為探討群醫中心門診高度使用者之特性，本研究選取大溪鎮衛生所79年10月至80年4月間的門診病人為對象，進行問卷訪視調查。本研究將月平均就診頻率為研究族群前5%之病人定義為高度使用組，共313人；並且自其餘門診病人中隨機抽取246人作為對照，稱之正常使用組。本研究以對數迴歸分析探討諸自變項對於高度使用門診的影響程度。研究結果發現：(1)年齡愈高者使用門診的機會愈大，大於65歲者成為高度使用組的可能性為小於40歲者的5.19倍；(2)在能力因素方面，有使康保險者成為高度使用組的可能性為沒有健康保險者的3.82倍；(3)在需要因素方面，罹患慢性病與自覺健康不佳皆為高度使用門診的原因，其勝算比分別為3.25與3.57；(4)社會支持功能不佳者成為高度使用組的可能性為社會支持功能良好者的2.11倍。根據研究結果得知，「需要因素」為高度使用門診最重要的因素；而健康保險所誘發的就診率增加，則有持進一步探討其適當性。

This study was designed to examine the characteristics of frequent users at a group practice center (GPC). Patients who had visited Da-Xi GPC from May 1990 to March 1991 were chosen as the study population. Subjects were divided into two groups, the frequent user group and the control group. The frequent user group was comprised of 313 persons whose visiting frequency was in the top 5% among all registered patients. The control group consisted of 246 persons randomly sampled from the remainder. A questionnaire was employed for data collection and logistic regression was used for data analysis. The results show that: (1) The liklihood of becoming a frequent user for patients older than 65 years of age was 5.19 times that of patients younger than 40. (2) Insured patients were 3.82 times more likely to be frequent users. (3) Regarding need, chronic disease and poor health perception were both associated with frequent use with an odds ratio of 3.25 and 3.57, respectively. (4) Those who were poorly socially supported were 2.11 times as likely to become frequent users as those who were well socially supported. These results indicated the need factor is the most important causal factor in frequent health service utilization. The higher visiting frequency associated with insurance deserves further study.

群醫中心 ； 高度使用者

Group Practice Center, frequent user