35卷6期

• Link 公衛論壇 Public Health Forum
• 台灣應平衡城鄉防疫醫療以因應蚊媒傳染病威脅The imperative of urban-rural rebalance concerning mosquito vectored disease threats in Taiwan
• 無
  Justin Cheung
• 無
  none
• 無
  none
• 567 - 569
• 10.6288/TJPH201635105050

• Link 公衛論壇 Public Health Forum
• 「不拋下任何人」的公平：揭露健康不平等的資料策略及挑戰「不拋下任何人」的公平：揭露健康不平等的資料策略及挑戰
• 廖漢騰
  廖漢騰
• 無
  none
• 無
  none
• 570 - 574
• 10.6288/TJPH201635105094

• Link 原著 Original Article
• 嘉南地區細懸浮微粒濃度與氣象因子相關性分析：2006-2014Correlations between atmospheric fine particulate matter and meteorological variables in the Chia-Nan Area of Taiwan, 2006-2014
• 黃淑倫、 林裕清、郭素娥、紀妙青、 林玠模、 周姜廷、黃友珊
  Su-Lun Hwang, Yu-Ching Lin, Su-Er Guo, Miao-Ching Chi, Chieh -Mo Lin, Chiang-Ting Chou, Yu-Shan Huang
• 嘉南地區 ； 細懸浮微粒 ； 氣象因子
  Chia-Nan Area ; fine particulate matter ; meteorological variables
• 目標：本研究探討嘉南地區大氣中細懸浮微粒(fine particulate matters, PM_(2.5))濃度與氣象因子相關性分析。方法：研究蒐集並分析2006-2014年行政院環保署空氣品質監測站PM_(2.5)與氣象資料(溫度、相對濕度、降雨量及風速)。研究區域為嘉南地區共計四縣市，分別為嘉義縣市(共3個測站：新港、朴子與嘉義)，台南縣市(共4個測站：新營、善化、安南與台南)。以四分位數(25%、50%及75%)、平均值、最小值及最大值進行PM_(2.5)及氣象資料描述性資料分析。進一步以皮爾森積差相關(Pearson product correlation)，探討PM_(2.5)濃度與氣象因子之相關性。結果：嘉南地區PM_(2.5)日平均38 μg/m^3，溫度日平均24℃，相對濕度日平均75%，累積降雨量日平均12.1 mm，風速日平均2.3 m/sec。嘉南地區PM_(2.5)濃度與溫度(r = -0.446)、相對濕度(r = -0.327)、累積降雨量(r = -0.279)與風速(r = -0.173)呈現統計上顯著負相關。此外，東北季風期間，風速與PM_(2.5)濃度之相關係數絕對值最大(r = -0.371)。非東北季風期間，溫度與PM_(2.5)濃度之相關係數絕對值最大(r = -0.525)。結論：嘉南地區PM_(2.5)濃度與氣象因子之風速與溫度相關性較高。
  Objectives: This article explors corrections between the fine particulate matter (PM_(2.5)) level and meteorological variables in the Chia-Nan area of Taiwan. Methods: Data regarding PM_(2.5) and meteorological variables (i.e., temperature, relative humidity, rainfall, and wind speed) between 2006 and 2014 were obtained from Environmental Protection Administration monitoring stations. The region studied is located in 4 southwestern districts (Chiayi City, Chiayi County, Tainan City, and Tainan County) and includes 3 ambient air quality-monitoring stations in Chiayi (Chiayi, Xingan, and Puzi stations) and 4 stations in Tainan (Xinying, Shanhua, Annan, and Tainan stations). Quartiles (25%, 50%, and 75%) and mean, minimum, and maximum levels were used to describe the characteristics of PM_(2.5) and meteorological variables, respectively. The relationship between PM_(2.5) and meteorological variables was estimated using the Pearson product correlation. Results: During the study period, the overall mean daily average level of PM_(2.5), temperature, relative humidity, cumulative level of rainfall, and wind speed were 38 µg/m^3, 24°C, 75%, 12.1 mm, and 2.3 m/s, respectively. In the Chia-Nan area of Taiwan, PM_(2.5) was negatively correlated with temperature (r = -0.446), relative humidity (r = -0.327), cumulative rainfall (r = -0.279), and wind speed (r = -0.173). During the Northeast Monsoon period, the absolute value of the correlation between wind speed and PM_(2.5) level was the largest (r = -0.371). However, during the Non–Northeast Monsoon period, the absolute value of the correlation between temperature and PM_(2.5) concentrations was the largest (r = -0.525). Conclusions: Wind speed and temperature have higher correlations with PM_(2.5) levels than do relative humidity and cumulative rainfall in the Chia- Nan area of Taiwan.
• 575 - 586
• 10.6288/TJPH201635105066

• Link 原著 Original Article
• 專責外傷制度成效之初探－以台南市某醫學中心為例Preliminary study of the effectiveness of trauma care system at a medical center in Tainan
• 王志榮、顏淑婷、黃詩芳、沈延盛、應純哲
  Chih-Jung Wang, Shu-Ting Yen, Shih-Fang Huang, Yan-Shen Shan, Jeremy C. Ying
• 專責外傷制度 ； 重大外傷 ； 持續性品質改善
  trauma care system ; major trauma ; continuous quality improvement
• 目標：為了解專責外傷制度成立後，執行持續性品質改善計畫(Continuous quality improvement, CQI)對於外傷病人照護品質是否持續改善。方法：本研究以病歷回溯方式，利用外傷登錄資料庫分析個案醫院成立外傷科後所收治之病人共1,619人。將其分為成立初期(2011~2013，895人)及成立近期(2014~2015，724人)，利用獨立樣本t檢定及卡方檢定檢視系統反應時間：包含接受緊急動脈栓塞(Transcatheter Arterial Embolism, TAE)與緊急胸腹手術病人在急診停留時間及緊急胸腹手術病人在鍵入刀序後至手術室時間，另對重大外傷(Injury Severity Score, ISS≧16)病人預後：包含住院天數及死亡率等變項進行差異性分析。結果：ISS在成立近期有顯著增加，由15.09增加到18.62；接受TAE病人於急診停留時間由143.52分鐘減少為117.94分鐘；另外在嚴重外傷(ISS=16~24)病人的住院天數由成立初期21.13天減少為成立近期16.27天，死亡率亦由5.34%降為1.03%，在統計上皆呈現顯著性差異。結論：專責外傷制度及持續性外傷品質改善計畫能有效提升急診處理病人的效率，且在嚴重外傷(ISS=16~24)族群可以減少住院天數及死亡率。
  Objectives: To evaluate the quality of care for trauma patients following the implementation of continuous quality improvement (CQI) in a trauma care system. Methods: This was a retrospective chart review study using the trauma registry database of a medical center in Tainan from 2011 to 2015. The patients were classified into two groups: the years 2011~2013 (early period, N=895) and 2014~2015 (late period, N=724). Chi-square and t-test analyses were used to examine the indicators: duration of stay in the emergency room (ER) for emergency transcatheter arterial embolism (TAE)/torso surgeries, waiting time after scheduled for torso surgery, and length of stay (LOS)/mortality rate of patients with an Injury Severity Score (ISS) greater than 15. Results: The average ISS of the late period group was significantly higher (18.62 vs. 15.09) and the duration of stay in the ER for emergency TAE was significantly lower (117.94 vs. 143.52) than those of the earlier period group. In addition, the LOS declined significantly (16.27 vs. 21.13), and the mortality rate was significantly reduced (1.03% vs. 5.34%) among patients with an ISS of 16~24. Conclusions: CQI in a trauma care system was effective in the ER management of trauma with significant reductions in LOS and mortality rate in patients with an ISS of 16~24.
• 587 - 594
• 10.6288/TJPH201635105080

• Link 原著 Original Article
• 風險校正模式於健保論人計酬制度之應用：以高屏家醫群為例The application of risk adjustment models to predict health expenditures under the capitation payment system in family medicine practice groups in the Kaoping Area
• 邱姵穎、張清雲、 蔡麗伶、張玉蓉、謝慧敏
  Pei-Yin Chiu, Ching-Jun Chang, Lih-Ling Tsai, Yu-Jung Chang, Hui-Min Hsieh
• 論人計酬支付制度 ； 社區醫療群模式 ； 風險校正計價模式 ； 家庭醫師整合性照護計畫
  capitation payment system ; community care medical group model ; risk-adjusted prediction model ; primary care physician integrated care plan
• 目標：本研究結合現行的家庭醫師整合性照護計畫與論人計酬支付模式，分析高屏地區鄉村型與都市型家醫群診所就醫病患樣本，探討影響醫療費用之風險校正因子，並建構適合預測醫療費用模式。方法：本研究資料來源主要為2012-2013年全民健保申報資料，和高屏地區鄉村與都市二個區域有參加「家庭醫師整合性照護計畫」診所就診的病人資料。先隨機抽樣一個地區家醫群診所就醫病患病人作為訓練樣本，建立預測醫療費用的風險校正模型，並與其他兩組隨機抽樣家醫群診所樣本進行模型組內和組間的交叉驗證，以評估及確認風險調整模型之預測能力。結果：鄉村型與都會型家醫群驗證樣本人口學特性或醫療利用特質差異影響實際醫療資源利用。鄉村型病人六十歲以上比例和疾病嚴重度相對都會型家醫群樣本較高，反應在2013年實際醫療總費用分別為29,658點和25,087點。另外，風險校正費用預測模型隨著加入變項數而影響醫療費用的預測力，校正後預測力R^2從6.19%增加到40.20%。結論：當進行風險計價模型時，應考量適切的風險因子和合理的成長率，以增加風險計價的準確度和推估的敏感度，並且視地區費用成長特性和個別族群病人風險特質，適切地反應其醫療資源耗用狀況，以確保醫療照護就醫公平性及醫療資源有效分配與利用。
  Objectives: The aims of this study were to investigate the risk factors associated with patients' health expenditures and to apply risk-adjusted medical expenditure prediction models using the primary care physician integrated care plan and the capitation payment model. Methods: Data were drawn from the 2012-2013 national health insurance (NHI) claims data and the primary care physician integrated care plan data for two primary care groups (one in a rural and the other in an urban area of the Kaoping area in southern Taiwan). We randomly selected one group of patients from one primary care group as a training set to conduct the risk-adjusted models, and compared two random samples from rural and urban primary care groups to assess the within and between group validity of the prediction models. Results: This study supported an association between patients' demographic or comorbid characteristics and health expenditures in the rural and urban primary care patient groups. Patients in the rural area were age sixty or older and their health expenditures in 2013 were greater than those in the urban group (NTD 29,658 vs. 25,087). In addition, the model's goodness-of-fit measured as adjusted R^2 increased from 6.19% to 40.20% when more risk factors were added to the risk-adjusted health expenditure models. Conclusions: When risk-adjusted models to predict medical costs are used, appropriate risk factors and reasonable growth rates need to be considered in order to increase the accuracy and sensitivity of the prediction of medical costs. Moreover, geographic variability also needs to be considered in order to reflect the consumption of medical resources in different areas and to ensure the horizontal equity and efficient allocation of medical resources across rural and urban areas.
• 595 - 608
• 10.6288/TJPH201635105044

• Link 評論 Commentary
• 評論：風險校正模式於健保論人計酬制度之應用：以高屏家醫群為例Commentary:The application of risk adjustment models to predict health expenditures under the capitation payment system in family medicine practice groups in the Kaoping Area
• 郭年真
  Raymond N. Kuo
• 無
  none
• 無
  none
• 609 - 610
• 10.6288/TJPH20163510504401

• Link 原著 Original Article
• 推估高風險手術集中化政策對照護結果影響之成效探討－以心血管處置為例The implementation of centralization for high-risk surgery- estimating potentially avoidable outcomes of cardiac procedures
• 陳靖怡、鍾國彪、 郭年真
  Ching-Yi Chen, Kuo-Piao Chung, Raymond N. Kuo
• 集中化政策 ； 高風險處置 ； 可避免不良照護結果發生人數 ； 病人就醫可近性 ； 醫療收入
  centralization ; high-risk surgery ; potentially avoidable outcome ; accessibility to care ; medical revenue
• 目標：探討若台灣針對經皮冠狀動脈氣球擴張術(PTCA)及冠狀動脈繞道手術(CABG)實施集中化政策，(1)對於病患處置後30日不良照護結果、(2)就醫可近性；以及(3)低服務量醫院之住院醫療收入之影響。方法：本研究對象為2010至2012年各年度第一次PTCA以及CABG之病患，以多階層羅吉斯迴歸以及G-Computation來估計可避免不良照護結果之事件發生人數，並且預測在集中化後病患需額外跨區就醫之人數。最後，瞭解醫院執行心臟處置之醫療收入占當年度住院醫療收入之比例來推測低服務量醫院在住院醫療收入的影響程度。結果：在2010年至2012年間，共有29,689人至低服務量醫院接受PTCA及4,150人接受CABG。集中化後，預估PTCA及CABG可避免死亡人數各有442人及127人，並且需額外跨區就醫的比例分別約為12%及18%。此外在低服務量醫院住院醫療收入影響上，平均各醫院每年可能將損失2%之CABG住院醫療收入；而PTCA則約損失6%。結論：集中化政策對於整體照護結果可以帶來正向影響，並對大部分病患就醫可近性及低服務量醫院財務的影響有限。
  Objectives: The aim of this study was to estimate how many adverse outcomes could potentially be avoided in Taiwan if a centralization policy were implemented for Percutaneous Transluminal Coronary Angioplasty (PTCA) and/or Coronary Artery Bypass Grafting (CABG). We further examined how such a policy might affect accessibility to care as well as the potential for financial losses in low-volume hospitals. Methods: The study population included 9530 patients who underwent PTCA or CABG for the first time between 2010 and 2012. We used multilevel logistic regression and G-computation to estimate the number of potentially avoidable adverse outcomes, and we predicted how many patients would have to travel farther to access medical care as a result of a centralization policy. Finally, we predicted the impact that centralization of surgery would have on inpatient revenue in low-volume hospitals by calculating the ratio of revenue from inpatient cardiac procedures to total hospital inpatient revenue. Results: We found that 4,150 of the 9,530 patients who underwent CABG were admitted to low-volume hospitals. We estimated that centralization of PTCA and CABG could reduce the number of deaths by 442 and 127, respectively, and 12% of the patients who underwent PTCA and 18% of patients who underwent CABG would have to travel farther to access medical care. We determined that low-volume hospitals incurred financial losses of approximately 6% and 2%, respectively, by referring PTCA and CABG patients to higher-volume surgical centers. Conclusions: Centralization policies could have a positive impact on healthcare outcomes, only a minor impact on accessibility to care for patients, and minor financial consequences for low-volume hospitals.
• 611 - 630
• 10.6288/TJPH201635105071

• Link 原著 Original Article
• 國軍醫院免費戒菸門診成效之探討The effectiveness of a free smoking cessation clinic for military personnel
• 邱于容、陳劭淇、江香慧、黃姝嘉、賴錦皇、李善茹、曾雅梅、林富宮、高森永
  Yu-Lung Chiu, Shao-Chi Chen, Shiang-Huei Jiang, Shu-Jia Huang, Ching-Huang Lai, Shan-Ru Li, Ya-Mei Tzeng, Fu-Gong Lin, Senyong Kao
• 戒菸門診 ； 戒菸 ； 經濟誘因 ； 軍人
  smoking cessation clinic ; smoking cessation ; financial incentives ; military personnel
• 目標：因國軍人員吸菸盛行率高於一般成年男性，國防部提供補助以增加戒菸門診的利用。本研究旨在比較軍人使用免費戒菸門診與自行戒菸者之戒菸成效，並找出影響戒菸成功的因素。方法：採觀察性研究，研究對象為吸菸軍人且有戒菸意願者，再依據研究對象的意願分為2組，免費戒菸門診組有222人，自行戒菸組405人。免費戒菸門診組會接受8週的醫師諮詢及藥物治療，而自行戒菸組不接受任何協助。研究工具為自擬結構式問卷，以電話方式追蹤一個月及三個月點戒菸率及連續戒菸率。結果：免費戒菸門診組點戒菸率顯著高於自行戒菸組(一個月23.9% vs. 11.6%, p ＜ 0.001；三個月27.9% vs. 5.7%, p ＜ 0.001)。免費戒菸門診組連續戒菸率顯著高於自行戒菸組(一個月20.3% vs. 5.9%, p ＜ 0.001；三個月27.0% vs. 5.7%, p ＜ 0.001)。三個月戒菸成效影響因素為組別(免費戒菸門診組 vs. 自行戒菸組)、教育程度(大學以上 vs. 高中職)、性別(女 vs. 男)、每月收入(＞ 5萬vs. ＜ 3萬)、工作性質(非領導職 vs. 領導職)及自覺戒菸成功的信心。結論：軍人使用免費戒菸門診者的戒菸成效高於自行戒菸者，教育程度、性別、每月收入、工作性質及自覺戒菸成功的信心為影響短期戒菸成效的因素，但本研究無法排除使用藥物之影響。
  Objectives: The prevalence of smoking by military personnel is higher than that of the general adult male population. The Ministry of National Defense provides a fee to increase the utilization of smoking cessation clinics. The purpose of the study was to compare the effectiveness of a free smoking cessation clinic and a self-help approach in order to determine the factors which influenced successful quitting by military personnel. Methods: This was an observational study in which participants who intended to quit smoking were assigned to two groups (free smoking cessation clinics and self-help) according to their choice. There were 222 and 405 participants in the free smoking cessation clinics and self-help groups, respectively. The free smoking cessation clinics group received counseling from a physician and 8 weeks of pharmacotherapy for smoking cessation. No support for smoking cessation was provided to the self-help group. Abstinence over the previous 7 days and sustained abstinence were evaluated by telephone using a self-administrated questionnaire 1 and 3 months after the first visit. Results: The 7-day point prevalence cessation rates at 1 month (23.9% vs. 11.6%) and at 3 months (27.9% vs. 5.7%) were higher in the free smoking cessation clinics than in the self-help group. The sustained abstinence rate at 1 month (20.3% vs. 5.9%) and at 3 months (27.0% vs. 5.7%) was higher in the free smoking cessation clinics than in the self-help group. Smokers who attended the free smoking cessation clinics and were more successful in sustained abstinence at 3 months, were characterized by higher education level, female gender, higher monthly income, supervisory position, and more confidence in quitting. Conclusions: Smokers who attended a free smoking cessation clinic had higher abstinence rates than those in a self-help group. Education level, gender, monthly income, job category and confidence in quitting smoking were important factors in successfully quitting; however, the influence of pharmacotherapy could not be ruled out.
• 631 - 641
• 10.6288/TJPH201635105064

• Link 原著 Original Article
• 台北市某行政區老人健康促進活動參與及其相關因素探討Participation in health promotion activities and related factors among the elderly in a selected district in Taipei City, Taiwan
• 許怡平、李雅欣、胡益進、莊莉菁、陳政友
  I-Ping Hsu, Ya-Hsin Lee, Yih-Jin Hu, Li-Ching Chuang, Cheng-Yu Chen
• 老人健康促進活動參與 ； 動機因素 ； 阻礙因素
  participation in health promotion activities ; motivators ; barriers
• 目標：台灣人口老化快速，老人健康促進活動在各地持續推展，本研究探討台北市某行政區老人參與健康服務中心辦理之健康促進活動情形及其動機因素、阻礙因素。方法：本研究採橫斷式問卷調查法。研究對象為設籍且居住於台北市某行政區年滿65歲(含)以上之老人，採分層隨機抽樣方式，依年齡分層為65-74歲、75-84歲及85歲以上，有效樣本共計375位。以結構式問卷進行相關資料收集，問卷內容包括個人基本變項及個人特質、健康促進活動參與動機因素及阻礙因素。結果：約有35.5%老人曾經參與健康服務中心辦理之健康促進活動；參與的活動類型以健康篩檢為最多。以多變項邏輯斯迴歸分析顯示：女性、是否擔任志工、外在誘因取向、資訊障礙、個人障礙為影響老人健康促進參與之統計顯著因素。結論：規劃老人健康促進活動時需善用資訊傳播的途徑，考量老人的體力、視力、聽力及識字程度，並鼓勵老人擔任志工。建議政府將身體活動列為重點，整合社區資源並規劃無障礙設施及交通系統，以提高老人參與之意願，維持其健康並預防及延緩失能。
  Objectives: This study investigated participation in health promotion activities, related motivators and barriers among the elderly in a selected district in Taipei City, Taiwan. Methods: The cross-sectional study included 375 persons over the age of 65 years. A stratified random sampling method was used, and the subjects were divided into three age groups: 65 to 74 years of age, 75 to 84 years of age, and 85 years of age and older. The data was collected by personal interviews to complete the structured questionnaires including demographics, motivators to participation in health promotion activity scale and barriers to participation in health promotion activity scale. Results: The participation rate of the health promotion activities in this study was 35.5%. The most popular activity was health screenings. Multivariable logistic regression analyses indicated that statistically significant factors influencing participation included female gender, voluntary participation, fewer barriers to information about the activity, lower degrees of individual disability, and higher external incentives for participation. Conclusions: When one is planning health promotion activities in the elderly, the channels for disseminating information should be considered. The physical, visual, hearing and literacy levels of the elderly should be taken into account, and they should be encouraged to become volunteers. We suggest that the Government focus on physical activity for the elderly, integrate community resources, and plan barrier-free facilities and transportation systems to enhance their willingness to participate in health promotion activities in order to maintain their health and prevent or delay disability.
• 642 - 657
• 10.6288/TJPH201635105051

• Link 原著 Original Article
• 家庭社經對台灣北部嬰幼兒出生至二歲飲食攝取及生長發展之影響An examination of the effect of family socioeconomic status on dietary intakes and growth development from birth to two years of age in northern Taiwan
• 盧立卿、朱卉安、賴又禎
  Li-Ching Lyu, Huei-An Jhu, Yu-Chen Lai
• 家庭社經背景 ； 生長發展 ； 營養素攝取 ； 哺餵方式
  family socioeconomic status ; growth development ; nutrient intakes ; feeding patterns
• 目標：長期追蹤世代研究，探討不同家庭社經背景之嬰幼兒營養素攝取及哺餵方式與生長發展情形。方法：依家庭社經背景分成三組，並使用24小時飲食回憶評估，分析405名出生至2歲嬰幼兒其營養素攝取及哺餵方式。結果：不同家庭社經背景分組，出生至2歲的嬰幼兒體型在三組間無顯著差異。2歲時的營養素攝取情況，三組間也無顯著差異。嬰幼兒哺餵方式，雖然在嬰幼兒第6個月時，配方奶哺餵率以高社經組最低(42%, p=0.03)，母乳哺餵率以高社經組最高(33%, p=0.06)，但2歲時不同的哺餵方式其三組間無達顯著差異。此外母乳哺餵時間、副食品開始添加之月齡，隨著社經地位增高而增加，其中高社經組母乳哺餵時間最高(約6個月)；配方奶哺餵時間則是相反。完全哺餵母乳月數與副食品開始添加月齡呈顯著正相關，與副食品開始添加月齡呈顯著負相關。結論：不同社經背景之家庭，其哺餵狀況雖然不盡相同，但在2歲時的營養素攝取無顯著的差異，並且不會造成嬰幼兒營養攝取及生長上的顯著差異。
  Objectives: We examined the effect of family socioeconomic status on nutrient intakes, feeding patterns, and the growth development of infants. Methods: Participants were divided into three groups according to the family socioeconomic status: low socioeconomic status, middle socioeconomic status, and high socioeconomic status. We analyzed the dietary intake by 24- hour recall by parents of 405 healthy infants from birth to two years of age. Results: Growth development (weight, length and head circumference) of infants in the three groups were not significantly different from age 0 to 2. The nutrient intakes of infants in the three groups were not significantly different at age 2. The proportion of formula feeding in the high socioeconomic group was significantly lowest (42%, p=0.03) at the 6th month, and the proportion of breastfeeding in the high socioeconomic group was highest (33%, p=0.06). The feeding methods for infants in the three groups were not significantly different at age 2. Family socioeconomic status was positively associated with the duration of breastfeeding and the month in which infants started to consume complementary food. The duration of exclusive breastfeeding in the high socioeconomic group was significantly highest (about 6 months). On the other hand, family socioeconomic status was negatively associated with the month in which infants started to consume complementary food. Conclusions: The family socioeconomic status of infants may affect the feeding patterns from birth to two years of age, but nutrient intakes and growth development at age 2 did not show significant differences.
• 658 - 670
• 10.6288/TJPH201635105069

• Link 實務 Public Health Practice
• 地理資訊系統應用於毒品查獲空間分布：縣市毒品查獲地點的分析Application of geographic information systems to the spatial distribution of illicit drug use: an analysis of the location of illicit drug seizures in a city
• 章可藍、蔡煜書、詹大千、束連文、陳娟瑜、顏正芳、余沛蓁、徐睿、蔡文瑛、陳為堅
  Ko-Lan Chang, Yu-Shu Tsai, Ta-Chien Chan, Lien-Wen Su, Chuan-Yu Chen, Cheng-Fang Yen, Pei-Jane Yu, Jui Hsu, Wen-Ing Tsay, Wei J. Chen
• 地理資訊 ； 非法藥物 ； 毒品 ； 空間分布型態 ； 熱點分析
  geographic information ; illicit drug ; narcotics ; spatial pattern ; hot spot analysis
• 目標：本研究針對三、四級毒品查獲地點，以地理資訊系統探討毒品查獲與地域環境的關係。方法：以某縣巿A從2011至2015五年間毒品查獲案件地點，使用ArcGIS進行空間分析。先進行全域分析，再將查獲率高低以視覺化圖形呈現。然後進行區域分析，包括二種熱點分析(Getis-Ord Gi*與核密度函數)。最後畫出毒品查獲數之年變動率圖。結果：5年間的平均最近鄰指數R皆遠小於1，顯示毒品查獲地點有空間聚集性。區域分布圖從只有少數高查獲率區，逐步蔓延成多區皆屬高查獲率區。南邊行政區域之查獲率屬中高等級者，其Getis-Ord Gi*的檢定也呈顯著而可判為熱區。套疊實際街道圖，用GeoPDF的格式輸出，可研判查獲地點與街道特性之相關性。核密度分布圖也顯示核密度值較高的點皆位於西南邊與鄰近幾區內。查獲數之年變動率與查獲率分年曲線圖，呈現各區毒品查獲之變動情勢不同。結論：透過地理資訊系統的視覺化歸納，配合熱點分析及風險圖像，有助於辨識出三、四級毒品的聚集點特徵，進而落實毒品防制的在地化策略。
  Objectives: To investigate the relationship between the use of Category Three or Four narcotics (illicit drugs) and geographical characteristics of the locations of seizures using the Geography Information System (GIS). Methods: Using the seizure data from a city over five years (2011-2015), we conducted a series of spatial analyses using ArcGIS software. We started with global analysis, and determined the seizure rate in different districts using visualized figures. Local analysis was then performed using two kinds of hot-spot analyses: Getis-Ord Gi* and kernel density analysis. Finally, the change rates in the number of seizures over the years for individual district were determined. Results: Estimates of the average number of nearest neighbors showed that the ratio Rs were all less than 1 for the five year period, indicating a strong spatial aggregation of the seizure of illicit drugs. The district-specific seizure rate showed that ”high-rate areas” started with a few and then spread to others. Local analyses confirmed that some southwest districts could be designated as hot spots since their Getis-Ord Gi* reached statistical significance. Combining the seizure locations with street maps in Geospatial PDF helped identify street characteristics associated with the use of illicit drugs. The results of kernel density analysis also indicated that the spots with the highest densities were located within the southwest districts and their neighbors. In addition, the rates of change in the number of seizures by year differed in individual districts. Conclusions: GIS-based visual displays with hot-spot analysis provided clues to the identification of geographic characteristics associated with the seizure of illicit drugs. These may enhance location-tailored strategies to prevent the use of illicit drugs.
• 671 - 684
• 10.6288/TJPH201635105036