家戶形成與關鍵人特性間之關係

中文摘要 本研究主要是探討家戶的形成與關鍵人的性別、年齡、居住地、初診疾病、初診醫師、初診科別以及看診次數等相關特性的關係，以進一步了解家戶形成的機制。本研究是屬於回溯型研究，研究對象是中山醫學院附設醫院家庭醫學科的家庭檔案共694戶，其中根據選擇條件及排除標準選出208人為關鍵人，另於門診資料中選出對照組353人。研究方法是採調閱所有個案組與對照組的病歷的方式，詳實地紀錄個人的基本資料，包括性別，年齡，居住地，初診疾病，初診醫師，初診科別以及看診次數。經過統計卡方檢定及邏輯迴歸模式的分析，研究結果為：家戶的形成與關鍵人的年齡、家庭角色、初診醫師有關，與居住地有統計上的趨勢；與性別、初診疾病、初診科別無關。45歲以上、母親角色、居住地在台中市、初診醫師為主治醫師的關鍵人，比45歲以下，子女角色，非居住在台中市，初診醫師為住院醫師的病患，容易形成家戶，且具統計學上的意義。 家庭醫學科的照顧，是強調以個人為中心，家庭為單位，社區為範疇，兼顧生物、心理、社會層面的全面性照顧。因此，家戶的形成即以家庭為單位的醫療照顧，是家庭醫學科門診主要目標。把握家戶形成關鍵人的特性，可較易達成此一目標，同時，亦能兼顧門診的業務發展。

Abstract The purpose of our study is to investigate the association between formation of the family patients and the characteristics of index person, and then to realize the mechanism in forming the family patients. The subjects of this retrospective study are 208 index persons selected from the 694 family files of the Department of Family Medicine of a medical center. The data were collected from the medical records and then analyzed by Chi-square test and logistic regression analysis. We found that there was a significant association between the formation of the family patients and the age, family role, first-visited doctor of the index person (p valve = 0.024, 0.000, 0.001 respectively ) and a statistical trend in residency (p = 0.064 ). And there were no statistically significant association between the formation of the family patients and the gender, first-visited disease, first-visited specialty of the index person. (p valve = 0.089, 0.571, 0.199 respectively). We concluded that old-age (especially older than 45 years old), mother role, residence in Taichung City, faculty physician as first-visited doctor of the index persons were more likely to form the family patients and have more compliance in visiting their family physician in the future.