospital-seeking behavior ; health inequality ; geographic information system GIS ; Taiwan cancer data base TCDB
• 目標：就醫地理可近性差異，可能導致就醫選擇不同，進而影響治療的內容、品質及結果。透過就醫流向，可深入探討其影響因素。本研究從地理可近性的觀點，分析肝癌病患的就醫選擇。方法：利用地理資訊系統與癌症診療資料庫，建立2004年罹患肝癌病患之首次就醫醫院網絡，分析就醫地理可近性與病患就醫流向的地理關聯。結果：大部分病患選擇在最近可就醫區內就醫。28.3%跨區就醫的病患中，在年齡與性別上無顯著差異；初期癌症有較高的比例跨區就醫(31.2%)。跨區就醫比例較高的區域特性包括：最近可就醫區內無醫學中心(59.1%)、醫院越少及跨區就醫增加交通時間越少。跨區就醫病患有更高的比例選擇醫學中心級醫院。而就醫地理可近性最差等級的病患，大多在最近可就醫區就醫(86.9%)。結論：本研究有兩個重要發現，肝癌病患居住地最近可就醫區內的醫院數、有無醫學中心及跨區就醫地理障礙明顯影響病患就醫行為；就醫地理可近性等級與跨區就醫病患比例呈現非線性的關係，在可近性最差的地區出現反轉。上述發現，有助我們闡述醫療資源不平等的現象與影響，能進一步分析就醫流向與醫療品質的關係。
  Objectives: The distance to hospitals affects a patient's hospital-seeking behavior and results in a variety of patterns of care, treatment quality and outcomes. We attempted to determine the impact of distance by applying the concepts of geographical accessibility. Methods: By using geographic information systems (GIS), we mapped the home townships of patients with hepatocellular carcinoma (HCC) diagnosed in 2004 and the hospitals of their first visit. We then established a patient-hospital network to analyze the association between geographical accessibility to hospitals and the travel patterns of patients. Results: We found that 28.3% of patients chose hospitals far away from their nearest hospitalaccessible area (cross-district). There were no statistically significant differences in age or gender between cross-district and within-district patients. Patients with early stage cancer had significantly more potential than those with late stage cancer to seek cross-district hospitals. We also found that patients with fewer hospitals and no medical centers within their nearest hospital-accessible area, and with shorter distances to access cross-district hospitals, significantly increased cross-district hospitalseeking behavior. They preferred medical centers. Furthermore, a non-linear relationship between geographical accessibility to hospitals and cross-district hospital-seeking behavior was identified. Patients with the greatest difficulty in hospital access tended to choose hospitals nearby. Conclusions: Employing a GIS-based accessibility approach, we found that medical resources within-district and distance to cross-district hospitals significantly affected patients' hospital-seeking behavior. By identifying the non-linear relationship between accessibility to hospitals and patients' cross-district hospital-seeking, this study showed the importance of incorporating spatial inequality into the planning for the provision and utilization of health care. Care patterns, treatment quality and outcomes for cancer hospitals also need to be considered in explaining cross-district hospital-seeking behavior.
• 517 - 529
• 10.6288/TJPH2009-28-06-08

• Link 原著 Original Article
• 臨床心理師非性雙重關係倫理態度與行為之調查研究The Investigations of Clinical Psychologists' Ethic Attitudes and Behaviors Toward non-sexual Dual Relationship
• 林美芳、張馥媛、王智弘
  Mei-Fang Lin, Fu-Yuan Chang, Chih-Hung Wang
• 非性雙重關係 ； 倫理態度 ； 倫理行為
  Non-sexual dual relationship ; ethical attitude ; ethical behavior
• 目標：雙重關係的普遍發生與潛在的可能傷害是導致專業社群對此議題重視之原因，近期有關雙重關係倫理議題之研究已開展至對非性雙重關係之關注。本研究試圖暸解臨床心理師治療中非性雙重關係倫理態度與行為之觀點與現象，並提供相關專業進行倫理省思與未來倫理守則擬定之參考。方法：採叢集隨機抽樣針對182位臨床心理師進行資料蒐集，內容包括非性雙重關係倫理態度與行為及基本資料。以SPSS12.0統計套裝軟體進行描述性統計、交叉表分析及T考驗，針對分析結果進行文獻比對、小組討論並撰寫結果報告。結果：研究發現除禮物收受與社交關係外，治療師對非性雙重關係倫理態度與行為普遍呈現一致；另外在背景變項上，性別、治療取向及服務對象對部分倫理態度與行為產生影響且達顯著差異。結論：調查研究顯示台灣地區臨床心理師在倫理態度與行為上具有一致性，但有關收受禮物與社交互動之行為表現值得關切。
  Objectives: The topic of dual relationships in psychotherapy has received increasing attention over the last decade. Dual relationships are frequent and their potentially harmful effects are often cited as justification for psychological intervention. Ethical issues in clinical practice have been raised by the question of non-sexual dual relationships. This study examined the viewpoints, ethical attitudes, and behaviors of clinical psychologists engaged in the psychotherapy of non-sexual dual relationship issues. The results may impact the adoption of a code of ethics in the future. Methods: A cluster random sample of 182 licensed Taiwanese clinical psychologists responded to questionnaires eliciting demographic information and information about their ethical attitudes and behaviors toward treatment of non-sexual dual relationship issues. Descriptive statistical analysis, cross table analysis, and t test were performed using SPSS 12.0 statistical package software. The current data were compared with data in the literature. Results: Ethical attitudes and behaviors (except for gift-receiving and social behaviors) of therapists toward nonsexual relationship issues were generally consistent. These ethical attitudes and some of the behaviors were significantly influenced by gender, theoretical orientation, and service target. Conclusions: Ethical attitudes and behaviors of clinical psychologists in Taiwan are consistent, but gift-receiving and social behaviors deserve further attention.
• 530 - 540
• 10.6288/TJPH2009-28-06-09

• Link 原著 Original Article
• 以系統動力學模擬登革熱擴散現象與評估防治策略效果－台南市為例Simulation and Evaluating Epidemic Intervention Policies with System Dynamics: A Case Study of Dengue Fever in Tainan
• 黃經洲、陳加屏、艾昌瑞
  Jin-Jun Huang, Chia-Ping Chen, Chang-Rui Ai
• 巴氏Bass模式 ； 登革熱 ； 系統動力學 ； 防治策略
  Bass Model ; Dengue Fever ; system dynamic ; intervention policies
• 目標：建構一個以台南市人文、氣候、感染人數等實際資料為依據的登革熱擴散因果模式，並用以評估數種防治策略的效果。方法：運用系統動力學，建構感染者中心－雙流巴氏模式(Agent-Dual flow Bass Model)。感染者中心以受感染者的活動半徑進行模擬，取代行政區域的人為劃分。單流式是人傳人的感染擴散型式，雙流式是指人與蚊交互接觸感染的擴散型式。結果：1.以感染者中心方法取代原本以人為區域劃分法，重新描繪台南市2007年登革熱感染人數變化曲線後，發現本模式的模擬行為能彌補人為區域劃分法的缺失。2.試著將氣溫增加2℃、雨量增加0.5倍時，感染人數會比原氣象水準高5.5倍，顯示登革熱暴發率對氣溫與雨量等氣候因素具高敏感性。3.防治策略能抑制感染人數的成長，而五種策略中，以噴殺蟲劑效果(-85%)最好，若合併三項同屬教育性質的策略，其綜合效果(-84%)與噴殺蟲劑旗鼓相當。結論：以氣溫閥值（約24.2℃），取代病媒蚊指數做為登革熱爆發門檻的領先指標，更能提前預防登革熱。
  Objectives: This research aims were to construct a modified model of dengue fever dispersion, taking into consideration geographic, demographic and climatic variables, and then evaluate the efficacies of intervention policies currently in use. Methods: From a system dynamics perspective, this study constructs a modified Agent-Dual Flow Bass Model. The definition of the variable Agent refers to the infectious population's activity sphere rather than a man-made administrative district. Single Flow indicates human-to-human spread, while Dual Flow refers to interactive infections between humans and mosquitoes. Results: 1. The modified Agent-Dual Flow Bass Model results in a better simulation correlation than the man-made administrative-district simulation by re-coding the 2007 dengue fever cases in Tainan. This result suggests that the new model can overcome the deficiencies in the previous model. 2. With a 2? temperature increase and a one-half times greater rainfall, the infectious population increases by 5.5 times, which indicates that a dengue fever outbreak is highly sensitive to temperature and rainfall. 3. The intervention policies are effective for decreasing the spread of dengue fever. Among the five intervention policies, fumigation is the most effective (-85%). However, when the three educational policies are combined, the effect (-84%) is equivalent to fumigation policies. Conclusions: These results suggest that using a temperature threshold (24.2?) as the leading indicator for dengue fever outbreak provides an earlier warning than the conventional Bretaeu index.
• 541 - 551
• 10.6288/TJPH2009-28-06-10

• Link 實務 Public Health Practice
• 民眾對遠距健康照護服務之認知與需求調查研究－以心臟病、高血壓及糖尿病為範疇A Survey of the General Publics Perception and Needs for Telehealth Services within the Focus Areas of Heart Disease, Hypertension and Diabetes Mellitus
• 林淑霞、劉榮宏、殷偉賢、 陳冠群、葉明陽、蔡勝國、陳俐君
  Shu-Hsia Lin, Jorn-Hon Liu, Wei-Hsian Yin, Kuan-Chun Chen, Ming-Yang Yeh, Shen-Kou Tsai, Li-Chun Chen
• 遠距健康照護 ； 認知 ； 需求
  Telehealth ; Perception ; Needs
• 目標：本研究主要目的為調查民眾對遠距健康照護之認知及需求。方法：本研究採隨機抽樣台北市某醫院之心臟病、高血壓及糖尿病病患共500名，進行郵寄自填問卷調查。有效樣本數為125份。採用的統計分析方法有描述性統計、卡方檢定、及逐步複迴歸分析。結果：在進行填寫此份問卷前有77.6%的填答者表示未曾聽過或不暸解遠距健康照護；在閱讀過本研究問卷開頭簡短的引言介紹有關遠距健康照護後，大部分填答者認同使用遠距健康照護的好處有：減少健保資源浪費、減少就醫次數及節省看診時間、安心自主的居家療養老化、早期發現及改善疾病、即時得到醫療協助、養成個人良好的健康管理習慣、協助醫病溝通。超過80%的填答者認同影響使用遠距健康照護之因素有：(1)健保給付、(2)病情及日常照顧上需要、(3)儀器功能穩定可靠及操作簡易、(4)工作人員服務態度及異常狀況時之醫療協助等。超過88%的填答者認同健保局應將遠距健康照護納入健保給付。僅有五成填答者同意自費使用遠距健康照護。至於有需要使用遠距健康照護者中只有13.6%的填答者目前願意花錢購買此服務。有79.2%的填答者表示每月願付使用遠距健康照護之費用為1,000元（含）以下。結論：本研究顯示目前推行遠距健康照護最大的障礙在於民眾認識不足。然而，由本研究調查結果顯示當民眾擁有遠距健康照護相關資訊時，是能夠認同「使用遠距健康照護具有潛在益處」。「費用」是推行遠距健康照護之第二個障礙。僅有極少數的民眾願意花少許金錢購買使用遠距健康照護。國外已有許多文獻證實使用遠距健康照護是具有成本效益的優點，所以建請政府主管機關應積極思考推行更多有關強化民眾認識瞭解遠距健康照護優點的政策、及評估將遠距健康照護納入健保給付的可行性。
  Objectives: The objective of this study was to investigate the general public's perception and needs for telehealth services. Methods: The study randomly sampled 500 patients diagnosed with heart disease, hypertension or diabetes from the database of one regional hospital located in Taipei City. Self-administered questionnaires were mailed to their addresses. The final effective sample size was 125. Descriptive statistics, Chi-Square test and multi-regression analysis were utilized in the analysis. Results: Most of the respondents (77.6%) had never heard of or did not know about telehealth before the survey. After reading the brief introduction to telehealth in the questionnaire, most people agreed that there would be benefits from telehealth such as resourcesavings for National Health Insurance (NHI), ageing at home with comfort, early diagnosis and treatment of diseases, instantaneous medical assistance, assistance with self-care skills, and improved communication between patients and doctors. More than 80% of the respondents agreed that the factors influencing their demand for the services included whether or not (1) the services were covered by NHI; (2) they themselves had the needs; (3) the telehealth equipment was stable, reliable and user-friendly; (4) the medical professionals were nice to patients and provided on-time services. More than 88% of the respondents thought telehealth should be covered by NHI. Only 50% agreed that users should pay for the services. As to the demand for telehealth, only 13.6% were willing to purchase the service at present. When asked about an acceptable monthly payment for using the telehealth services, 79.2% of the respondents chose NT$1,000 or less. Conclusions: The results showed that the largest barrier to the development of telehealth services is the lack of knowledge among the general public. However, this survey demonstrated that people agree with the concept and the potential benefits of telehealth services when they have information about them. The second barrier is money. Few people are willing to pay out of their own pocket unless it is very inexpensive. As the literature had shown that telehealth is cost-effective, policy makers need to consider how to enhance public awareness of telehealth benefits and evaluate the feasibility of NHI coverage.
• 552 - 564
• 10.6288/TJPH2009-28-06-11