(3.230.76.48) 您好!臺灣時間:2021/04/13 16:38
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:葉玲玲
研究生(外文):Ling-Ling Yeh
論文名稱:台灣精神分裂症患者之健康照護需要與需求研究
論文名稱(外文):Needs and demands for mental health care for patients with schizophrenia in Taiwan
指導教授:藍忠孚藍忠孚引用關係
指導教授(外文):Chung-Fu Lan
學位類別:博士
校院名稱:國立陽明大學
系所名稱:公共衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2003
畢業學年度:91
語文別:中文
論文頁數:276
中文關鍵詞:精神分裂症精神健康照護服務需要需求
外文關鍵詞:schizophreniamental health careneedsdemands
相關次數:
  • 被引用被引用:27
  • 點閱點閱:841
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:269
  • 收藏至我的研究室書目清單書目收藏:15
早期西方以住院醫療服務為主的精神健康照護模式,帶給公部門(public sector)相當沈重的財務壓力,因此各國紛紛試圖將財務壓力由中央分散到地方甚至於私人保險的精神醫療照護計畫,結果都未成功。公部門仍需擔負精神醫療照護的財務責任。台灣公部門主導的全民健保幾乎照顧所有精神疾病患者,因此我們可未雨綢繆利用精神健康照護需要與需求研究資料,思考在有限資源下如何發展精神健康照護體系。
本研究利用1993年開始之「多層面精神病理研究計畫-精神分裂症」,及其「精神分裂症多層面精神病理研究計畫」研究資料檔,進行精神健康照護需要與需求之探討。該系列研究共納入225位精神分裂症患者與197位主要照顧者資料,一年追蹤時則追蹤到191精神分裂症患者與126位主要照顧者。
本研究依據患者一年追蹤時精神症狀、功能表現、自我照顧能力與經濟狀況等四面向,客觀評估患者精神健康照護需要。因為考量需要範圍與資源耗用有關,因此將四面向之無、輕微與嚴重三種程度,區分為兩種定義。從嚴定義乃將患者呈現無與輕微程度定義為不需要;從寬定義則將輕微與嚴重程度定義為需要,因此從嚴定義的需要範圍比從寬定義的需要範圍小。客觀評估之精神健康照護需要則包括精神科門診或住院需要、精神社區復健需要、終生養護需要與生活費用補助需要。因為考量主要照顧者長時間與患者相處及其在患者預後扮演重要的角色,因此本研究納入主要照顧者主觀評估患者精神健康照護需要。主觀評估之精神健康照護需要則包括精神社區復健需要、終生養護需要與生活費用補助需要。精神健康照護需求則包括患者一年追蹤時精神科門診、精神科住院、精神社區復健等精神醫療照護,以及終生養護、生活費用補助等精神福利服務。本研究亦藉著精神分裂症患者與主要照顧者健康照護需要與需求之影響因素分析,以瞭解不同特質患者精神健康照護需要與需求。
本研究並依據個別患者需要與需求之關聯狀況建立精神健康照護需要與需求關聯型態之分析模型,以資探討精神健康照護服務。精神健康照護需要與需求關聯型態包括五個子型態,每個子型態其需要與需求關聯狀況可分為滿足需要、未滿足需要、過度提供與沒有需要四個類別。型態一只考量客觀評估患者從嚴定義之需要與患者實際需求情形;型態二只考量客觀評估患者從寬定義之需要與患者實際需求情形;型態三只考量主要照顧者主觀評估患者需要與實際需求情形;型態四則同時考量客觀評估患者從嚴定義與主要照顧者評估患者的需要,以及患者實際需求情形;型態五則同時考量客觀評估患者從寬定義與主要照顧者評估患者的需要,以及患者實際需求情形。
經由精神健康照護需要與需求關聯型態之家庭負荷與生活品質探討分析之後,本研究結果呈現精神科門診或住院服務型態二需再增加4.1%患者數的服務設施;精神社區復健服務模型四模型需再增加66.3%患者數的服務設施;終生養護服務模型三需再增加7.4%患者數的服務設施;而生活費用補助服務模型三則需減少16.7%患者數的服務。
經精神健康照護需要與需求影響因素之分析結果,發現在精神健康照護體系初期擴增精神社區復健設施時可將重點置於提供約50%精神分裂症患者之提升就業功能的社區復健服務,再漸近式增加提升不同面向社會功能的精神社區復健服務。尤其是生病年數較長、照顧者年齡較大、家庭經濟狀況較差、醫療滿意度較低、家人有高情緒表露者、家屬排斥患者、社會支持較差的精神分裂症患者較需要精神社區復健服務。而精神衛生政策應該及早預防讓精神分裂症患者的家庭經濟陷入困境,否則長久下來將會增加政府財務負擔,尤其更應該著力於患者與照顧者教育年數較短、社會支持較差與家庭經濟狀況較差者。
精神健康照護需要與需求關聯型態考慮了資源的有限性、主要照顧者對患者需要的看法,以及以家庭負荷與生活品質提供分析探討精神健康照護服務的機制,並可以指出不同健康照護服務需要增加供給的具體數據。因此其分析結果提供多面向資訊,可作為發展精神健康照護體系的依據。本研究僅以精神分裂症患者為研究對象,因此未來值得以精神健康照護需要與需求關聯型態之分析模型陸續探討其他重要精神病性精神病,據此系列研究結果建立嚴重精神疾病健康照護體系;接著再探討分析輕型精神疾病,屆時精神健康照護體系才得以完備。
The history of caring for mentally ill people in western society forms the main provision of hospital-based care; such care heavily burdens governmental finances. Returning the responsibility of caring for the mentally ill to local authorities, or even to private insurance groups, has not been successful; the public continues to assume most of the responsibility. In Taiwan, the Bureau of National Health Insurance includes almost all of the mentally ill patients; therefore, we must determine effective methods to develop the mental health care systems with limited resources. To address this challenge, we conducted an analytic study and examined the needs and demands for mental health care.
The purpose of the present study was to analyze data sets from serial research projects that included the Multidimensional Psychopathological Group Research Project (MPGRP) and the Multidimensional Psychopathological Study of Schizophrenia (MPSS). The study subjects included 225 patients with schizophrenia and 197 chief caregivers. At the 1-year follow-up, 191 patients and 126 chief caregivers completed the final interview.
For the 1-year follow-up, we objectively assessed whether the patients required mental health care according to 4 possible dimensions of patient performance: psychiatric symptoms, social functioning, self-care ability, and economic status. Both strict and loose definitions of mental health care needs were developed based on the severity of the 4 dimensions because of limited resources. The scope of mental health care need according to the strict definition was narrower than that for the loose definition. Mental health care needs encompassed 4 items: psychiatric ambulatory care or admission, psychiatric community rehabilitation, long-term care, and subsidies of daily living expenses.
The chief caregiver who has lived with the patient for a long time is able to observe and describe the patient more accurately than other people are able to do. The chief caregiver also plays an important role in influencing the treatment outcome of patients with schizophrenia. In the present study, the chief caregivers provided subjective observations of the needs assessment for mental health care, including the need for community rehabilitation, long-term care, and subsidized daily living expenses.
The mental health care demands of patients with schizophrenia during the 1-year follow-up period constituted not only psychiatric care (e.g., psychiatric ambulatory care, psychiatric admission, and psychiatric community rehabilitation) but also social care (e.g., long-term care and subsidized daily living expenses). Understanding the characteristics of patients and caregivers requires an analysis of the factors relating to the needs and demands for mental health care. Such information will undoubtedly benefit the development of care systems.
An analytic model encompassing needs and demands related types (NDRTs) was developed. This model consisted of each patient’s needs and demands for mental health care. NDRTs of mental health care included 5 subtypes. The strict definition of needs and demands for mental health care formed the 1st subtype, and the loose definition of needs was the 2nd subtype. Needs assessment by the chief caregiver and demands for mental health care comprised the 3rd subtype. The combination of needs according to the strict definition and the caregiver’s assessment constituted the 4th subtype. The 5th subtype included a combination of the loose definition of needs and the caregiver’s assessment. Each subtype was divided into 4 categories according to the relationship between needs and demands for mental health care: met need, unmet need, overprovision, and no need.
Analysis of the family’s burden and the patient’s subjective quality of life via NDRTs reveals that the provision of ambulatory care or admission in mental health care systems must increase 4.1% with the 2nd subtype of NDRTs. The provision of community rehabilitation must increase 66.3% with the 4th subtype of NDRTs. The provision of long-term care must increase 7.4% with the 3rd subtype of NDRTs. Subsidies of daily living expenses must decrease 16.7% with the 3rd subtype of NDRTs.
For the factors relating to needs and demands for mental health care, our results indicate that mental health system reform should initially focus on a 50% increase in services that would improve the patients’ occupational functioning. Subsequently, gradual improvements in other dimensions of social function regarding psychiatric community rehabilitation should be instituted. Further attention should be given to the patient and the caregiver when certain factors are present: lengthy illness duration, aged caregiver, poor economic status, low satisfaction with mental health care, high expression of emotion in the family and resistance toward the patient, and poor social support. Mental health policymakers should attempt to prevent bankruptcy in those families who are caring for patients in conjunction with authorities; otherwise, the economic burden on the public sector will become increasingly heavier. Mental health policies must concentrate on the patient and the caregiver, especially in situations with low educational levels, poor social support, and poor economic status.
Positive aspects of the analytic model of NDRTs for mental health care are the consideration of limited resources and the inclusion of caregivers’ opinions. Also, a connection was established between family burden and quality of life to understand whether the patient and the caregiver had different NDRTs in terms of comfort. This analytic model is useful because it estimates the amount of mental health care provision that is necessary. Therefore, these results provide multidimensional information that is essential for developing or reforming mental health care systems. The case described in the present study was 1 schizophrenic patient. The research schedule could be applied to patients with other psychoses or to those with minor psychiatric disorders. Once this schedule is completed, a comprehensive mental health care system will be available.
目錄
誌謝 I
中文摘要 III
英文摘要 V
目錄 IX
表次 XIV
圖次 XVIII
附錄次 XIX
本文 1
第一章 前言 1
第一節 研究背景 1
第二節 研究目的 3
第三節 重要名詞解釋 5
第四節 論文章節說明 7
第二章 精神健康照護體系之內涵 9
第一節 精神疾病與精神疾病患者 10
第二節 精神分裂症與精神分裂症患者 12
壹、精神分裂症的診斷 12
貳、精神分裂症的症狀 13
參、精神分裂症的病程 15
肆.精神分裂症的社會功能障礙與併發症 18
伍.精神分裂症的治療方式 19
陸、精神健康照護服務 21
柒.精神分裂症的預後 26
第三節 精神分裂症患者的照顧者與家人 28
第四節 精神健康照護政策與體系 30
壹、國外精神健康照護政策與體系發展 30
貳、台灣精神健康照護政策與體系 32
一、衛生體系 32
二、社政體系 36
第五節 精神健康照護體系內涵對精神健康照護需要的意義 43
第三章 文獻探討 45
第一節 精神健康照護服務面面觀 46
第二節 精神健康照護需要(needs) 47
壹、需要的定義 47
貳、評估需要的方法 50
一、評估需要的方法論 50
二、評估需要的測量工具 54
參、精神健康照護需要的實證研究 57
肆、精神健康照護需要的影響因素 61
第三節 精神健康照護服務利用(utilization) 67
壹、健康服務利用的定義 67
貳、健康服務利用理論 68
一、病患決策理論 (model of patient decision-making) 68
二、健康信念模型理論 (health belief model) 70
三、健康服務利用行為模型理論 (behavioral model of health service utilization ) 72
四、包含照顧者因素之健康服務利用行為模型 80
參、健康服務利用分析模型 80
一、人口模型 (demographic models) 81
二、社會結構模型 (social structure models) 81
三、社會心理模型 (social psychological models) 81
四、經濟模型 (economic models) 81
五、組織模型 (organization) 82
六、系統模型 (systems models) 82
七、過濾模型 (filters models) 82
肆、精神健康照護服務利用實證研究 84
伍、精神健康照護服務利用的影響因素 90
第四節 精神健康照護需求(demand) 98
壹、需求的定義 98
貳、經濟模型理論-健康需求 (demand for health) 模型與健康照護需求 (demand for health care) 模型 99
參、精神健康照護需求實證研究 103
肆、健康需求與健康照護需求的影響因素 104
伍、健康照護需求實證研究的分析方法 104
第五節 精神健康照護服務相關文獻綜合討論 106
壹、精神健康照護需要與評估 106
貳、精神健康服務利用與需求 107
參、精神健康照護需要與需求的關係 108
第四章 研究方法 111
第一節 研究架構 112
壹、研究架構說明 112
貳、研究假設 113
第二節 資料來源說明 115
壹、研究資料檔說明 115
貳、研究個案說明 118
第三節 研究變項說明 119
壹、病患及主要照顧者特質自變項之說明 119
貳、精神健康照護需要依變項之說明 119
參、精神健康照護需求依變項之說明 121
肆、分析需要與需求關聯型態之研究變項說明 121
伍、研究變項資料來源與屬性之說明 122
第四節 資料分析方法 127
壹、統計分析 127
貳、資料分析步驟 127
第五章 研究結果 129
第一節 基本資料描述 130
壹、精神分裂症患者基本資料 130
貳、精神分裂症患者家庭資料 130
參、精神分裂症患者主要照顧者資料 130
肆、精神分裂症患者精神症狀、社會功能、自我照顧能力與家庭經濟狀況分析 131
第二節 精神健康照護需要之分析 132
壹、以患者症狀、功能、自我照顧能力與經濟狀況客觀評估患者精神健康照護需要 132
貳、主要照顧者主觀評估患者精神健康照護需要 132
參、客觀評估與主觀評估患者精神健康照護需要之比較分析 133
肆、精神健康照護需要影響因素之分析 133
一、客觀評估需要之單變項分析與多變項分析 133
二、主觀評估需要之單變項分析與多變項分析 136
第三節 精神健康照護需求之分析 138
壹、精神分裂症患者精神健康服務使用情形 138
貳、門診精神醫療照護服務需求之影響因素分析 138
一、使用門診服務之分析 138
二、門診次數之分析 139
參、住院精神醫療照護服務需求之影響因素分析 139
一、使用住院服務之分析 139
二、住院日數之分析 139
肆、社區復健精神醫療照護服務需求之影響因素分析 140
一、社區復健服務之分析 140
二、社區復健日數之分析 140
伍、精神福利服務需求之影響因素分析 140
第四節 精神健康照護需要與需求關聯型態之分析 142
壹、精神健康照護需要與需求之比較分析 142
一、精神健康照護需要與需求個案分布情形之分析 142
二、精神健康照護需要與需求影響因素之分析 143
貳、客觀與主觀評估精神健康照護需要與需求關聯型態之建立 143
參、精神健康照護需要與需求關聯型態在家庭負荷之分析 145
肆、精神健康照護需要與需求關聯型態在患者生活品質之分析 146
伍、精神健康照護需要與需求關聯型態在健康服務供給之分析 146
第六章 討論 149
第一節 研究限制 150
壹、研究資料的限制 150
貳、前題假設的限制 151
參、當前精神健康照護資源的限制 151
第二節 精神健康照護需要之討論 153
壹、考量資源耗用因素之需要評估 153
貳、同時考量患者與照顧者因素之需要評估 155
參、評估需要方法之討論 156
第三節 精神健康照護需求之討論 158
壹、精神健康照護需求之國際比較 158
貳、精神健康照護需要與需求之關係 159
第四節 整體患者精神健康照護需要與需求比較之討論 160
第五節 精神健康照護需要與需求關聯型態之討論 162
壹、精神健康照護需要與需求關聯型態之建立 162
貳、精神健康照護需要與需求關聯型態之分析 163
參、精神健康照護需要與需求關聯型態對健康服務供給的衝擊 164
肆、精神健康照護需要與需求關聯型態的限制 165
第六節 需要與需求關聯型態分析在精神健康照護體系之應用 167
壹、台灣精神健康照護體系的限制與優勢 167
貳、精神健康照護需要與需求關聯型態在健康照護體系之應用 170
第七章 結論與建議 173
第一節 結論 173
壹、精神健康照護需要與需求關聯型態 173
貳、精神健康照護需要與需求關聯型態未來的研究方向 174
第二節 建議 175
壹、對精神健康照護體系 175
貳、對精神衛生政策 175
參、對未來研究 175
第八章 參考資料 177
第一節 中文資料 177
第二節 英文資料 180
表格 195
附錄 251
第一節 中文資料
中央健康保險局:醫療服務支付標準,2002.
內政部社會司:http://volnet.moi.gov.tw/sowf,2003。
玉里榮民醫院: http://www.vhyl.gov.tw,2003。
署立玉里醫院: http://www.ttyl.tpg.gov.tw/index.asp,2003。
行政院衛生署:精神衛生法及其施行細則。1992。
行政院衛生署:衛生統計(一)公務統計。行政院衛生署。1998。
行政院衛生署:衛生統計(一)公務統計。行政院衛生署。2000。
行政院衛生署:衛生統計(一)公務統計。行政院衛生署。2002。
行政院衛生署:醫療保健計畫-籌建醫療網計畫。行政院衛生署。1986。
行政院衛生署:建立醫療網第二期計畫。行政院衛生署。1993。
行政院衛生署:建立醫療網第三期計畫。行政院衛生署。1996。
行政院衛生署:醫療網第四期計畫。行政院衛生署。2000。
李明濱:整合性精神醫療體系規研究第一年─病患分類、治療指引及品質監控系統。 中央健康保險局委託研究報告,2000。
宋麗玉:精神疾病照護者負荷的程度與相關因素之探討。行政院國科會研究報告;1997a。
宋麗玉:台灣省精神障礙者生活現況及對社會福利需求調查報告。台灣省政府社會處;1997b。
林 憲:臨床精神醫學。台北:茂昌圖書有限公司,1985。 
吳肖琪:健康保險與醫療網區域資源對醫療利用之影響。台灣大學公共衛生研究所博士論文,1991。
吳就君、黃梅羮、胡海國、蔡春美、鄭若瑟、張宏俊、鄭夙芬:精神分裂症病患照顧者表露情緒與社會心理因素之關係─兩年追蹤研究。台大社會工作學刊第四期;1991。
吳就君、黃梅羮、胡海國、陳珍信:精神分裂症家屬表露情緒之變化:兩年追蹤研究。台灣精神醫學。1999;13(1):54-64。
胡海國、葉英堃、張苙雲、葉元麗:精神疾病流行病學與社區精神醫療行政-精神疾病盛行率與社區精神醫療人力之探討。中華心理衛生學刊。1987;3(1):43-55。
胡海國:演進模式之精神病理研究-以精神分裂症為例。民族學研究所集刊。中央研究院民族學研究所,1993。
胡海國、林憲、陳建仁、張素凰、黃梅羹、葉玲玲:台灣地區精神科住院病患的個人、家庭與臨床研究。 中華精神醫學。1995;19(1):16-31。
胡海國、林信男編譯:精神與行為障礙之分類。中華民國精神醫學會。台北;1996a。
胡海國、陳珍信、林憲、陳健仁、張素凰、黃梅羮、葉玲玲:台灣精神科床位分佈。中華精神醫學。1996b;10(1):45-53。
胡海國:精神分裂症:描述性精神病理。橘井文化事業股份有限公司,1999。
胡海國:精神分裂症之社區流行病學。當代醫學。2002;29(9):717-727。
陳永興:國家醫療與精神醫療政策。台灣精神醫學。1997;11(1):3-15。
陳彥承:台灣精神障礙者照護之現況分析與未來發展(一)社會福利政策層面 台灣精神障礙者照護發展研討會。 國家衛生研究院主辦 2002。
曾文星、徐靜:現代精神醫學。水牛出版社,1994。
莊明敏:精神病患醫療服務體系之檢討。行政院研考會編印,1995。
馮燕、李明政(譯):楚曼博士原著:社會工作實務研究法。桂冠圖書股份有限公司;1986。
張清溪、許嘉棟、劉鶯釧、吳聰敏:經濟學:理論與實際。雙葉書廊有限公司,1993。
葉玲玲、李玉春、楊銘欽、劉絮愷、胡海國:嚴重精神病患經濟成本分析。中華心理衛生學刊。1997;10(3):1-15。
葉玲玲、藍忠孚、鄭若瑟:台灣精神分裂症患者精神醫療利用與費用之分析探討。台灣公共衛生雜誌,2003。(投稿中)
葉英堃、呂淑妤、戴傳文、范碧玉、蘇喜、陳毓萍:台灣歷次精神醫療院所評鑑之比較。台灣精神醫學。 1999;13(2):105-114。
鄭若瑟:台灣精神障礙者照顧者之現分析與未來發展-醫療層面。台灣精神障礙者照護發展研討會。 國家衛生研究院主辦; 2002。
萬育維:社會福利服務。三民書局;1996。
謝啟瑞:健康經濟學。五南圖書出版公司;1996。
蘇昭如:台灣精神障礙者照護之現況分析與未來展望-就業政策面 台灣精神障礙者照護發展研討會。 國家衛生研究院主辦;2002。
第二節 英文資料
AbuMadini MS, Rahim SI. Psychiatric admission in a general hospital: patients profile and patterns of service utilization over a decade. Saudi Med Journal. 2002;23(1):44-50.
Aday LA, Shortell SM. Indicators and predictors of health services utilization. In: Williams ST, Torrens PR,eds. Introduction to health services. 3rd ed. New York: John Wiley & Sons;1988 :51-81.
Alanen YO, Lehtinen K, Rakkolainen V, Aaltonen J. Need-adapted treatment of new schizophrenic patients: experiences and results of the Turku Project. Acta Psychiatr Scand. 1991;83:363-372.
American Medical Association. Physicians’ current procedure terminology CPT 97. 1997.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSMIII . 1980.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSMIV. 1994.
Andersen R. A behavioral model of families’ use of health service. Center for Health Administration Studies University of Chicago;1968.
Andersen R. Revising the behavioral model and access to medical care: dose it matter? Journal of Health and social Behavior. 1995;36:1-10.
Anderson RL, Lyons JS. Needs-based planning for persons with serious mental illness residing in intermediate care facilities. Journal of Behavioral Health Services & Research. 2001;28(1):104-110.
Andersen RM, Davidson PL. Measuring access and trends. In:Williams SJ, Torrens PR, eds. Introduction to health services. Delmar Publishers;1999;59-85.
Arnhoff FN. Reassessment of the trilogy: need, supply and demand. American Psychology. 1968;23(5):312-316.
Arrow KJ. Uncertainty and the welfare economics of medical care. American Economic Review. 1963;53(5):941-973.
Arvidsson H. Needs assessed by patients and staff in a Swedish sample of severely mentally ill subjects. Nord Journal of Psychiatry. 2001;55:311-317.
Avison WR. Impact of mental illness on the family. In:Aneshensel CS, Phelan JC, eds. Handbook of the sociology of mental health. New York: Kluwer Academic/ Plenum Publishers;1999;495-518.
Bass DM, Noelker LS. The influence of family caregivers on elder’s use of in-home services: an expanded conceptual framework. Journal of Health and Social Behavior. 1987;28:184-196.
Bass DM, Looman WJ, Ehrlich P. Predicting the volume of health and social services: integrating cognitive impairment into the modified Andersen framework. The Gerontologist. 1992;32(1):33-43.
Baldwin S. Problems with needs:where theory meets practice in mental health services. In :Baldwin S, eds. Needs assessment and community care:Clinical practice and policy making. Butterworth-Heinemann;1998.
Becker GS. Theory of the allocation of time. Economic Journal. 1965;75:493-517.
Bellack AS, Haas GL, Schooler NR, Flory JD. Effects of behavioral family management on family communication and patient outcomes in schizophrenia. British Journal of Psychiatry. 2000;177:434-439.
Bengtsson-Tops A, Hansson, L. Clinical and social needs of schizophrenic outpatients living in the community: the relationship between needs and subjective quality of life. Soc Psychiatry Psychiatr Epidemiol. 1999;34:513-518.
Berren MR, Santiago JM, Zent MR, Carbone CP. Health care utilization by persons with severe and persistent mental illness. Psychiatric Services. 1999;50(4):559-561.
Bijl RV, Ravelli A. Psychiatric morbidity, service use, and need for care in the general population: results of the Netherlands mental health survey and incidence study. American Journal of Public Health. 2000;90(4):602-607.
Black DW, Andreasen NC. Schizophrenia, schizophreniform disorder, and delusional disorder. In:Hales RE, Yudofsky SC, eds. Synopsis of psychiatry. The American Psychiatric Press;1996.
Boye B, Bentsen H, Notland TH, Munkvold OG, Lersbryggen AB, Oskarsson KH, Uren G, Ulstein I, Bjorge H, Lingjaerde O, Malt UF. What predicts the course of expressed emotion in relatives of patients with schizophrenia or related psychoses? Soc Psychiatry Psychiatr Epidemiol. 1999;34:35-43.
Boye B, Bentsen H, Ulstein I, Notland TH, Lersbryggen A, Lingjaerde O, Malt UF. Relatives’ distress and patients’ symptoms and behaviours: a prospective study of patients with schizophrenia and their relatives. Acta Psychiatrica Scandinavica. 2001;104:45-50.
Bradford D, Stroup S, Lieberman J. Pharmacological treatments for schizophrenia. In:Nathan PE, Gorman JM, eds. A guide to treatment that work. Oxford University Press;2002.
Breakey WR. Developmental milestones for community psychiatry. In:Breakey WR, eds. Integrated Mental Health Services. Oxford University Press;1996.
Brewin CR, Wing JK, Mangen SP, Brugha TS, MacCarthy B. Principles and practice of measuring needs in the long-term mentally ill: the MRC needs for care assessment. Psychological Medicine. 1987;17:971-981.
Brewin CR, Wing JK, Mangen SP, Brugha TS, MacCarthy B. Needs for care among the long-term mentally ill: a report from the Camberwell High Contact Survey. Psychological Medicine. 1988;18:457-468.
Brewin CR. Measuring individual needs for care and services. In:Thornicroft G, eds. Measuring mental health needs. Gaskell Royal College of Psychiatrists; 2001.
Burgy R, Hafner-Ranabauer W. Need and demand in psychiatric emergency service utilization: explaining topographic differences of a utilization sample in Mannheim. Eur Arch Psychiatry Clin Neursoci. 2000;250:226-233.
Carr VJ, Lewin TJ, Barnard RE, Walton JM, Allen JL, Constable PM, Chapman JL. Comparisons between schizophrenia patients recruited from Australian general practices and public mental health services. Acta Psychiatr Scand. 2002;105:346-355.
Chapman Helen. Self-help groups, family carers and mental health. Australian and New Zealand Journal of Mental Health Nursing. 1997;6:148-155.
Cheah YC, Parker G, Pavlovic HD, Gladstone G, Eyers K. Development of a measure profiling problems and needs of psychiatric patients in the community. Soc Psychiatry Psychiatr Epidemiol. 1998;33:337-344.
Cooper-Patrick L, Gallo JJ, Powe NR, Steinwachs DM, Eaton WW, Ford DE. Mental health service utilization by African Americans and whites. Medical Care. 1999;37(10):1034-1045.
Craig TJ, Fennig S, Tanenberg-Karant M, Bromet EJ. Rapid versus delayed readmission in first-admission psychosis:quality indicators for managed care? Annals of Clinical Psychiatry. 2000;12(4):233-238.
Dardanoni V, Wagstaff A. Uncertainty and the demand for medical care. Journal of Health Economics. 1990;9:23-28.
Diehr P, Williams SJ, Martin DP, Price K. Ambulatory mental services utilization in three provider plans. Medical Care. 1984;22(1):1-13.
Domenici SPV, Mexico R N. Mental health care policy in the 1990s: Discrimination in health care coverage of the seriously mentally ill. Journal of Clinical Psychiatry. 1993;53(3):5-6.
Duan N, Manning WG, Morris CN, Newhouse JP. A comparison of alternative models for the demand for medical care. Journal of Business & Economics Statistic. 1983;1(2):115-126.
Dyck DG, Hort R, Vitaliano PP. Predictors of burden and infectious illness in schizophrenia caregivers. Psychosomatic Medicine. 1999;61:411-419.
Falloon IR, Shanahan W, Laporta M, Krekorian HAR. Integrated family, general practice and mental health care in the management of schizophrenia. Journal of the Royal Society of Medicine. 1990;83:225-228.
Feldstein PJ. Health care economics. 3rd ed. New York:Delmar Publishers;1988;347-367.
Feldstein PJ. Health care economics. 5th ed. New York:Delmar publishers;1998;82-116.
Flisher AJ, Kramer RA, Grosser RC, Alegria M, Bird HR, Bourdon KH, Goodman SH, Greenwald S, Horwitz SM, Moore RE, Narrow WE, Hoven CW. Correlates of unmet need for mental health services by children and adolescents. Psychological Medicine. 1997;27(5):1145-1154.
Folland S, Goodman AC, Stano M. The economics of health and health care. Prentice Hall; 1997
Frank RG, Huskamp HA, McGuire TG, Newhouse J P. Some economics of mental health carve-outs. Arch Gen Psychiatry. 1996;53:933-937.
Frank RG, McGuire TG. A review of studies of the impact of insurance on the demand and utilization of specialty mental health services. Health Services Research 1986;21(2):241-265.
Frank RG, Manning WG. Economics and mental health. The Johns Hopkins University Press; 1992.
Frank RG, McGuire TG. Economics and mental health. National Bureau of Economic Research Working Paper. 1999.
Freeman HL, Bennett DH. Origins and development. In:Bennett DH, Freeman HL, eds. Community Psychiatry. Churchill Livingstone;1991.
Fried BJ, Topping S, Morrissey JP, Ellis AR, Stroup S, Blank M. Comparing provider perceptions of access and utilization management in full-risk and no-risk Medicaid programs for adults with serious mental illness. The Journal of Behvaioral Health Services & Research. 2000;27(1):29-46.
Freidl W, Rasky E, Stronegger W-J. Operationalisation of a demand/resource model of health : an explorative study. Journal of Epidemiol Community Health. 1998;53: 187-188.
Fuchs RF. The future of health economics. National Bureau of Economic Research. Working Paper 1999.
Gallo JJ, Marino S, Ford D, Anthony JC. Filters on the pathway to mental health care, II. Sociodemographic factors. Psychological Medicine. 1995;25:1149-1160.
Gelder MG, L’opex-lbor jr JJ, Andreasen NC, eds. New Oxford textbook of psychiatry. Oxford University Press;2000.
Glover GR, Robin E, Emami J, Arabscheibani GR. A needs index for mental health care. Soc Psychiatry Psychiatr Epidemiol. 1998;33:89-96.
Gold M. : The demand for hospital outpatient services. Health Service Research 1984;19(3):382-412.
Goodman AB, Craig TJ. A needs assessment strategy for an era of limited resources. American Journal of Epidemiology. 1982;115(4):624-632.
Grad J, Sainbury P. Mental illness and the family. The Lancet. 1963:544-547.
Grassi L, Peron L, Marangoni C, Zanchi P, Vanni A. Characteristics of violent behaviour in acute psychiatric inpatients: a 5-year Italian study. Acta Psychiatr Scand. 2001;104:273-279.
Greenberg JS, Greenley JR, Benedict P. Contributions of persons with serious mental illness to their family. Hospital and Community Psychiatry. 1994;45(5):475-480.
Grossman M. On the concept of health capital and the demand for health. Journal of Political Economy. 1972;80:223-255.
Grossmand M. The human capital model of the demand for health. National Bureau of Economics Research. Working Paper 1999.
Hansson L, Sandlund M. Utilization and patterns of care in comprehensive psychiatric care organizations: a review of studies and some methodology considerations. Acta Psychiatr Scand. 1992;86:255-261.
Harding K, Baldwin S, Baser C. Towards multi-level needs assessment. Behavioural Psychotherapy. 1987;15:134-143.
Haro JM, Slvador-carulla L, Cabas’es J, Madoz V, V’azquez-barquero JL, the PSICOST Group. Utilisation of mental health services and costs of patients with schizophrenia in three areas of Spain. British Journal of Psychiatry. 1998;173:334-340.
Hatfield AB, Spaniol L, Zipple AM. Expressed emotion: a family perspective. Schizophrenia Bulletin. 1987;13(2):221-226.
Herz MI, Marder SR. Schizophrenia — comprehensive treatment and management. Lippincott Williams & Wilkins;2002;21-34.
Hopko DR, Lachar D, Bailley SE, Varner RV. Assessing predictive factors for extended hospitalization at acute psychiatric admission. Psychiatric Services. 2001;52:1367-1373.
Horgan C. Specialty and general ambulatory mental health services: A comparison of utilization and expenditures. Archives of General Psychiatry. 1985;42:565-572.
Horgan C. The demand for ambulatory mental health services from specialty providers. Health services Research. 1986;21(2):291-320.
Horgan C , Salkever D. The demand for outpatient mental health care from nonspeciality providers. Advance in Health Economics and Health Services Research. 1987;8:211-233.
Hu TW, Snowden LR, Jerrell JM, Nguyen TD. Ethnic populations in public mental health:services choice and level of use. American Journal of Public Health. 1991;81(11):1429-1434.
Hopton JL, Dlugolecka M. Need and demand for primary health care: a comparative survey approach. BMJ. 1995;310:1369-1373.
Howard KI, Cornille TA, Lyons JS, Vessey JT, Lueger RJ, Saunders SM. Patterns of Mental Health Service Utilization. Arch General Psychiatry. 1996;53:696-703.
Hwu HG, Chen JZ, Lin HN, Wu CC. Multidimensional Psychopathological Group Research Project. Report of National Health Research Institute, DOH-83-HR-306 (in Chinese). National Health Research Institute. Taiwan;1993.
Hwu HG, CHen CH, Hwang TJ. Symptom patterns and grouping of schizophrenic patients: significance of negatives symptoms assessed on admission. Schizophrenia Research. 2000;56:105-119.
Jensen GA, Rost K, Burton RP. Mental health insurance in the 1990s: Are employers offering less to more. Health Affairs. 1998;17(3):201-209.
Jibson MD, Tandon R. Treatment of acute psychotic episodes. In:Csernansky JG, eds. Schizophrenia — a new guide for clinicians. Marcel Dekker, Inc.;2002.
Johnson S., Prosser D., Bindman J., Szmukler G.:Continuity of care for the severely mentally ill: concepts and measures. Soc Psychiatry Psychiatr Epidemiol 1997;32:137-142.
Kazarian SS, McCabe SB, Joseph LW. Assessment of service needs of adult psychiatric inpatients: a systematic approach. Psychiatric Quarterly. 1997;68(1):5-23.
Kavanagh DJ, O’Halloran P, Manicavasagar V, Clark D, Piatkowska O, Tennant C, Rosen A. The family attitude scale: reliability and validity of a new scale for measuring the emotional climate of families. Psychiatry Research. 1997;70:185-195.
Kallert TW, Leisse M. Schizophrenic patients'' normative needs for community-based psychiatric care: an evaluative study throughout the year following hospital release in the Dresden region. Soc Psychiatry Psychiatr Epidemiol. 2001;36:1-12.
Kemp DR, Brody E, eds. International handbook on mental health policy. London:Greenwood Press;1993.
Klerman GL, Olfson M, Leon AC, Weissman MM. Measuring the need for mental health care. Health Affairs. 1992;23-33.
Knapp M, Chisholm D, Leese M, Amaddeo F, Tansella M, Schene A, Thornicroft G, Vazquez-Barquero JL, Knudsen HC, Becker T, the EPSILON Study Group. Comparing patterns and costs of schizophrenia care in five European countries: the EPSILON study. Acta Psychiatr Scand. 2002;105:42-54.
Koegel P, Sullivan G, Burnam A, Morton SC, Wenzel S. Utilization of mental health and substance abuse services among homeless adults in Los Angeles. Medical Care . 1999;37(3):306-317.
Kopelowicz A, Liberman RP, Zarate R. Psychosocial treatments for schixophrenia. In:Nathan PE, Gorman JM, eds. A guide to treatment that work. Oxford University Press;2002.
Kuipers L. Family burden in schizophrenia: implications for services. Social Psychiatry Psychiatric Epidemiology. 1993;28:207-210.
Laitinen-Krispijn S, Van Der Ende J, Wierdsma AI, Verhulst FC. Predicting adolescent mental health service use in a prospective record-linkage study. Journal of American Academic Child Adolescent Psychiatry. 1999;38(9):1073-1080.
Lamb HR. Public psychiatry and prevention. In:Hales RE, Yudofsky SC, eds. Synopsis of psychiatry. Washington, DC:The American Psychiatric Press;1996;1323-1341.
Lauriello J, Horan WP, Bustillo J. Schizophrenia from the life-cycle perspective. In: Csernansky JG, eds. Schizophrenia — a new guide for clinicians. Marcel Dekker, Inc.;2002.
Leaf PJ, Bruce ML, Tischler GL, Freeman DH, Weissman MM, Myers JK. Factors affecting the utilization of specialty and general medical mental health service. Medical Care. 1988;26(1):9-26.
Lehtinen Klaus. Need-adapted treatment of schizophrenia: family interventions. British Journal of Psychiatry. 1994;164(suppl. 23):89-96.
Lesage AD, Clerc D, Urib’e I, Cournoyer J, Fabian J, Tourjaman V, Haaster I, Chang CH. Estimating local-area needs for psychiatric care: a case study. British Journal of Psychiatry. 1996;169:49-57.
Link BG, Phelan JC. Labeling and stigma. In:Aneshensel CS, Phelan JC, eds. Handbook of the sociology of mental health. New York:Kluwer Academic/ Plenum Publishers;1999;481-494.
Liljas B. The demand for health with uncertainty and insurance. Journal of Health Economics. 1998;17:153-170.
Liss PE. Assessing health care need:the conceptual foundation. In:Baldwin ,eds. Needs assessment and community care:Clinical practice and policy making. Butterworth-Heinemann;1998.
Lockwood A, Marshall M. Can a standardized needs assessment be used to improve the care of people with severe mental disorders? A pilot study of "needs feedback". Journal of Advanced Nursing. 1999;30(6):1408-1415.
Lockwood A, Marshall M. The Cardinal Needs Schedule:a standardized research instrument for measuring individual needs. In:Thornicroft G, eds. Measuring mental health needs. Gaskell Royal College of Psychiatrists;2001.
Magliano L, Fadden G, Economous M, Held T, Xavier M, Guarneri M, Malangone C, Marasco C, Maj M.Family burden and cooping strategies in schizophrenia: 1-year follow-up data from the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol. 2000;35:109-115.
Magliano L, Fadden G, Economous M, Xavier M, Held T, Guarneri M, Marasco C, Tosini P, Maj M. Social and clinical factors influencing the choice of coping strategies in relatives of of patients with schizophrenia: results of the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol. 1998a;33:413-419.
Magliano L, Fadden G, Fiorillo A, Malangone C, Sorrentino D, Robinson A, Maj M. Family burden and coping strategies in schizophrenia: are key relatives really different to other relatives? Acta Psychiatr Scand. 1999;99:10-15.
Magliano L, Fadden G, Madianos M, Caldas JM, Almcida de, Held T, Guarneri M, Marasco C, Tosini P, Maj M. Burden on the families of patients with schizophrenia: results of the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol. 1998b;33:405-412.
Manning WG, Newhouse JP, Duan N, Keeler E, Leibowitz A, Marquis MS. Health insurance and the demand for medical care: evidence from a randomized experiment. The American Economic Review. 1987;77(3):251-278.
Manning WG, Newhouse JP, Duan N, Keeler E, Benjamin B, Leibowitz A, Marquis MS, Zwanziger J. Health insurance and the demand for medical care: evidence from a randomized experiment. RAND Corporation Health Insurance Experiment Series. 1988.
Marino S , Gallo JJ, Ford D, Anthony JC. Filters on the pathway to mental health care, I. Incident mental disorders. Psychological Medicine. 1995;25(6) 1135-1148.
McDonagh MS, Smith DH. Measuring appropriate use of acute beds a systematic review of methods and results. Health Policy. 2000;53:157-184.
McAlpine DD, Mechanic D. Utilization of specialty mental health care among persons with severe mental illness: the roles of demographics, need, insurance, and risk. Health Services Research. 2000;35(1):277-292.
Meadows G, Harvey C, Fossey E, Burgess P. Assessing perceived need for mental health care in a community survey: development of the Perceived Need for Care Questionnaire (PNCQ). Soc Psychiatry Psychiatr Epidemiol. 2000;35:427-435.
Melzer D, Watters L, Paykel E, Singh L, Gormley N. Factors explaining the use of psychiatric services by general practices. British Journal of General Practice. 1999;49:887-891.
Miller BA, Mcfall S. The effect of caregiver’s burden on change in frail older persons’ use of formal helpers. Journal of Health and Social Behavior. 1991;32:165-179.
Milliken ME. Understanding human behavior : a guide for health care providers. Delmar Publishers;1998.
Mocan HN, Tekin E, Zax JS. The demand for medical care in urban China. National Bureau of Economic Research. Working Paper 2000.
Murray V, Walker HW, Mitchell C, Pelosi AJ. Needs for care from a demand led community psychiatric service: a study of patients with major mental illness. BMJ 1996;312:1582-1586.
Muurinen JM. Demand for health: a generalized Grossman model. Journal of Health Economics. 1982;1::5-28.
Newhouse JP. The demand for medical care services: a retrospect and prospect. In:Gaag JVD, Perlman M, eds. Health ,economics and health economics. New York: North-Holland Publishing Company;1981.
Ng CH : The stigma of mental illness in Asian cultures. Australian and New Zealand Journal of Psychiatry 1997;31:382-390.
OECD Health Data 1998 available in CD.
Oheri JU. Perception of the social support role of the extended family network by some Nigerians with schizophrenia and affective disorders. Social Science Medicine. 1998;47(10):1463-1472.
Ohaeri JU. Caregiver burden and psychotic patients’ perception of social support in a Nigerian setting. Soc Psychiatry Psychiatr Epidemiol. 2001;36:86-93.
Pardes H. Future needs for psychiatrists and other mental health personnel. Arch Gen Psychiatry. 1979;36:1401-1408.
Pindyck RS, Rubinfeld DL. Microeconomics. New Jersey: Prentice Hall; 1997.
Petersen DJ, Alexander GR. Needs assessment in public health : a practical guide for students and professionals. New York:Kluwer Academic/Plenum Publishers; 2001;15-37.
Richman A, Boutilier C, Harris P. The relevance of socio-demographic and resource factors in the use of acute psychiatric in-patient care in the Atlantic Provinces of Canada. Psychological Medicine. 1984;14:175-182.
Richardson M, Thornton SS. Mental health services. In:Williams SJ, Torrens PR, eds. Introduction to health services. Delmar Publishers;1999;349-379.
Regier DA, Shapiro S, Kessler LG,Taube CA. Epidemiology and health service resource allocation policy for alcohol, drug abuse, and mental disorders. Public Health Reports. 1984;99(5):483-492.
Rothbard AB, Kuno E, Schinnar AP, Hadley TR, Turk R. Service utilization and cost of community care for discharged state hospital patients: a 3-year follow-up study. American Journal of Psychiatry. 1999;156(6):920-927.
Royse D, Drude K. Mental health needs assessment: beware of false promises. Community Mental Health Journal. 1982;18(2): 97-106.
Sadock B, Sadock V, eds. Comprehensive textbook of psychiatry. Lippincott Williams & Wilkins;1999.
Salize HJ, Kustner BM, Torres-Gonzalez F, Reinhard I, Estevez JFJ, Rossler W. Needs for care and effectiveness of mental health care provision for schizophrenic patients in two European regions: a comparison between Granada (Spain) and Mannheim (Germany). Acta Psychiatr Scand. 1999;100:328-334.
Salokangas R, Palo-oja T, Ojanen M, Jalo K. Need for community care among psychotic outpatients. Acta Psychiatr Scand. 1991;84:191-196.
Santos A B, Henggeler S W, Burns B J, Arana G W, Meisler N. Research on field-based services: Models for reform in the delivery of mental health care to populations with complex clinical problems. Am J Psychiatry. 1995;152(8):1111-1123.
Santerre R E, Neun S P. Health economics: theories, insights, and industry studies Irwin;1996:353.
Selden TM. : Uncertainty and health care spending by the poor: the health capital model revisited. Journal of Health Economics. 1993;12:109-115.
Shapiro S, Skinner EA, Kessler LG et al. Utilization of health and mental health services: three epidemiologic catchment area sites. Arch Gen Psychiatry. 1984;41:971-978.
Shapiro S, Skinner EA, Kramer M, Steinwachs D, Regier DA. Measuring need for mental health services in a general population. Medical Care. 1985;23:1033-1043.
Shern DL, Donahue SA, Felton C, Joseph GR, Brier N. Partial capitation versus fee-for-service in mental health care. Health Affairs. 1995;209-217.
Shortell SM. Factors associated with the use of health services. In:Williams ST, Torrens PR, eds. Introduction to health services. 2nd. New York: John Wiley & Sons;1984.
Simon GE, Vonkorff M, Durham ML. Predictors of outpatient mental health utilization by primary care patients in a health maintenance organization. American Journal of Psychiatry. 1994;151(6):908-913.
Simon GE, Un’utzer J. Health care utilization and costs among patients treated for bipolar disorder in an insured population. Psychiatric Services. 1999;50(10):1303-1308.
Slade Mike. Needs assessment: Involvement of staff and users will help to meet needs. British Journal of Psychiatry. 1994;165:293-296.
Slade M, McCrone P. The Camberwell Assessment of Need (CAN). In:Thornicroft G,eds. Measuring mental health needs. Gaskell Royal College of Psychiatrists; 2001.
Slade M, Powell R, Strathdee G. Current approach to identifying the severely mentally ill. Soc Psychiatry Psychiatr Epidemiol. 1997;32:174-184.
Smith D. Psychiatric manpower in British Columbia. Canada Medical Association Journal. 1984;131(9):1120-1123.
Smith H. Needs assessment in mental health services: the DISC framework. Journal of Public Health Medicine. 1998;20(2):154-160.
SPSS Inc. Statistic package of social sciences. 11.5th 2002.
Smith P. Sheldon TA, Martin S. An index of need for psychiatric services based on in-patient utilisation. British Journal of Psychiatry. 1996;169:308-316.
Taube CA, Kessler LG, Burns BJ. Estimating the probability and level of ambulatory mental health services use. Health Service Research. 1986;21(2):321-340.
Thornicroft G, Tansella M, eds. Mental health outcome measures. Springer; 1996;217-226
Tarrier N, Barrowclough C, Vaughn C, Bamrah JS, Porceddu K, Watts S, Freeman H. Community management of schizophrenia: a two-year follow-up of a behaviour intervention with families. British Journal of Psychiatry. 1989;154:625-628.
Umberson D, Williams K. Family Status and mental health. In:Aneshensel CS, Phelan JC, eds. Handbook of the sociology of mental health. New York:Kluwer Academic/ Plenum Publishers;1999;225-254.
Vega WA, Kolody B, Aguilar-Gaxiola S, Catalano R. Gaps in service utilization by Mexican American with mental health problems.  American Journal of Psychiatry. 1999;156(6):928-934.
Veltman A, Cameron JI, Stewart DE. The experience of providing care to relatives with chronic mental illness. The Journal of Nervous Mental Disease. 2002;190:108-114.
Watts CA, Scheffler RM, Jewell NP. Demand for outpatient mental health services in a heavily insured population: the case of Blue Cross and Blue Shield Association’s federal employees health benefits program. Health Service Research. 1986;21(2):267-289.
Winefield HR, Harvey EJ. Needs of family caregivers in chronic schizophrenia. Schizophrenia Bulletin. 1994;20(3):557-566.
Wing J, Brewin CR, Thornicroft G. Defining mental health needs. In:Thornicroft G, eds. Measuring mental health needs. United Kingdom : Gaskell Royal College of Psychiatrists;2001;1-21.
Williams SJ, Torrens PR. Historical patterns of disease in the United States. In:Williams SJ, Torrens PR, eds. Introduction to health services. Delmar Publishers ; 1999;59-85.
Wiersma D, Sytema S, Busschbach JV, Schreurs M, Kroon H, Driessen G. Prevalence of long-term mental health care utilization in the Netherlands.  Acta Psychiatr Scand. 1997;96:247-253.
Wuerker AK, Fu VK, Haas GL, Bellack AS. Age, expressed emotion, and interpersonal control patterning in families of persons with schizophrenia. Psychiatry Research. 2002;109:161-170.
Yeh LL, Lan CF, Liu SK, Wu ACC, Hwu HG. Assessment of the need for admission and the burden of caregivers of patients with schizophrenia under exaggerated clinical conditions. Psychiatry Services. 2003. (Submitting)
Zarkin GA, Bray JW, Junfeng Q. The effect of employee assistance programs use on healthcare utilization. Health Service Research. 2000;35(1):77-100.
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔