臺灣博碩士論文加值系統

本研究使用行政院主計處1999年至2006年之家庭收支調查資料(Survey of Family Income and Expenditure)，對於保健食品是否對健保醫療費用支出產生影響進行實證分析。本研究分析主要以家戶為基本單位，使用之應變數為健保醫療費用。主要探討家戶消費保健食品的多寡，是否會對健保醫療費用產生影響。
計量方法上，針對模型中保健食品與健保醫療費用之間產生的內生性問題，而使用兩階段最小平方法進行分析，並使用工具變數解決內生性問題。
研究結果顯示，保健食品支出多寡對健保醫療費用呈現顯著負向的影響，說明保健食品食用較多，對健保醫療費用的降低有幫助。健康食品對健保醫療費用呈現顯著負向的影響，效果和保健食品差異不大。而中藥補品方面卻呈現顯著正向的影響，說明中藥多以治療為效果，而不是預防。

The purpose of this study is to explore the effects of health food on National Health Insurance (NHI) medical expenditure.
We employ data from the year 1999 to 2006 in Survey of Family Income and Expenditure. Since dietary supplement, health food and herbal supplement in the regression may be endogenous, we use instrumental variables and two-stage least squares instead of the ordinary least squares to solve the endogeneity problem inherent the econometric model.
The findings of this study are as follows:
First, the dietary supplements have significantly negative effect on the NHI medical expenditure.
Second, the health foods have significantly negative effect on the NHI medical expenditure.
Third, the herbal supplements have significantly
positive effect on the NHI medical expenditure.

摘要 i
Abstract ii
誌謝 iii
目錄 iv
表目錄 vi
壹、緒論 1
貳、文獻回顧 3
一、保健食品、健康食品與中藥補品 3
二、保健食品與健康 4
三、影響保健食品消費之人口、家庭特徵 6
四、影響醫療費用支出之人口特徵 7
參、研究設計 10
一、研究方法 10
二、實證模型 11
肆、實證分析 15
一、資料來源 15
二、變數選擇及說明 16
（一）應變數 16
（二）自變數 17
三、敘述統計 25
（一）全樣本 25
（二）有無購買保健食品 29
（三）有無購買健康食品 29
（四）有無購買中藥補品 29
四、實證結果分析 42
（一）第一階段迴歸 42
（二）第二階段迴歸 51
伍、結論 57
參考文獻 60
一、中文部分 60
二、英文部分 61

一、中文部分
1.陳琪婷、陳政雄、謝邦昌、何偉瑮，2006，“台北市民對健康食品認知與消費行為之研究”，觀光旅遊研究學刊，第2卷，第1期，1-21。
2.陳師瑩、林佳蓉、高美丁、杭極敏、潘文涵，2003，“台灣地區老年人營養健康狀況調查1999-2000年老年人服用膳食補充品的狀況與相關因素”，老人營養健康狀況調查專刊，行政院衛生署。
3.潘子明，2004，保健食品在台灣，健康世界，第218期：頁101-103
4.鄭保志，胡玉蕙，1997，台灣家庭醫療需求的實證分析，台北銀行月刊，第27卷，第5期，頁71-88。
5.齊燕駒，2008，“家庭醫療保健支出影響因素之研究”，佛光大學，碩士論文。
6.陳禮穆，1998，“個人醫療支出變化的解釋—風險因子的探討”，國立中央大學，碩士論文。
7.列嘉祺，1999，“健保多元體制下風險調整機制之探討：台灣全民健保資料的實證分析”，國立中正大學，碩士論文。
8.陳思遐，2005，“家庭醫療保健支出決定因素—分量迴歸法”，私立世新大學，碩士論文。
9.鄭新慶，2004，“台灣醫療支出成長因素之探討--時間序列與有向圖之應用”，逢甲大學，碩士論文。
10.謝啟瑞、林建甫、游慧光，1998，“台灣醫療保健支出成長原因之探討”，人文及社會科學期刊，第10卷，第1期，頁1-32。
11.林榮斌，1993，“以家庭生命週期為基礎分析家庭醫療費用的特性”，國立交通大學，碩士論文。
12.鄭筱凡，2009，“醫療保健支出與生命價值”，國立中央大學，碩士論文。
13.張文玲，2002，“台灣地區家庭保健及醫療支出行為之分析”，國立海洋大學，碩士論文。
14.陳易宏，2011，“中藥材供健康食品使用之研究與基準之建立”，中醫藥年報，第29期，第五冊。
15.黃俊文，2004，“民俗醫療（乩童）－以民安宮保生大帝為例的訪查報告”，中正歷史學刊，第七期，頁143-167
二、英文部分
1. Arai, S., 2002. “Global View on Functional foods: Asian Perspectives”, British Journal of Nutrition 88:S139-S143
2. Block, G., Cox, C., Madans, J., Schreiber, G. B., Licitra, L. and Melia, N., 1988. “Vitamin supplement use, by demographic characteristics”, American Journal of Epidemiology 127:297-309
3. Diplock, A. T., Aggett, P. J., Ashwell, M., Bornet, F., Fern, E. B. and Roberfroid, M. B., 1999. “Scientific Cincepts of Functional Foods in Europe: Consensus Document”, Britiish Jounrnal of Nutrition 81: 1-27.
4. Verschuren,P. M., 2002.“Functional Foods :Scientific and Global Perspectives”, British Journal of Nutrition 88: 125-130.
5. Hasler, C. M., 2002. “Functional Foods :Benefits, Concerns and Challenges-A Position Paper from the American Council on Science and Health”, The Journal of Nutrition 132:3772-3781.
6. Kirk, S., Woodhouse, A., Conner, M., 1998. “Beliefs, attitudes and behaviour in relation to supplement use in the UK Women Cohort study”, Proceedings of the Nutrition Society 57:54
7. Hensrud, D. D., Engle,D. O. and Scheitel, S. M., 1999. “Underreporting the Use of Dietary Supplements and Nonprescription Medications among Patients Undergoing Periodic Health Examination”, Mayo Clinic Proceedings 74: 443-447.
8. Devcich, D. A., Pedersen, I. K. and Peteie, K.J., 2007. “You Eat What You Are: Modern Health Worries and the Acceptance of Natural and Synthetic Additives in Functional Foods”, Appetite 48:333-337.
9. Subar, A. F., and Block, G., 1990. “Use of Vitamin and Mineral Supplements: Demographics and Amounts of Nutrients Consumed: the 1987 Health Interview Survey”, American Jurnal of Epidemiology 132:1091-1101.
10. Slesinski, M.J., Subar, A. F. and Kahie, L. L., 1995. “Trends in Use of Vitamin and Mineral Supplements in the United States: the 1987 and 1992 National Health Interview Surveys”, Journal of the American Dietetic Association 95: 921-923.
11. Lyle, B. J., Mares-Perlman, J. A., Klein, B. E., Klein, R. and Greger, J. L., 1998. “Supplement Users Differ from Nonusers in Demographic, Lifestyle, Dietary and Health Characteristics”, Journal of Nutrition 128: 2355-2362.
12. Patterson, R. E., Neuhouser, M. L., White, E., Hunt, J. R. and Kristal, A. R., 1998. “Cancer-related Behavior of Vitamin Supplement Users”, Cancer Epidemiology, Biomarkers & Prevention 7: 79-81.
13. Stewart, M. L., McDonald, J. T., Levy,A. S., Schucker, R. F. and Henderson, D. P., 1985, “Vitamin/mineral Supplement Use: a Telephone Survey of Adults in the United States”, Journal of the American Dietetic Association 85: 1585-1590.
14. Nichter, M. and Thompson, J. J., 2006. “For My Wellness, Not Just My Illness: North Americans Use of Dietary Supplements”, Cultuer, Medicine and Psychiatry 30:175-222.
15. Ishihara, J., Sobue, T., Yamamoto, S., Sasaki, S. and Tsugand, T., 2003,.“Demographics, Lifestyles, Health Characteristics, and Dietary Intake among Dietary Supplement Users in Japan”, International Journal of Epidemiology 32: 546-553.
16. Umberson, D., 1992. “Gender, Marital Status and the Social Control of Health Behavior”, Social Science & Medicine 34: 907-917.
17. Goodwin, J.S., Hunt, W. C., Key, C. R., and Smaet, J. M., 1987. “The Effect of Marital Status on Stage, Treatment, and Survival of Cancer Patients”, Journal of the American Medical Association 258:3125-3130.
18. Gordon, H. S. and Rosenthal, G. E., 1995. “Impact of Marital Status on Hospital Outcomes: Evidence from an Academic Medical Center”, Archives of Internal Medicine 155:2465-2471.
19. Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S. and Gwaltney, J. M., 1997. “Social Ties and Susceptibility to the Common Cold”, Journal of the Amrtican Medical Association 277:1940-1944.
20. Eisenbery, D. M., Kessler, R.C., Foster, C., Norlock, F. E., Calkins, D. R., Delbanco, T. L., 1993. “Unconventional medicine in the United States. Prevalence, costs, and patterns of use”, The New England journal of medicine. 328:246-252
21. Greger, J. L., 2001. “Dietary Supplement Use: Consumer Characteristics and Interest”, Journal of Nutrition 131: 1339-1349
22. Chang, Chu-Hui, and Tung-Liang Chiang, 2002. “Vitamin/Calcium Supplement Use in Taiwan: Findings from the 1994 National Health Interview Survey”, Kaohsiung Journal Medical Sciences 18: 171-181
23. Hul, Shene-Pin, 1995. “Health Beliefs and Supplement Use : Adults in Taipei Area”, Nutrition Research 15:1277-1285
24. Parkin, D.M., Pisani, P., Lopez, A.D. and Masuyer, E., 1994. “At Least one in Seven Cases of Cancer is Caused by Smoking: Global Estimates for 1985”, International Journal Cancer, 59:494-504.
25. McLaughlin, J.K., Hrubec, Z., Blot, W. J. and Fraumeni, J.F., 1995. “Smoking and Cancer Mortality Among U.S. Veterrans: A 26-Year Follow-up”, International Journal of Cancer, 60:190-193.
26. Vineis, P. and Caporaso, N., 1995. “Tobacco and Cancer: Epidemiology and Laboratory”, Environ Health Perspect, 103:156-160.
27. Anderson K.M. and Odell, P.M., 1991. “Cardiovascular disease risk profiles”, 121:293-298.