39卷1期

• 政策論壇 Policy Forum
• 青少年網路成癮Internet addiction among adolescents
• 蕭宇涵、李宣信、李孟智
  Yu-Han Hsiao, Shiuan-Shinn Lee, Meng-Chih Lee
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• 1-4
• 無none

• 公衛論壇 Public Health Forum
• 公共衛生緊急事件與2019新型冠狀病毒（COVID-19）之法政議題A study on legal policy of public health emergency and COVID-19
• 林展甲
  Chad Chan-Chia Lin
• 無none
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• 5-7
• 無none

• 綜論 Review Article
• 兒童死亡回顧Child death review
• 梁富文、呂立、呂宗學、江東亮、呂鴻基
  FU-WEN LIANG, FRANK LEIGH LU, TSUNG-HSUEH LU, TUNG-LIANG CHIANG, HUNG-CHI LUE
• 無none
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• 8-16
• 無none

• 綜論 Review Article
• 成人每日步行數與健康：日行萬步健康才保固？Daily steps and health in adults: should we walk 10,000 steps per day for optimal well-being?
• 陳上迪、陳俐蓉、古博文
  SHANG-TI CHEN, LI-JUNG CHEN, PO-WEN KU
• 無none
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• 17 - 26
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• 原著 Original Article
• 探討健康促進學校國際認證成效：從學生健康行為表現之觀點Effectiveness of health promoting school international accreditation: a study from the perspective of students' health behaviors
• 陳富莉、邱詩揚、陸玓玲、王英偉
  FU-LI CHEN, SHY-YANG CHIOU, DIH-LING LUH, YING-WEI WANG
• 無none
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• 27 - 40
• 無none

• 原著 Original Article
• 建構具專家及老人團體共識之台灣高齡友善城市指標Development of indicators of the ageing-friendly city for Taiwan through a consensus of experts and the elderly
• 李佳霙、廖麗娜、李采娟、林志學、劉秋松、林文元、龍紀萱、林雪淳、王英偉、張李淑女、王中儀、李心瑜、吳文慈、林正介
  CHIA-ING LI, LI-NA LIAO, TSAI-CHUNG LI, CHIH-HSUEH LIN, CHIU-SHONG LIU, WEN-YUAN LIN, CHI-HSUAN LUNG, HSUEH-CHUN LIN, YING-WEI WANG, SHU-NU CHANG LEE, JONG-YI WANG, HSIN-YU LEE, WEN-TZU WU, CHENG-CHIEH LIN
• 無none
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• 41 - 51
• 無none

• 原著 Original Article
• 台灣親密關係暴力被害人醫療利用與費用分析Medical care utilization by intimate partner violence victims and associated costs in Taiwan
• 江宛霖、劉淑瓊、黃志中
  WAN-LIN CHIANG, SHU-CHIUNG LIU, JOH-JONG HUANG
• 無none
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• 52 - 63
• 無none

• Link 原著 Original Article
• 再論藥價差Revisiting the pharmaceutical price gap
• 劉亞明
  YA-MING LIU
• 藥價差 ； 全民健保
  pharmaceutical price gap ; National Health Insurance
• 目標：本文目的在探討台灣藥價差形成的機制，並利用藥價調整公式估算學名藥與原廠藥之相對藥價差比例。方法：資料上透過健保署所公佈的第五、六、七次藥價調查清單，計算個別藥品的平均價差，再估計學名藥與原廠藥的相對藥價差比例，以及利用迴歸方法探究影響相對價差比例的因素。結果：分析結果顯示學名藥藥價差略高於原廠藥藥價差，學名藥競爭降低學名藥相對原廠藥的藥價差比，療效市場競爭則會提高該藥價差比。不過，由於資料所能估計藥價差的品項較少，且多屬於相對較新進的品項，因此對藥價差比例的估計有可能傾向低估。結論：本文認為藥價政策除調整藥品絕對價格以控制醫療支出外，也應考量學名藥與原廠藥間的相對價格比例水準以保障民眾用藥選擇權益。
  Objectives: The aim of this paper is to discuss the mechanism underlying the pharmaceutical price gap and to estimate the relative profit margins of generic and brand-name drugs. Methods: Data were obtained from the drug list from the fifth to seventh waves of price adjustment and population claims data compiled by the National Health Insurance Database. Results: The analysis indicated that generic-to-brand price ratios and discount rates jointly determined generic-to-brand profit ratios. The profit margins of generic drugs were slightly higher than those of their brand-name counterparts. Competition between generic drugs reduced the generic-to-brand profit ratio, but therapeutic competition increased this ratio. Conclusions: The results of this study indicate that policy makers may select an appropriate generic-to-brand price ratio in order to improve resource allocation between generic and brand-name drug markets.
• 64 - 73
• 10.6288/TJPH.202002_39(1).108112

• Link 原著 Original Article
• 影響平均餘命增長之生命表特性及其相關死亡率模式分析Effect of life table indices and a related mortality model on increase of life expectancy
• 林正祥、張怡陵
  CHENG-HSIANG LIN, YI-LING CHANG
• 平均餘命 ； 存活曲線矩形化 ； 死亡變異 ； 混合模式 ； 遲緩衰老
  life expectancy ; rectangularity of the survival curves ; variability in the distribution of ages at death ; hybrid model of mortality ; senescence-slowing
• 目標：探討死亡年齡變異、存活曲線矩形化間之生命表特性及相關的死亡率模式對平均餘命的影響。方法：利用1998－2016年台灣生命表資料，以各類相關指標測量存活曲線矩形化與死亡年齡變異趨勢。並以相關死亡率模式中重要的混合模式，探討平均餘命增長變化受到死亡率下降與遲緩衰老步調下降消長影響情況。結果：存活曲線間逐漸呈現矩形化的情況，且死亡年齡變異也呈下降狀態；以年齡95歲為上限利用面積差異百分比來檢測矩形化，結果顯示矩形化逐漸趨向平均餘命極限。另透過死亡率混合模式的分析結果得知平均餘命增長趨勢，其中32%是受到死亡率下降的影響，而受到延遲老化的影響則為68%。結論：各種指標均顯示存活曲線有逐漸矩形化的情況，死亡年齡的變異則是呈現下降的趨勢，平均餘命的增長受到一定的限制。從死亡率混合模式分析結果顯示這些年來平均餘命受到遲緩衰老的影響遠較死亡率下降來的大，對於平均餘命的展延，遲緩衰老當扮演舉足重的角色。
  Objectives: To investigate the effect of variation in age at death and rectangularity in the survival curve on the increase of life expectancy and further investigate this phenomenon by using a hybrid mortality model. Methods: By using life table data in Taiwan, we measured the rectangular trend in survival curves and variation of age at death on the basis of related life table indices. We then applied a hybrid mortality model to interpret the effects of declining mortality and senescence-slowing on life expectancy. Results: The survival curve, which is closely related to life expectancy, gradually became rectangular from 1998 to 2016, and the variation of age at death declined. We measured the rectangularity of survival curve by setting the upper limit age of 95 years through using the percentage difference in area and found that rectangularity gradually approached the limit. Analysis using the hybrid mortality model revealed that 32% and 68% of the increase of life expectancy resulted from declining mortality and senescence-slowing, respectively. Conclusions: All indicators pointed to the survival curve gradually becoming rectangular and the variation of age at death trending downward, implying that human life expectancy is approaching a certain limit. The hybrid model of mortality revealed that the increase of life expectancy was affected more by senescence-slowing than by declining mortality.
• 74 - 89
• 10.6288/TJPH.202002_39(1).108052

• Link 實務 Public Health Practice
• 一般護理之家照護標準作業流程項目需求探討Importance-performance analysis for the evaluation of care standard operating procedures in Taiwan nursing homes
• 梁亞文、林育秀、蘇侰寧
  YIA-WUN LIANG, YU-HSIU LIN, CHUN-NING SU
• 一般護理之家 ； 照護 ； 標準作業流程 ； 重要－表現分析法
  nursing home ; caring ; standard operating procedure ; importance-performance analysis
• 目標：本研究旨在探討臺灣一般護理之家對照護標準作業流程的重要性及需要性，作為政府協助擬訂照護標準作業流程項目的優先順序參考。方法：本研究為一橫斷性研究，以結構式問卷調查一般護家管理者對照護標準作業流程項目的重要性及需要性認知。統計分析先以成對樣本t檢定檢視受調查者對照護標準作業流程項目的重要性及需要性認知間是否存在顯著差異，再以「重要-表現分析法」探討重要性高需要性高的項目。結果：53個照護項目中有34個項目之重要性顯著高於需要性；31項照護項目落在第一象限（重要性高需要性高），應列為優先考量訂定照護標準作業流程的項目。結論：一般護家照護標準作業流程可強化護理人員及照顧服務員提供完整、正確的照護，達到照護有效性以及降低變異性。本研究發現一般護家重要性高且需要性高的照護標準作業流程項目，且發現需求項目因規模而有不同，主管機關可依研究結果，考量規模因素，制定公版流程供一般護家參考，提升住民照護品質。
  Objectives: The aim of this study is to identify and prioritize standard operating procedures (SOPs) for nursing home care based on the perceptions of their importance and desirability reported by nursing home administrators. Methods: This was a cross-sectional study. Structured questionnaires were used to measure the perceptions of importance and desirability toward SOPs for care among nursing homes administrators. A paired t-test was used to test the differences between the administrators' perceptions of the importance and desirability of these SOPs. Importance-performance analysis (IPA) was adopted to explore the "concentrate here" items for further improvement. Results: For 34 SOPs, the perceived importance was significantly higher than the perceived performance. In quadrant I items (i.e., concentrate here), administrators perceived SOPs as highly important, and perceptions of desirability were above average, indicating that these SOPs required the greatest attention. Conclusions: Nursing home SOPs not only ensure that nurses and nursing assistants provide complete and accurate nursing home care but also improve the care effectiveness and reduce the care variability. This study revealed that the nursing home scale affects the SOP desirability. The results are useful for identifying areas for strategic focus to facilitate the development of SOPs for nursing home care.
• 90 - 101
• 10.6288/TJPH.202002_39(1).108101