Vol.43 No.6
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2024 / 12
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pp. 537 - 550
經濟合作暨發展組織國家或區域與台灣健康公平指標之文獻回顧
Literature review of health equity indicators among Organisation for Economic Co-operation and Development countries or regions and Taiwan
作者
劉禮慧 Li-Huei Liu
(國立臺灣大學群體健康研究中心)
鍾國彪 Kuo-Piao Chung *
(國立臺灣大學群體健康研究中心;國立臺灣大學公共衛生學院健康政策與管理研究所)
賴嬿竹 Yen-Chu Lai
(國立臺灣大學群體健康研究中心;國立臺灣大學公共衛生學院健康政策與管理研究所)
劉禮慧 Li-Huei Liu
國立臺灣大學群體健康研究中心
鍾國彪 Kuo-Piao Chung *
國立臺灣大學群體健康研究中心;國立臺灣大學公共衛生學院健康政策與管理研究所
賴嬿竹 Yen-Chu Lai
國立臺灣大學群體健康研究中心;國立臺灣大學公共衛生學院健康政策與管理研究所
中文摘要
消弭健康不平等為聯合國永續發展及臺灣2020國民健康白皮書目標之一,它涉及社會、政治、環境等多面向。本文聚焦健康照護體系可改善之層面,除探討健康照護公平性外,向前延伸至初級預防風險因子及健康照護體系之結果公平性。以國家衛生研究院《縮短臺灣健康不平等之政策研議》報告為基礎,綜覽國內外健康照護公平相關監測指標,回顧與比較經濟合作暨發展組織國家及我國健康公平指標的現況及提供發展方向建議。研究結果與國際相較,我國尚缺乏整合性健康監測系統或報告。本文提出整體建議:第一,臺灣目前尚未確立在地健康公平測量指標,未來如欲發展,方法學可參考美國及以色列,以重要性、可行性、公眾關注等作為選擇標準,比較群體間差異,呈現上建議可參考英國、澳洲、加拿大建立指標監測儀表板,盤點現有資料及歷年趨勢,視覺化呈現,並強化資料管理機制,定期更新追蹤;第二,須依政策需求定出比較公平的分層類別,並呈現分層間差異,儘管分層資料非必定完整呈現在所有年度,但未來資料管理也利於對症下藥、精準補充。
英文摘要
Eliminating health inequality is a core objective of the United Nations Sustainable Development Goals and Taiwan's 2020 National Healthy People initiative. Achieving this objective necessitates addressing social, political, and environmental dimensions. This review focused on equity in the health-care system and its outcomes as well as primary prevention risk factors that could be mitigated through targeted interventions. On the basis of the "Policy Discussion on Shortening Health Inequality in Taiwan" report, this study reviewed and compared health equity indicators between Organisation for Economic Co-operation and Development countries and Taiwan and provided recommendations for future development. The findings indicated that compared with other countries, Taiwan lacks a comprehensive health equity monitoring system or report. In response, the following recommendations are proposed: (a) Taiwan should establish localized health equity indicators by adopting methods from the United States and Israel; selection criteria such as importance, feasibility, and public concern could be used for determining differences between groups. Moreover, Taiwan could adopt presentation models from the United Kingdom, Australia, and Canada to incorporate existing data and historical trends into visualized monitoring dashboards, thereby enhancing data management mechanisms and ensuring regular updates. (b) Policies should define and present standardized equity stratifiers to compare health outcomes between distinct population groups. Although trends in these categories may not be available for all years, these metrics can serve as benchmarks for future enhancement of interventions.
中文關鍵字
健康公平;公平指標建立;健康照護;經濟合作暨發展組織;國際比較
英文關鍵字
healthcare equity, equity indicators development, healthcare, OECD, international comparison