34卷1期

• Link 公衛論壇 Public Health Forum
• 公共衛生與健康不平等：三個歷史的教訓公共衛生與健康不平等：三個歷史的教訓
• 江東亮
  Tung-Liang Chiang
• 無
  none
• 無
  none
• 1-4
• 10.6288/TJPH201534103125

• Link 綜論 Review Article
• 補充保險費對解決健保財源不足問題的效果Determining the Effectiveness of Using the Supplementary Insurance Premium to Solve the Financial Problems of the National Health Insurance
• 梁景洋、 鄭清霞
  Ching-Yang Liang, Ching-Hsia Cheng
• 補充保險費 ； 平衡費率
  supplementary insurance premium ; balance of payment rate
• 我國全民健康保險自2002年7月起全面推動總額支付制度，雖然保險成本得以有效控制，不過於2009年卻累計近600億元的財務虧損，隔年將費率自4.55%調升至5.17%，才暫時解除健保財務危機，其主要原因在於保費收入成長有所侷限。為改善此問題，我國全民健康保險收費方式自2013年起出現重大變革，除維持現行健保計費方式之外，另行課徵雇主及保險對象補充保險費。雖然健保新制實施第一年(2013年)收取的補充保險費高達402億元，然此新制到底只是短暫改善財務問題的措施，亦或是長久改善財源不足問題的改革呢？本文推估一般保險費之平衡費率至2023年，研究結果發現十年內的平衡費率將突破法定費率的上限(6%)，屆時勢必恐將面臨全民健康保險法再度修法的壓力。此外，健保新制的實施能緩衝或延後修法的時間僅有一至三年，補充保險費只是短暫改善財務問題的措施，並無法長久改善健保財務收支失衡的問題。本文希冀透過各種情境下所估算的平衡費率資訊，做為主管機關規劃健保財務時之參考。
  The National Health Insurance (NHI) officially promoted the global budget payment system in July 2002. Although this system effectively controlled insurance costs, approximately NT$60 billion in accrual deficit accumulated during 2009. The premium rate increased from 4.55% to 5.17% in 2010, temporarily relieving the NHI financial crisis. The main cause for the financial problems was the limited growth of premium revenues. To resolve this problem, major reforms in the payment methods of the NHI were enacted in 2013. In addition to maintaining the existing payment methods, the supplementary insurance premium on employers and beneficiaries were added. Although the supplementary insurance premium collected NT$40.2 billion during the first year of implementing the new financing mechanism, whether this mechanism is a short-term or long-term solution remains unknown. This study evaluated the balance of payment rates until 2023, indicating that the statutory premium rate ceiling (6%) will be exceeded within 10 years, at which time a reamendment of the NHI Act will likely be required. This study provided the balance of payment rate estimated according to various scenarios, which can be used as a reference by the authority when making future adjustments.
• 5-20
• 10.6288/TJPH201534103099

• Link 原著 Original Article
• 2012年人工流產修法爭議之分析An Analysis of the Controversy over Proposed Revisions to Taiwan's Abortion Legislation in 2012
• 成令方
  Ling-Fang Cheng
• 人工流產 ； 強制輔導諮商 ； 強制思考期 ； 醫師同意權 ； 性別
  abortion ; mandatory waiting periods ; mandatory counseling ; consent from doctors ; gender
• 目標：2012年有四個人工流產修法版本交付立法院。其中楊麗環立委提案，提出「強制思考期6天」、「強制輔導諮商」，賴士葆立委提出「需經過二位醫師同意權」，均希冀降低墮胎率，提升生育率。政院版則主張「強制醫療諮詢」、「強制思考期3天」。吳宜蓁立委提出「醫療機構應提供人工流產資訊」、「各級地方政府應提供民眾生育健康諮詢」。故本文針對修法之爭辯論述進行分析。方法：本文採取三種研究法分析三類資料：(1)以論述分析分析國內外學術文獻、國際組織、政府統計數據與媒體新聞資料。(2)以描述性統計(descriptivestatistics)分析2007及2008年分別對婦女和婦產醫師進行「強制思考期」、「強制輔導諮商」之調查結果。(3)以文本分析方式分析婦女和醫師回答調查問卷中開放性的問題。結果：楊版與政院版提出的「強制思考期」，與實情不符。本研究調查，孕婦從知道非預期懷孕到決定人工流產，再到實際求醫都已經等待、思考超過一週甚至一個月。楊版與政院版提出的「強制輔導諮商」則是違反人權公約與諮商專業倫理。賴版的「二位醫師同意」，對婦女就醫造成困難，受到婦產科醫師的反對。結論：在2012年修法爭議中浮現二種論述，其中「嚴格管控論述」缺乏學術研究支持，與本研究提出的婦女與醫師的調查結果不符合，也不合乎心理諮商專業倫理原則。眾多研究也顯示「強制思考期」與墮胎率高低無顯著關連。「婦女中心論述」合乎婦女的實際現狀的需求，而本研究中婦產科醫師提出的「病患為中心」論述的倫理實踐，則可作為支持「婦女中心論述」的依據。至於有效降低墮胎率，政策制訂者應重視避孕措施的普及，改善經濟與社福大環境，促使婦女願意保留非預期懷孕之胎兒。
  Objectives: Four revised versions of Taiwan's abortion legislation were proposed in 2012 and raised controversy. Legislators led by Li-huan Yang proposed a six-day 'mandatory waiting periods' coupled with 'mandatory counseling'. Legislators led by Shi-bao Lai proposed 'consent from two doctors'. Both of these aimed to reduce the abortion rate and increase the birth rate. The Administrative Yuan for its part proposed a 'mandatory waiting period' of three days plus 'mandatory counseling'. And finally, legislators led by Yi-chen Wu proposed that medical institutions should provide all kinds of information related to abortion', and that local government 'should provide birth counseling to citizens'. This paper aims at analyzing the controversy. Methods: Three methods are adopted. (1) Discourse analysis is applied on documents collected from legal and medical research papers, government data and news reports. (2) Descriptive statistics is applied on two surveys conducted in 2007 and 2008 on women and obgynecologists nationwide respectively. (3) Text analysis is applied to the written texts provided by women and ob-gynecologists on some open-ended questions in the survey. Results: The 'Mandatory waiting periods' as proposed by Yang and the Administrative Yuan is found to lack consideration of reality, as our survey shows that most women considering the terminating of an unplanned pregnancy have already been thinking much longer than the stipulated period, typically having already done this for periods ranging from over one week to a whole month. As regards 'mandatory counseling', this is found to be in violation of human rights and professional ethics. As to 'consent from two doctors', this is found to create difficulties for women, and is opposed by a majority of ob-gynecologists. Conclusions: Two types of discourse appear in the controversy, the 'restrictive and controlling discourse' receives little support from academic research, or in surveys of women and physicians, and also runs counter to the professional ethics of counseling. Many research findings have shown that 'Mandatory waiting periods' do not contribute to the reduction of the abortion rate. The 'women centered discourse' reflects the women's needs and practice on the matter, and the 'patient centered discourse' practiced by ob-gynecologists can give support to 'women centered discourse'. As for an effective reduction of abortion rate, the paper finds that policy makers would achieve greater success by promoting greater use of contraceptives, and improving economic and social welfare, thus enabling women to consider keeping unplanned fetuses.
• 21 - 35
• 10.6288/TJPH201534103049

• Link 評論 Commentary
• 評論：圍繞著墮胎法修法的躁動Commentary: the restless struggle around the revision of Abortion Act in Taiwan
• 江盛
  Sheng Chiang
• 無
  none
• 無
  none
• 36 - 36
• 10.6288/TJPH20153410304901

• Link 原著 Original Article
• 探討社經地位對血管支架置入病患死亡風險之影響Impact of Socioeconomic Status on Mortality Following Stent Implantation
• 黃鈞奕、陳慧珊、 張嘉恬、吳肖琪
  Chun-I Huang, Hui-Shan Chen, Chia-Tien Chang, Shiao-Chi Wu
• 社經地位 ； 血管支架 ； 塗藥支架 ； 死亡
  socioeconomic status ; stents ; drug-eluting stents ; mortality
• 目標：台灣全民健保大幅減少民眾就醫費用之負擔，改善民眾就醫可近性，在此情況下是否能消弭健康不平等？本研究針對接受治療冠心病的重要方法－血管支架置放術(stentimplantation)之患者，探討社經地位是否會影響其死亡情形。方法：本研究採回溯性世代研究法，使用2008-2010年全國健保及相關次級資料，以2009年第一次接受血管支架置入之成年病患(19,113位)為研究對象，以邏輯斯迴歸探討血管支架置入病患之社經地位(教育程度與收入狀況)對其一年內死亡情形之影響，並控制病人特質、共病症指數及醫院特質。結果：2009年接受血管支架置入新個案之一年內心血管疾病死亡率為5.65%、全死因死亡率為11.93%。校正相關變項後發現，教育程度為小學以下者之心血管疾病死亡及全死因死亡風險分別為大專以上者之1.37倍(95%CI=1.06-1.77)及1.54倍(95%CI=1.28-1.85)；而低收入者之心血管疾病死亡及全死因死亡風險分別為高收入者之1.22倍(95%CI=1.02-1.46)及1.16倍(95%CI=1.02-1.32)，教育程度之差距較收入差距大。結論：接受血管支架置入病患在死亡風險上存在社經差異，建議衛生主管單位可加強提升低社經族群的健康識能，以縮小不同社經地位之血管支架置入病患的健康差距。
  Objectives: The burden of medical expenditures has been reduced and the accessibility to health care has improved as a result of the implementation of the Taiwan National Health Insurance program. Nevertheless, does health inequality still exist? The objective of this study was to determine the association between the cross-level effects of individual socioeconomic status (SES) on mortality in patients who have undergone stent implantation in Taiwan. Methods: This study involved a retrospective cohort. Adults from the 2008-2010 Taiwan National Health Insurance database who underwent stent implantation in 2009 and relative secondary data were examined. Logistic regression models were performed to determine the effect of SES (educational level and income status) on the 1-year mortality rate by controlling the characteristics of patients and major health care organizations. Results: The 1-year mortality rate of patients who underwent stent implantation in 2009 was 11.93%. Patients with a primary school level of education had a 1.54-fold risk of death compared to patients with a university education after controlling for other factors (OR=1.54, 95% CI=1.28-1.85), and the risk of death in the low-income group was 1.16- fold that of the high-income group (OR=1.16, 95% CI=1.02-1.32). Conclusions: Disparities in mortality exist between different SES groups. If the government enhances healthy literacy in the low-SES group, the gap in health disparities for patients who undergo stent implantation might decline.
• 37 - 49
• 10.6288/TJPH201534103062

• Link 原著 Original Article
• 台灣地區兒童急診醫療利用及其相關因素之研究Factors Associated with Emergency Medical Care Utilization among Children in Taiwan
• 沈希哲、胡鎮如、李中一、柯明中、 陳楚杰
  Hsi-Che Shen, Cheng-Ju Hu, Chung-Yi Li, Ming-Chung Ko, Chu-Chieh Chen
• 兒童 ； 急診醫療利用 ； 全民健康保險研究資料庫
  children ; emergency medical care utilization ; National Health Insurance Research Database (NHIRD)
• 目標：本研究旨在探討我國兒童急診醫療利用情形，及影響兒童急診醫療利用及成為經常利用急診醫療者的相關因素。方法：使用國家衛生研究院發行之全民健康保險研究資料庫的2005年百萬人抽樣歸人檔，以得到兒童急診醫療利用的資料。使用複邏輯斯迴歸分析影響兒童急診醫療利用及成為經常利用急診醫療者的因素。結果：2005年我國全民健康保險的被保險人中兒童共計有233,382位，有43,976人(18.84%)共使用急診醫療65,839人次。在利用急診醫療方面，男童、都市兒童、有重大傷病兒童及門診次15次以上兒童利用急診醫療的機率較高，相較於未滿1歲兒童，1歲至6歲兒童利用急診醫療的機率較高，但7歲以上兒童則較低。在成為經常利用急診醫療者方面，男童、未滿1歲兒童、有重大傷病兒童、門診次15次以上兒童、都市兒童成為經常利用急診醫療者的機率較高。結論：男童、有重大傷病兒童、門診利用次數多的兒童、都市兒童，其利用急診醫療及成為經常利用急診醫療者的機率較高。
  Objectives: This study aimed to determine emergency medical care (EMC) utilization among children in Taiwan and factors associated with EMC utilization. Methods: This was a populationbased study using the Longitudinal Health Insurance Database of 2005 (LHID 2005), which was released by the National Health Research Institutes. All emergency department visits among children <18 years of age in 2005 were analyzed to determine the rates and factors associated with EMC utilization. A multivariate logistic regression model was used to assess the independent effect of various characteristics on the risk of EMC utilization. Results: Of 233,382 children, 43,976 (18.84%) had emergency department visits accounting for 65,839 emergency department visits. Compared with girls, boys were more likely to utilize EMC. Compared with children < 1 year of age, children 1-6 years of age had a higher risk of utilizing EMC. Compared with children living in urban areas, children living in suburban areas were less likely to utilize EMC. Children with catastrophic diseases were more likely to use EMC. Children with ? 15 outpatient department visits had a lower risk of EMC utilization compared to children with 16-20 and ? 21 outpatient department visits. Boys were more likely to have frequent EMC utilization. Compared with children < 1 year of age, children 7-11 or 12-17 years of age had a lower risk of frequent EMC utilization. Children with catastrophic diseases were more likely to have frequent EMC utilization. Children with ? 15 outpatient department visits had a lower risk of frequent EMC utilization than children with 16-20 and ? 21 outpatient department visits. Conclusions: Boys, children with catastrophic diseases, children living in urban areas, and children with more outpatient department visits were more likely to utilize EMC and have frequent EMC utilization.
• 50 - 60
• 10.6288/TJPH201534103108

• Link 原著 Original Article
• 台灣地區高中職學生正確使用止痛藥知識、態度與行為之研究Knowledge, Attitudes, and Behavior Regarding Correct Analgesic Use among Senior/Vocational High School Students in Taiwan
• 楊俊龍、張鳳琴、 紀雪雲、黃莉蓉
  Jyun-Long Yang, Fong-Ching Chang, Hsueh-Yun Chi, Li-Jung Huang
• 高中職 ； 止痛藥 ； 知識 ； 態度 ； 行為
  senior/vocational high school ; analgesics ; knowledge ; attitudes ; behavior
• 目標：本研究目的在探討台灣地區高中職學生正確使用止痛藥知識、態度與行為的現況及其相關因素。方法：研究對象為102學年度第一學期全國高中職學生，採等比機率抽樣。研究工具採自填結構式網路調查問卷，共調查33所學校，計2,910名學生完成填寫。結果：五成以上受測學生答錯或不知道成年人每天使用解熱鎮痛藥不可以超過4,000毫克。約三成學生不曉得解熱鎮痛藥會產生肝毒性。複迴歸分析顯示，學生年級愈高、疼痛問題處理方式是服用醫師開立的止痛藥、使用藥品以外的方法(如熱／冷敷、按摩等)，資訊來源為家人，會看止痛藥使用標示及正確使用止痛藥知識、態度、效能、藥袋素養愈高者，其正確使用止痛藥行為表現愈好。疼痛問題處理方式是服用家人／朋友提供止痛藥品以及在過去一年曾服用消炎止痛藥的學生，其正確使用止痛藥行為表現愈不好。結論：建議學校與藥師合作，增能師生正確使用止痛藥知能，鼓勵推動正確用藥親子教育活動。
  Objectives: The purpose of this study was to determine students' knowledge, attitudes, and behavior regarding the correct use of analgesics and to examine the related factors. Methods: A probability-proportionate-to-size sampling method was used. Thirty-three senior/vocational high schools were randomly selected. A total of 2,910 students completed the online selfadministered questionnaire in 2013. Results: Greater than one-half of the students did not know that when taking pain medication containing acetaminophen, adults should not exceed 4,000 mg per day. Approximately 22.1% of the students were unaware of the hepatotoxicity risk associated with acetaminophen. Multiple regression analysis showed that students in higher grades who had greater levels of correct analgesic knowledge, attitude, and self-efficacy, take analgesic prescriptions and use other pain management techniques, such as hot/cold therapy, relaxation, and massage, and were more likely to demonstrate correct analgesic use behaviors if they had received pain management information from family members and had read the warning labels. In contrast, students taking analgesics from drug stores or family/friends were more likely to practice poor analgesic use behavior. Conclusions: The promotion of partnerships between schools and pharmacists is suggested, along with the implementation of teachers' training workshops, students' education programs, and parent-child activities in order to enhance correct analgesic use literacy.
• 61 - 73
• 10.6288/TJPH201534103081

• Link 原著 Original Article
• 新移民保健媒體的設計和評估－以台北新移民小兒過敏保健媒體的設計為例Development and Evaluation of Healthcare Media for New Immigrants: A Case Study of the Design of Children's Allergy Healthcare Media for New Immigrants in Taipei, Taiwan
• 洪雅玲、陳凱倫、 Catherine Stones、Thomas Cassidy
  Yah-Ling Hung, Kai-Ren Chen, Catherine Stones, Thomas Cassidy
• 新移民 ； 保健媒體 ； 可用性評估
  new immigrant ; healthcare media ; usability evaluation
• 目標：本研究目的是規劃有用的設計策略，以幫助健康信息的設計師，設計新移民適用的保健媒體。方法：這項研究將分六個階段實施，其中包括焦點團體訪談、測試媒體的設計、可靠性和有效性測試、問卷調查、觀前觀後的理解能力測試與使用者評估。結果：移民母親照護子女的健康常遇到的問題，包含語言，信心，知識，文化，如何照顧，以及使用醫療媒體六個因素。手冊與網站的健康干預均產生了明顯的效果，然而手冊效果與網站效果並沒有顯著差異。新移民評估保健媒體的標準可分為內容品質、外觀品質、過程品質。結論：如何幫助新移民使用保健媒體來照顧子女仍處於早期發展階段。建議未來研究影響移民用戶學習健康資訊的特點，確定這些因素並結合解決方案，可以有效地優化健康干預的信息系統。
  Objectives: The aim of this study is to establish useful design strategies for health Information designers when planning and designing healthcare media for new immigrants. Methods: The study is implemented in six stages, namely, a focus group interview, the development of testing media, reliability and validity tests, a questionnaire survey, pre-post knowledge tests, and a usability survey. Results: The results suggest that the key challenges for immigrant mothers when caring for their children's health relate to six factors, namely language, confidence, knowledge, culture, how to take care, and the use of healthcare media. The findings indicate that both leaflet intervention and website intervention are effective and there is no significant difference between them; furthermore, the criteria new immigrants use to evaluate healthcare media can be analysed in terms of the quality of the content, appearance, and process. Conclusions: The study concludes that efforts to assist new immigrants to take care of their children's health by applying healthcare media are still at an early stage of development. Further study is needed to identify which of the characteristics of immigrant users impact their ability to learn about health information in order to incorporate these into an effective health intervention medium that optimises information systems.
• 74 - 85
• 10.6288/TJPH201534103075

• Link 原著 Original Article
• 中老年人吸戒菸行為對失能影響之長期追蹤研究Effects of Smoking and Smoking Cessation on Physical Functional Disability among Middle-Aged and Elderly Persons: A Longitudinal Analysis
• 范雅渝、李玉春
  Ya-Yu Fan, Yue-Chune Lee
• 吸菸 ； 戒菸 ； 失能
  smoking ; smoking cessation ; physical functional disability
• 目標：本研究應用失能形成進程模式，探討中老年人不同吸、戒菸行為對失能情形之影響，以進一步了解生活型態中的風險因子-吸菸與身體活動功能間的關聯。方法：採縱貫性研究設計，使用『台灣地區中老年身心社會生活狀況長期追蹤調查』1989~2007年共計6波之調查資料，以50歲以上且調查基期時未失能之中老年人為研究對象；並以邏輯斯迴歸及Cox's比例風險模式分析校正人口學特質及健康狀況等背景變項後，吸、戒菸行為對中老年人失能之影響。結果：控制相關影響因素後，吸菸者之失能風險顯著較未吸菸者高，但已戒菸者之失能風險則與未吸菸者無顯著差異；吸菸年數亦與失能有關；而戒菸部分，在60歲前戒菸與戒菸年數大於15年者，其失能風險皆與未吸菸者無顯著差異。結論：中老年人不同之吸、戒菸行為對失能情形有不同之影響，故菸害防制相關政策除勸導大眾勿吸菸外，亦應鼓勵吸菸者儘早戒菸。
  Objectives: To determine whether or not different smoking behavior would have different effects on the elderly, we used the disablement process model to examine the associations between smoking, smoking cessation, and physical functional disability among middle-aged and elderly persons. Methods: This study was based on a longitudinal study design, applying data obtained from the ”Survey of Health and Living Status of Middle Aged and Elders in Taiwan,” which had been conducted in 1989, 1993, 1996, 1999, 2003, and 2007 by the Health Promotion Administration of the Ministry of Health and Welfare. The study populations were middle-aged and elderly persons > 50 years of age, and physically functional independent in Taiwan. Logistic regression and Cox's proportional hazards model were performed to examine the relationship between the independent and dependent variables after controlling for confounding factors. Results: There was a positive association between smoking, smoking cessation, and physical functional disability among middle-aged and elderly persons. Smokers had higher risks of physical functional disability than never-smokers after controlling for other factors. There were no significant differences on physical functional disability between former smokers and neversmokers. Whether former smokers or smokers, a longer duration of smoking was associated with poorer physical performance. No significant differences existed between former smokers who had quit smoking > 15 years, former smokers who had quit smoking under 60 years of age, and neversmokers. Conclusions: Different smoking status and different smoking cessation behavior leads to different effects on physical performance. Based on the results of this study we suggest that the Health Promotion Administration of the Ministry of Health and Welfare should recommend people not to smoke, encourage smokers to quit smoking as soon as possible, and be committed to promoting a smoke-free environment.
• 86 - 102
• 10.6288/TJPH201534103069

• Link 原著 Original Article
• 台灣不同地區之氣溫與全死因及心血管疾病死亡風險之相關分析Ambient Temperature and All-cause and Cardiovascular Diseases Mortality Risk by Areas in Taiwan
• 林于凱、俞菘維、林沛練、王玉純
  Yu-Kai Lin, Sung-Wei Yu, Pay-Liam Lin, Yu-Chun Wang
• 溫度 ； 死亡 ； 全死因 ； 心血管
  temperature ; mortality ; all causes ; cardiovascular
• 目標：本研究探討2000-2008年間台灣民眾暴露地區別大氣溫度所增加的全死因及心血管疾病死亡風險。方法：將台灣本島區分為7個區域來進行分析，利用遞延非線性分配模式(distributed lag non-linear model)分析在各地區內族群暴露熱季(5-10月)高溫累加8日及冷季(1-4月及11-12月)低溫累加26日之全死因(ICD-9000-999)及心血管死因(ICD-9390-459)死亡相對風險及其95%信賴區間(confidence intervals, CI)。結果：台灣地區族群暴露於低溫時的全死因及心血管死亡風險大於高溫暴露之影響，低溫下降，相對風險明顯增加，其中，心血管疾病死亡受到低溫的影響更勝於全死因。冷季極端低溫所造成的死亡效應以桃竹苗地區風險最高，對全死因及心血管死亡風險分別可高達2.21(95% CI: 1.33-3.67)及4.09(95% CI: 1.39-12.03)；雲嘉南及高屏地區全死因死亡則顯著與熱季極端高溫相關，但高溫與心血管的死亡效應則較不顯著。花東地區僅心血管死亡與高溫呈顯著相關。結論：本研究所建立的最低死亡風險溫度及對應之極端溫度死亡風險結果，可做為各區域未來建置高低溫預警及衛生單位應變系統之參考。
  Objectives: To evaluate the all-cause (ICD-9 000-999) and cardiovascular diseases (ICD-9 390-459) mortality risks associated with regional ambient temperatures in Taiwan between 2000 and 2008. Methods: We applied the distributed lag non-linear model to estimate the 8-day cumulative mortality risks associated with high temperatures during the hot season (May-October) and 26-day cumulative mortality risks associated with low temperatures during the cold season (November-April) in 7 study areas. Area cause-specific mortality risks were estimated in association with daily average temperatures at Z±1 and ±2 and by study season. Results: The mortality risks in Taiwan were greater from low temperatures than hot temperatures, especially for mortality from cardiovascular diseases. The mortality risk associated low temperatures was highest in the Taoyuan-Hsinchu-Miaoli area, with relative risks of 2.21 (95% confidence interval [CI]: 1.33-3.67) for all-cause and 4.09 (95% CI: 1.39-12.03) for cardiovascular diseases. High temperatures also elevated the all-cause mortality, but not cardiovascular diseases mortality, in the Yunlin-Chiayi-Tainan and Kaohsiung-Pingtung areas. In contrast, extremely high temperatures were associated with cardiovascular diseases mortality in the Hualien-Taitung area only. Conclusions: Cumulative all-cause and cardiovascular diseases mortality risks for high and low temperatures are various among regions in Taiwan. This study provides the reference for a temperature-health warning and response system for the local health authority in Taiwan.
• 103 - 114
• 10.6288/TJPH201534103039