Need of Health Center-based Integrated Healthcare Services for the Elderly in Rural Area

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O b j e c t i v e s: The challenge of an increasing elderly population has coupled with ever- present social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly.

M e t h o d s: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly.

R e s u l t s: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model.

Income was a significant variable in increasing the need of health care and welfare services.

C o n c l u s i o n s: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

Key words : Health center, Integrated health care service, Elderly

⏣㽢㰖㡃⽊Ị㏢㭧㕂㦮 ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺䞚㣪☚

㤦㦖㑯

^{1 )}

, ₖ㿮⺆

^{2 )}

, 㧻㎎㰚

^{2 )}

, ⹫㫛ῂ

^{2 )}

, 䡚㑯㩫

^{2 )}

ṫ㤦☚ 䢣㻲ῆ⽊Ị㏢

^{1 )}

, 㡆㎎╖䞯ᾦ 㤦㭒㦮ὒ╖䞯㡞⹿㦮䞯ᾦ㔺

^{2 )}

Need of Health Center-based Integrated Healthcare Services for the Elderly in Rural Area

Eun-Sook Won

^{1 )}

, Chun-Bae Kim

^{2 )}

, Sei-Jin Chang

^{2 )}

, Jong-Ku Park

^{2 )}

, Sook-Jung Hyun

^{2 )}

Kangwondo Hongcheongun Public Health Center

^{1 )}

,

D e p a rtment of Preventive Medicine, Yonsei University Wonju College of Medicine

^{2 )}

୙ABSTRACT୙

J Agri Med & Community Health 2007;32(1):27~39

* ᾦ㔶㩖㧦: ₖ㿮⺆, 220-701 ṫ㤦☚ 㤦㭒㔲㧒㌆☯ 1 6 2, 㩚䢪: 0 3 3 - 7 4 1 - 0 3 4 4, 䕿㓺: 0 3 3 - 7 4 7 - 0 4 0 9, E-mail: k i m c b @ y o n s e i . a c . k r

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昢嵦

㑮ⳛ㦮㡆㧻ὒ 㧎ῂ㦮 ἶ⪏䢪⓪ 㩚㎎Ἒ ㍶㰚ῃὒ Ṳ⹲☚㌗ῃ✺㦮㩚⹮㩗㧎㿪㎎⪲㍲㧊㠦 ➆⯎ Ⱒ㎇㰞䢮㦮㯳Ṗ⓪ ṗ㫛㌳䢲⓻⩻㦮㩖䞮㢖䟟☯㦮㩲䞲㦚 Ṗ㪎┺㭒㠊㩦㹾 ⏎㧎

✺㦮㧦Ⱃ㌳䢲㦚⿞Ṗ⓻䞮Ợ 䞮ἶ 㧞┺. 㧊⩆

㌗䢿䞮㠦㍲ ⏎㧎✺㦮 Ịṫⶎ㩲⓪ ⽊Ị䞯㩗㧎䁷Ⳋ㈦Ⱒ㧊㞚┞⧒ ㌂䣢㩗, ἓ㩲㩗㧎䁷Ⳋ㠦㍲

☚ ⰺ㤆㭧㣪䞲㦮⹎⯒ Ṗ㰚┺.

㍶㰚ῃὒ ṯ㧊㤆Ⰲ⋮⧒☚ 2 0 0 5⎚㠦 ⏎㧎㧎 ῂṖ 9 . 1 %⪲  ㏣䞲 ⏎⪏䢪㌂䣢⪲ ⼖䢪䞮ἶ 㧞⓪ Ṗ㤊◆, Ⱒ㎇㰞䢮㧊䢮㧦Ṗ 㯳Ṗ䞮ἶ 㧞㠊 ⏎㧎⽊Ị㦮 ⶎ㩲Ṗ ⽊Ị㦮⬢㦮㭒㣪 ⶎ㩲

⪲ ╖⚦♮ἶ 㧞┺[1]. 䔏䧞㤆Ⰲ⋮⧒ ⏎㧎㦮 ἓ㤆˄ 䟟㥚㦮㑮䟟䁷Ⳋ㦮㌌㦮㰞˅ ὖⰂṖ 㔲 䞲㔺㩫㦒⪲, 65㎎㧊㌗ ⏎㧎㦮 Ⱒ㎇㰞䢮㥶⼧⮶㦖㟓 8 6 %㧊Ⳇ, 99.7%Ṗ 㰖㡃㌂䣢㠦㍲

㌳䢲䞮ἶ 㧞⓪ ⏎㧎㧊┺[2]. 㧊⩂䞲 ⏎⪏㧎ῂ 㦮㯳Ṗ⓪ ㌂䣢㩚⹮㠦 Ỏ㼦 Ⱔ㦖⼖䢪㢖 ⶎ 㩲㩦㦚 Ṗ㪎㡺ἶ 㧞㦒Ⳇ, ⏎㧎㧎ῂ㦮㯳Ṗ㠦

➆⧒ Ⱒ㎇㰞䢮㥶⼧⮶㧊 ⏨㞚㰦㦒⪲㖾 ⏎㧎✺

㦮㌌㦮㰞㦚 Ṧ㏢㔲䋺ἶ 㦮⬢゚㣿 ⡦䞲 Ⱏ╖

䞮Ⰲ⧒ 㡞㌗♲┺.

㰖⋲ 1 9 7 1⎚⿖䎆 ⹎ῃ ㌢䝚⧖㔲㓺䆪㭒㦮⿗

⿖䟊㞞㭧ῃ㧎㧊 Ệ㭒䞮⓪ On Lok㰖㡃㠦㍲

⏎㧎㦚㥚䞲䐋䞿⽊Ị㦮⬢㍲゚㓺䝚⪲⁎⧾㧎 PACE(Program of All-inclusive Care for the Elderly) ⳾◎㧊㔲㧧♮㠞┺[3-10]. PACE ⳾◎

㦖㰖㡃㌂䣢⌊ ⽊Ị㦮⬢㧎㦚㭧㕂㦒⪲ 䂮⬢, Ṗ㩫Ṛ䢎㍲゚㓺, 㭒Ṛ Ịṫ䝚⪲⁎⧾㦚䐋䞿㩗㦒⪲ 㤊㡗䞾㦒⪲㖾㰖⁞₢㰖㎇Ὃ㩗㦒⪲ 㔲䟟

♮ἶ 㧞⓪ 䝚⪲⁎⧾㧊┺[11-19]. 㧊 ἆὒ ⏎㧎㦮⬢゚⯒ 㩞Ṧ䞶㑮㧞⓪ 㨂㩫㩗㧎䣾ὒ☚ Ṗ 㪎㡾㧎㩫♲ 䝚⪲⁎⧾㧊⧒ἶ 䞶㑮㧞㦒Ⳇ [20-24], 䡚㨂⓪ ⹎ῃ⌊ ㈦Ⱒ 㞚┞⧒ 㡗ῃ ❇ 㡂⩂ ῃṖ✺㠦☚ 䢫㌆, 㥶㌂䞲䝚⪲⁎⧾✺㧊䢲㣿♮ἶ 㧞┺[ 2 5 - 2 7 ] .

⁎ ☯㞞㤆Ⰲ⋮⧒㦮⽊Ị⽋㰖䐋䞿㍲゚㓺㠦

╖䞲䝚⪲⁎⧾㦖⽋㰖⯒ 㭒㿫㦒⪲ 䞮♮ ⽊Ị

㦚 ⁎ 䞲㿫㠦 ⚦ἶ ⳾䡫 Ṳ⹲ ❇㦚䞲㡆ῂ Ṗ ╖⿖⿚㧊㠞┺. ⁎⩂⋮, ⏎㧎㦮㌌㦮㰞㦖㧊

✺㦮 Ⱒ㎇㰞䢮ὖⰂ ❇ Ịṫ㌗䌲㢖 ⰺ㤆 ⹖㩧䞲 ὖἚṖ 㧞㠊㦮⬢㦮㩚ⶎ㎇㦚 Ṧ㞞䞲┺Ⳋ

⽊Ị㏢⯒ 㭧㕂㦒⪲ 䞲䐋䞿⽊Ị㦮⬢㍲゚㓺㦮㩲Ὃ ⳾䡫 Ṳ⹲㧊㔲 䧞㣪ῂ♲┺ἶ ⽎┺.

➆⧒㍲㧊㡆ῂ㦮 ⳿㩗㦖 ⹎ῃ㠦㍲㔲䟟♮

ἶ 㧞⓪ PACE ⳾䡫㦚 ⁒Ệ⪲ Ṳ⹲♲ ㍺ⶎ㰖

⪲ ṫ㤦☚ ⌊ 㧒Ṳ ῆ㦮 ⏎㧎㧎ῂ⯒ ╖㌗㦒⪲

⽊Ị㦮⬢ 㡗㡃ὒ ⽋㰖㡗㡃㦚䙂䞾䞲䐋䞿⽊

Ị㦮⬢㍲゚㓺㦮䞚㣪☚⯒ 㫆㌂䞮㡂 ⏎㧎✺㦮 Ⱒ㎇㰞䢮 ⹲㌳㦚㡞⹿䞮ἶ ㌌㦮㰞㦚䟻㌗㔲䌊㦒⪲㖾 ⏎䤚⯒ ⽊┺ Ịṫ䞮Ợ ㌊㑮㧞⓪

╖㞞㦚㩲㔲䞮ἶ㧦䞮㡖┺.

堆旇愕愯憛

1. 櫶割堆旇愕沖巒朞滗愯憛

㧊㡆ῂ⓪ ṫ㤦☚ Hῆ ⽊Ị㏢㠦 ❇⪳♲ 6 0

㎎㧊㌗ ⏎㧎㭧䘎㦮㿪㿲⹿⻫( c o n v e n i e n c e s a m p l i n g ) 㠦㦮䟊㍶㩫♲ 㽳 1 1 0ⳛ㦚 ╖㌗㦒⪲

2 0 0 5⎚ 1 1㤪⿖䎆 1 2㤪₢㰖 2Ṳ㤪㡂☯㞞㠦 Ỏ㼦㧦⬢⯒ 㑮㰧䞮㡖┺. 㧦⬢㑮㰧㦖㰚⬢ ╊╏ 㦮

㌂㢖㡆ῂ⳿㩗ὒ ㍺ⶎ⌊㣿㦚㌂㩚ᾦ㥷㦒⪲ 㿿

⿚䧞䤞⩾♲ 2ⳛ㦮⽊Ị㣪㤦㠦㦮䟊㧦₆₆㧛㔳㍺ⶎὒ Ⳋ㩧㦚䐋䟊㧊⬾㠊㪢┺.

2. 櫶割壊割愕猧洛愯憛

㡆ῂ☚ῂ⓪ 䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ὖ䞲 ῃ

⌊½ 㣎㦮㍶䟟㡆ῂ ⹥ ⶎ䠢ἶ㺆㦚䏶╖⪲ ἶ 㞞䞲 ῂ㫆䢪♲ ㍺ⶎ㰖⪲ 䞮㡖㦒Ⳇ, 2005⎚ 1 1 㤪㽞㑲㠦㡞゚㫆㌂⯒ Ệ㼦⽊㢚½ 㑮㩫䞮㡖┺.

㧊⓪ 䋂Ợ 5Ṳ 㡗㡃㦒⪲ ⿚⮮䞮♮ 6 8Ṳ ⶎ䟃㦒⪲ 㾲㫛 ῂ㎇䞮㡖┺. 㧊㡆ῂ㠦㍲㍶㩫䞲 ṗ

⼖㑮✺㦮䁷㩫㦚㥚䟊㧊㣿♲ 㡂⩂ 䟃⳿✺㦮㔶⬆㎇㦚 Ỗ㩫䞮₆ 㥚䞮㡂㔶⬆☚ ⿚㍳㦚䞲 ἆὒ, Cronbach ˄ s alpha⓪ 㭒ὖ㩗㧎㔶㼊₆⓻㌗

䌲 0.748 Ịṫ䟟䌲 0.449 ⽊Ị㦮⬢㡗㡃㦮㍲゚

㓺䞚㣪☚ 0.679 ⽋㰖㡗㡃㦮㍲゚㓺䞚㣪☚

0 . 8 5 3㦒⪲ Ịṫ䟟䌲⯒ 㩲㣎䞮ἶ⓪ ゚ᾦ㩗 Ⱒ㫇

(3)

䞶 Ⱒ䞲㑮㭖㧊㠞┺.

1) Ịṫ㌗䌲

Ịṫ㌗䌲⓪ Ⱒ㎇㰞䢮㧊䢮㥾, 㭒ὖ㩗㧎㔶㼊

₆⓻㌗䌲⪲ ⋮⑚㠊䁷㩫䞮㡖┺. Ⱒ㎇㰞䢮㧊䢮㥾㦖 (ὒỆ㠦⽊Ị㦮⬢₆ὖ⿖䎆㰚┾⹱㞚) ㍺ ⶎ㫆㌂ ╏㔲䡚㨂 (㦮㌂⪲⿖䎆䢫㧎♮㠊) 㞢 ἶ 㧞⓪ Ⱒ㎇㰞䢮㧊㧞⓪㰖⯒ 1 7Ṳ ⶎ䟃㦒⪲

ῂ⿚䞮㡂䁷㩫䞮㡖┺. 㭒ὖ㩗㧎㔶㼊₆⓻㌗䌲

⓪ 㔲⩻, 㼃⩻, 㦢㔳ⲏ₆, ╖/㏢⼖⽊₆, ọ₆, 㩫㔶㌗䌲, 㩚㼊㩗㧎 Ịṫ㌗䌲㦮 5Ṳ 䟃⳿㦚䘟Ṗ 䞮㡖┺.

2) Ịṫ䟟䌲

Ịṫ䟟䌲⓪ 㿿⿚䞲㑮Ⳋ, ′䂯㩗㤊☯, ‶䡫㧞⓪ 㔳㌂, ⁞㡆, ⁞㭒, 㩫₆Ỗ㰚, Ịṫ㔳䛞㎃䀾㡂⿖㦮 7Ṳ 䟃⳿㦒⪲ 䁷㩫䞮㡖㦒Ⳇ, ˄ ⹮✲

㔲䞲┺˅ 5㩦㠦㍲˄ 㩚䡖 ⴑ䞲┺˅ 1㩦㦒⪲ ♲ 5 㩦㻯☚⪲ 䁷㩫䞮㡂㩦㑮Ṗ ⏨㦚㑮⪳ ṗṗ㦮 Ịṫ䟟㥚⯒ 㔺㻲䞮ἶ 㧞⓪ ộ㦒⪲ 䕦┾䞮㡖┺.

3) ⽊Ị㏢㦮㍲゚㓺 Ⱒ㫇☚

⽊Ị㏢㦮㍲゚㓺 Ⱒ㫇☚⓪ 㫆㌂ ╏㔲䟊╏

㍲゚㓺⯒ ⹱㦖 ἓ䠮㧊㧞▮ ⏎㧎㦚 ╖㌗㦒⪲

㰚⬢㍲゚㓺, Ịṫ㌗╊, ⽊Ịᾦ㥷, ⶒⰂ䂮⬢, ⹿ ⶎṚ䢎㍲゚㓺㦮 5Ṳ 䟃⳿㦒⪲ ⋮⑚㠊䁷㩫䞮㡖┺. ṗ 䟃⳿㦖˄ ⰺ㤆 Ⱒ㫇䞲┺˅ 5㩦㠦㍲˄ ⰺ 㤆⿞Ⱒ㫇䞲┺˅ 1㩦㦒⪲ ♲ 5㩦㻯☚⪲ 䁷㩫䞮㡂㩦㑮Ṗ ⏨㦚㑮⪳ ⽊Ị㏢㍲゚㓺㠦 Ⱒ㫇䞮⓪ ộ㦒⪲ 䕦┾䞮㡖┺.

4) ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺䞚㣪☚

㡆ῂ╖㌗㧦㦮䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲䞚㣪☚⯒ 㞢㞚⽊₆ 㥚䞮㡂⽊Ị㦮⬢ 㡗㡃ὒ

⽋㰖㡗㡃㦒⪲ 䋂Ợ ῂ⿚䞮㡂 ⶎ䟃㦚 ῂ㎇䞮㡖┺. ⽊Ị㦮⬢ 㡗㡃㦖㰗㩧㰚⬢㍲゚㓺( 3Ṳ ⶎ 䟃), ⽊Ị㌗╊ ⹥ ⽊Ịᾦ㥷㍲゚㓺( 4Ṳ ⶎ䟃) , Ịṫ㯳㰚㍲゚㓺( 2Ṳ ⶎ䟃), 㰖㡃㦮⬢₆ὖ 㡆Ἒ ( 1Ṳ ⶎ䟃)㦮 4Ṳ 䞮㥚㡗㡃㦒⪲ 䁷㩫䞮㡖┺.

⽋㰖㡗㡃㦖㌳䢲㰖㤦㍲゚㓺( 3Ṳ ⶎ䟃)㢖㡂

Ṗ㰖㤦㍲゚㓺( 3Ṳ ⶎ䟃)㦒⪲ ⋮⑚㠊䁷㩫䞮㡖㦒Ⳇ, 㣪ῂ㩫☚㠦 ➆⧒˄ ⰺ㤆䞚㣪䞮┺˅ 5㩦㠦

㍲˄ 㩚䡖䞚㣪䞮㰖㞠┺˅ 1㩦㦒⪲ ♲ 5㩦㻯☚

⪲ 䁷㩫䞮㡂㩦㑮Ṗ ⏨㦚㑮⪳ 䟊╏ ㍲゚㓺㠦

╖䞲䞚㣪☚Ṗ ⏨㦖 ộ㦒⪲ 䕦┾䞮㡖┺.

5) 㧎ῂ㌂䣢䞯㩗䔏㎇

㡆ῂ╖㌗㧦㦮㧎ῂ㌂䣢䞯㩗䔏㎇㦚㎇, 㡆⪏, ᾦ㥷㩫☚, 㫛ᾦ, 㦮⬢⽊㧻䡫䌲, Ṗ㫇㌂䟃, ㏢✳

㦮 ⶎ䟃㦒⪲ 䁷㩫䞮㡖┺.

3. 把昣愯憛

㧊㡆ῂ㠦㍲⓪ 㑮㰧♲ 㧦⬢㦮䐋Ἒ⿚㍳㦚㥚䟊 SPSS PC

⁺

(Version 12.0)⯒ 㧊㣿䞮㡖┺.

ゞ☚⿚㍳㦚䐋䞮㡂㡆ῂ╖㌗㧦㦮㧎ῂ㌂䣢䞯㩗䔏㎇, Ⱒ㎇㰞䢮㦮㧊䢮㌗䌲, ⽊㫆㔳䛞 ⹥ ⽊㫆₆ῂ ㌂㣿㡂⿖, Ịṫ䟟㥚 ❇㦚䕢㞛䞮㡖┺.

⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲㩚㼊㩗㧎䞚㣪☚, ⽊Ị㦮⬢ ⹥ ⽋㰖㡗㡃㦮㍲゚㓺䞚㣪☚

㠦 ⹎䂮⓪ 㩲 ☛Ⱃ⼖㑮✺㦮㍺ⳛ⩻㦚䕢㞛䞮

₆ 㥚䞮㡂 t-test, ⿚㌆⿚㍳ ⹥ ㌗ὖ⿚㍳ ┾Ἒ 㠦㍲㥶㦮䞲㧎ῂ㌂䣢䞯㩗䔏㎇ ❇㦮 ☛Ⱃ⼖

㑮✺㦚㭧㕂㦒⪲ 㥚Ἒ㩗 ┺㭧䣢‖⿚㍳㦚㔺㔲䞮㡖┺.

冶刂

1. 櫶割堆旇沖汞汾割斲箒穟洇瞿昷

㫆㌂╖㌗ ⏎㧎✺㦮㧎ῂ㌂䣢䞯㩗䔏㎇㠦㍲

㽳 ╖㌗㧦 1 1 0ⳛ 㭧 ⋾㧦Ṗ 4 0ⳛ(36.4%), 㡂㧦 Ṗ 7 0ⳛ( 6 3 . 6 % )㧊㠞┺. ⏎㧎✺㦮䘟‶㡆⪏㦖 7 2 . 4㎎(䚲㭖䘎㹾 6 . 3㎎)⪲㍲ 7 0㎎㠦㍲ 7 9㎎₢㰖 Ṗ 5 4 . 5 %㡖ἶ, 60-69㎎ 32.7%, 80㎎㧊㌗㦖 1 2 . 7 %㡖┺. ᾦ㥷㑮㭖㦖 ╖⿖⿚㧎 4 7 . 3 %Ṗ ⶊ 䞯㧊㠞ἶ, 36.4%Ṗ 㽞❇䞯ᾦ 㫎㠛㑲㧊㠞┺.

㫛ᾦ⓪ ⶊᾦṖ 4 8 . 2 %㡖ἶ, ┺㦢㧊 ₆☛ᾦ (19.1%), 㻲㭒ᾦ(17.3%) 㑲㧊㠞┺.

㦮⬢⽊㧻㦖 Ịṫ⽊䠮㧊 8 5 . 5 %㡖ἶ, Ṗ㫇㌂䟃

㠦㍲ ☛㔶㧊 10%, ⺆㤆㧦Ṗ 㧞⓪ ⏎㧎㧊 1 0 % ,

㧦⎖㠦㦮㫊䞮⓪ ⏎㧎㧊 36.4%, ⺆㤆㧦 ⹥ 㧦

(4)

⎖㢖䞾℮ ㌳䢲䞮⓪ ⏎㧎㧊 4 1 . 8 %㡖┺. 㤪䘟

‶ ㏢✳㑮㭖㦖 2 0 - 4 9Ⱒ㤦㧊 3 2 . 7 %㡖ἶ, 50-99 Ⱒ㤦 18.2%, 10-19Ⱒ㤦 16.4% 㑲㧊㠞┺(䚲 1 ) .

2. 櫶割堆旇沖汞廒昷滎筞決筞愕兺儛旇痢

╖㌗㧦㦮 Ⱒ㎇㰞䢮㧊䢮㌗䌲⓪ ἶ䡞㞫㧊 8 4 ⳛ( 7 6 . 4 % )㦒⪲ Ṗ㧻 Ⱔ㞮ἶ, ╏␾⼧㧊 3 1ⳛ (28.2%), ὖ㩞㡒㧊 2 8ⳛ(25.5%), Ἶ┺Ὃ㯳㧊 2 5 ⳛ(22.7%) 㣪䐋㧊 2 1ⳛ(19.1%) 㑲㧊㠞┺. ⏎㧎䂮ⰺ, 㞢⩞⯊₆, 㞞ὒ 㰞䢮, 㧊゚㧎䤚ὒ 㰞䢮㦖

┾ 䞲ⳛ☚ 㠜㠞┺(䚲 2). 㧊✺ 㭧 ╖⿖⿚㧎 8 4

ⳛ( 7 6 . 4 % ) 㦖 2Ṳ 㧊㌗㦮 Ⱒ㎇㰞䢮㠦㧊䢮♮㠊㧞㠊㩚㼊 ╖㌗㧦㦮㧊䢮♲ 䘟‶ Ⱒ㎇㰞䢮㑮

⓪ 2 . 1 (䚲㭖䘎㹾 0 . 8 0 )㧊㠞┺.

⏎㧎✺㦮㭒ὖ㩗㧎㔶㼊₆⓻㌗䌲⓪˄ 㔲⩻㧊㫡┺˅ Ṗ 4 9ⳛ(44.5%), ˄ 㫡㰖㞠┺˅ Ṗ 2 3ⳛ ( 2 1 . 9 % ) 㧊㠞┺. 㼃⩻㦖 6 7ⳛ( 5 0 . 9 % ) 㠦㍲㫡┺, 2 3ⳛ( 2 0 . 9 % )㦖㫡㰖㞠┺ἶ 䞮㡖┺. 㔳㌂⓪ 7 2 ⳛ( 6 5 . 4 % ) 㧊㧮䞮㡖ἶ, 12ⳛ( 1 0 . 9 % ) 㧊㧮ⴑ䞲

┺ἶ 㦧╋䞮㡖┺.

╖/㏢⼖⽊₆⓪ 5 3ⳛ( 4 8 . 2 % )㠦㍲㧮䞮㡖ἶ, 3 4ⳛ( 3 0 . 9 % )㦖㫡㰖㞠㞮┺. ọ₆⓪ 4 1ⳛ 䚲 1. ╖㌗㧦㦮㧎ῂ㌂䣢䞯㩗䔏㎇

䔏㎇ ῂ⿚㑮(ⳛ) %

㎇ ⋾㧦 4 0 3 6 . 4

㡂㧦 7 0 6 3 . 6

㡆⪏(㎎) 6 0 - 6 9 3 6 3 2 . 7

7 0 - 7 9 6 0 5 4 . 6

80 㧊㌗ 1 4 1 2 . 7

ᾦ㥷㑮㭖 ⶊ䞯 5 2 4 7 . 3

㽞㫎 4 0 3 6 . 4

㭧㫎 7 6 . 4

ἶ㫎 8 7 . 3

╖㫎㧊㌗ 3 2 . 6

㫛ᾦ ⶊᾦ 5 3 4 8 . 2

⿞ᾦ 1 6 1 4 . 5

₆☛ᾦ 2 1 1 9 . 1

㻲㭒ᾦ 1 9 1 7 . 3

₆䌖 1 0 . 9

㦮⬢⽊㧻 Ịṫ⽊䠮 9 4 8 5 . 5

㦮⬢ 㡂( 1㫛) 1 3 1 1 . 8

㦮⬢ 㡂( 2㫛) 3 2 . 7

Ṗ㫇(☯Ệ)㌂䟃 ☛㔶 1 1 1 0 . 0

⺆㤆㧦 1 1 1 0 . 0

㧦⎖ 4 0 3 6 . 4

⺆㤆㧦 ⹥ 㧦⎖ 4 6 4 1 . 8

₆䌖 ☯Ệ㧎 2 1 . 8

㏢✳(Ⱒ㤦) 㠜㦢 1 1 1 0 . 0

10 ⹎Ⱒ 1 1 1 0 . 0

1 0 - 1 9 1 8 1 6 . 4

2 0 - 4 9 3 6 3 2 . 7

5 0 - 9 9 2 0 1 8 . 2

100 㧊㌗ 1 4 1 2 . 7

Ἒ 1 1 0 1 0 0 . 0

(5)

( 3 7 . 2 % ) 㠦㍲ ⶎ㩲㠜㠞㦒⋮, 49ⳛ( 4 4 . 6 % ) 㠦㍲

Ệ☯䞮₆Ṗ ⿞䘎䞮┺ἶ 䞮㡖ἶ, 㩫㔶㌗䌲⓪ 5 0ⳛ( 4 5 . 5 % )㠦㍲ Ịṫ䞮㡖ἶ, 25ⳛ( 2 2 . 7 % )㦖 Ịṫ䞮㰖㞠㞮┺. ⏎㧎✺㦮㩚㼊㩗㧎 Ịṫ㌗䌲

⓪ 3 6ⳛ( 3 2 . 7 % )㦮 ⏎㧎㦖 Ịṫ䞮㡖㦒⋮, 39ⳛ ( 3 5 . 7 % ) 㧊 Ịṫ䞮㰖㞠㞮┺. 㡆ῂ╖㌗㧦㦮㭒 ὖ㩗㧎㔶㼊₆⓻㌗䌲㠦㍲㦢㔳 ⲏ₆Ṗ 4 . 0㦒⪲

Ṗ㧻 ⏨㞮㦒Ⳇ, ọ₆Ṗ 3 . 0㦒⪲ Ṗ㧻 ⌄㞚⽊䟟㦮㠊⩺㤖㧊 Ṗ㧻䋆 ộ㦒⪲ 䕢㞛♮㠞┺(䚲 3 ) .

㫆㌂╖㌗ ⏎㧎✺㦮 Ịṫ䟟䌲㠦㍲㿿⿚䞲㑮 Ⳋ㦚䞮⓪ ⏎㧎㦖 5 8ⳛ(52.7%), ⁎⩝㰖 ⴑ䞲 ἓ㤆Ṗ 3 9ⳛ( 3 5 . 5 % ) 㧊㠞㦒Ⳇ, ′䂯㩗㧎㤊☯㦚䞮⓪ ἓ㤆⓪ 4 7ⳛ(42.7%), 㤊☯㦚䞮㰖 ⴑ䞮⓪ 䚲 2. ╖㌗㧦㦮 Ⱒ㎇㰞䢮㧊䢮㌗䌲

^*

( N = 1 1 0 )

㰞⼧ⳛ 㧞㦢㠜㦢

㑮 ( % ) 㑮 ( % )

ἶ䡞㞫 84 (76.4) 26 (23.6)

╏␾⼧ 31 (28.2) 79 (71.8)

ὖ㩞㡒 28 (25.5) 82 (74.5)

Ἶ┺Ὃ㯳 25 (22.7) 85 (77.3)

㣪䐋 21 (19.1) 89 (80.9)

㞪 8 ( 7.3) 102 (92.7)

㥚㧻㰞䢮 7 ( 6.4) 103 (93.6)

Ṛ㰞䢮 5 ( 4.5) 105 (95.5)

㭧䛣 5 ( 4.5) 105 (95.5)

㕂㧻㰞䢮 4 ( 3.6) 106 (96.4)

䢎䦷₆㰞䢮 3 ( 2.7) 107 (97.3)

ẇ⎚₆㧻㞶 1 ( 0.9) 109 (99.1)

゚␾₆㰞䢮 1 ( 0.9) 109 (99.1)

₆䌖 8 ( 7.3) 102 (92.7)

Ἒ 8 ( 7.3) 102 (92.7)

*㭧⽋㦧╋ Ṗ⓻䞮Ợ ㍺ⶎ ῂ㎇䞮㡖㦒Ⳇ, ⏎㧎䂮ⰺ, 㞢⩞⯊₆, 㞞ὒ㰞䢮, 㧊゚㧎䤚ὒ㰞䢮㠦⓪ 1ⳛ

☚ 㦧╋䞮㰖㞠㞮㦢.

䚲 3. ╖㌗㧦㦮㭒ὖ㩗㧎㔶㼊₆⓻㌗䌲

㔶㼊₆⓻ ⰺ㤆㟧䢎䞾㟧䢎䞾⽊䐋㟧䢎䞮㰖 ⰺ㤆䘟‶

ⴑ䞾㟧䢎䞮㰖ⴑ䞾

㔲⩻ 2 4 ( 2 1 . 8 ) 2 5 ( 2 2 . 7 ) 3 8 ( 3 4 . 5 ) 2 2 ( 2 0 . 0 ) 1 ( 0 . 9 ) 3 . 5 㼃⩻ 4 6 ( 4 1 . 8 ) 2 1 ( 1 9 . 1 ) 2 0 ( 1 8 . 2 ) 1 9 ( 1 7 . 3 ) 4 ( 3 . 6 ) 3 . 8 㦢㔳ⲏ₆ 4 6 ( 4 1 . 8 ) 2 6 ( 2 3 . 6 ) 2 6 ( 2 3 . 6 ) 1 2 ( 1 0 . 9 ) 0 ( 0 . 0 ) 4 . 0

╖/㏢⼖⽊₆ 3 1 ( 2 8 . 2 ) 2 2 ( 2 0 . 0 ) 2 3 ( 2 0 . 9 ) 3 3 ( 3 0 . 0 ) 1 ( 0 . 9 ) 3 . 5 ọ₆ 1 6 ( 1 4 . 5 ) 2 5 ( 2 2 . 7 ) 2 0 ( 1 8 . 2 ) 4 0 ( 3 6 . 4 ) 9 ( 8 . 2 ) 3 . 0 㩫㔶㌗䌲 1 9 ( 1 7 . 3 ) 3 1 ( 2 8 . 2 ) 3 5 ( 3 1 . 8 ) 2 3 ( 2 0 . 9 ) 2 ( 1 . 8 ) 3 . 4 㩚㼊㩗㧎 Ịṫ㌗䌲 1 3 ( 1 1 . 8 ) 2 3 ( 2 0 . 9 ) 3 5 ( 3 1 . 8 ) 3 6 ( 3 2 . 7 ) 3 ( 2 . 7 ) 3 . 1

Ἒ(䘟‶· 䚲㭖䘎㹾) 3 . 4 4· 0 . 7 2

(6)

⏎㧎㦖 4 9ⳛ( 4 4 . 6 % ) 㧊㠞┺. ‶䡫㧞⓪ 㔳㌂⯒

䞮⓪ ⏎㧎㦖 4 2ⳛ(38.2%), 㔳㌂⯒ 䞮㰖 ⴑ䞮⓪

⏎㧎㦖 2 5ⳛ( 2 2 . 7 % ) 㧊㠞ἶ, ⁞㡆㦚䞮⓪ ⏎㧎㦖 7 6ⳛ(69.1%), 䦷㡆㦚䞮⓪ ⏎㧎㦖2 8ⳛ ( 2 5 . 4 % ) 㧊㠞┺. 㦢㭒䞮⓪ ⏎㧎㦖 6 7ⳛ( 6 0 . 9 % ) ,

⁞㭒䞮⓪ ⏎㧎㦖 2 1ⳛ( 1 8 . 1 % ) 㧊㠞┺. 㩫₆㩗㦒

⪲ ỊṫỖ㰚㦚 ⹱⓪ ⏎㧎㦖 5 4ⳛ(49.1%), Ỗ㰚㦚 ⹱㰖 ⴑ䞮⓪ ⏎㧎㧊 4 8ⳛ( 4 3 . 6 % ) 㧊㠞┺. ⏎ 㧎✺㧊 Ịṫ㔳䛞㦚㎃䀾䞮⓪ ἓ㤆⓪ 2 5ⳛ (22.8%), Ịṫ㔳䛞㦚㎃䀾䞮㰖 ⴑ䞮⓪ ⏎㧎㦖 6 9ⳛ( 6 2 . 7 % ) 㧊㠞┺. ⏎㧎✺㦮 Ịṫ䟟䌲⓪ ⁞㡆㧊䘟‶ 3 . 9⪲ Ṗ㧻 ⏨㞮㦒Ⳇ, Ịṫ⽊㫆㔳䛞㦮

㎃䀾Ṗ 2 . 1⪲ Ṗ㧻 ⌄㞮┺.

Ịṫὖ㕂☚⓪ ὖ㕂㧊㧞⓪ ⏎㧎㦖 69ⳛ (62.7%), ⽊䐋㧊 2 9ⳛ(26.4%), Ịṫ㠦 ὖ㕂㧊㠜⓪ ⏎㧎㦖 1 2ⳛ( 1 0 . 9 % ) 㧊㠞┺(䚲 4).

3. 櫶割堆旇沖汞懺兺暒喺匶浺昢捊枪櫖堆穢廒海壊

⽊Ị㏢⌊ ₆㫊㍲゚㓺⯒ ⹱㦖 ἓ䠮㠦 ╖䞲 Ⱒ㫇☚ 㫆㌂ ἆὒ, 㰚⬢㍲゚㓺⓪ 8 4ⳛ( 7 8 . 5 % ) 㧊, ⶒⰂ䂮⬢⓪ 1 6ⳛ( 6 6 . 7 % ) 㧊 Ⱒ㫇䞲┺ἶ 㦧

╋䞮㡖┺. ⹿ⶎṚ䢎㍲゚㓺⓪ 5ⳛ(71.4%), Ịṫ

㌗╊㦖 2ⳛ(1.8%), ⽊Ịᾦ㥷㦖 6ⳛ( 8 5 . 7 % )㧊 Ⱒ㫇䞲┺ἶ 㦧╋䞮㡖㦒⋮, ㍲゚㓺⯒ ⹱㦖 ἓ䠮㧊㠜⓪ ㌂⧢㧊 90% 㧊㌗㦒⪲ ㍲゚㓺 ⹱㦖 ἓ 䠮㧦㑮Ṗ ⰺ㤆㩗㠞┺(䚲 5 ) .

4. 噾汾皻穯懺兺汞巒昢捊枪櫖堆穢穊殚壊䐋䞿⽊Ị㦮⬢㍲゚㓺 1 6Ṳ 䟃⳿㠦 ╖䞲䞚㣪

☚⓪ 㩚㼊䘟‶㧊 3 . 6 7㧊㠞㦒Ⳇ, 㧊㭧⽊Ị㦮⬢

㡗㡃 ὖ⩾䟊㍲ ⹿ⶎṚ䢎㍲゚㓺Ṗ 䘟‶ 4 . 0 8⪲

Ṗ㧻 ⏨㞮㦒Ⳇ, Ⱒ㎇㰞䢮ὖⰂ(䘟‶ 4.06), 㩫㔶

⽊Ị㌗╊(䘟‶ 3.95), ⽋㰖㡗㡃 ὖ⩾䟊㍲⓪ 㤊

㏷㍲゚㓺(䘟‶ 4.05), ⳿㣫㍲゚㓺(䘟‶ 3.79) 㑲㧊㠞┺. ㍲゚㓺Ṗ Ṗ㧻 ⌄㦖䟃⳿㦖㎇㌗╊㍲

゚㓺(䘟‶ 2 . 0 8 )⪲ 䞚㣪䞮┺ἶ 㦧╋䞲㌂⧢㧊 1 2ⳛ( 1 0 . 9 % )㧊㠞㦒Ⳇ, ⁎ ┺㦢㦖㣪Ṗ(䘟‶

䚲 4. ╖㌗㧦㦮 Ịṫ䟟䌲

Ịṫ䟟䌲 ⹮✲㔲 Ṗ⓻䞮Ⳋ ⼚⪲䞮㰖㩚䡖

䞲┺ 䞲┺ ⽊䐋㧊┺ ⴑ䞲┺ ⴑ䞲┺ 䘟‶

㿿⿚䞲㑮Ⳋ 4 4 ( 4 0 . 0 ) 1 4 ( 1 2 . 7 ) 1 3 ( 1 1 . 8 ) 3 1 ( 2 8 . 2 ) 8 ( 7 . 3 ) 3 . 5

′䂯㩗㧎㤊☯ 2 4 ( 2 1 . 8 ) 2 3 ( 2 0 . 9 ) 1 4 ( 1 2 . 7 ) 2 8 ( 2 5 . 5 ) 2 1 ( 1 9 . 1 ) 3 . 0

‶䡫㧞⓪ 㔳㌂ 1 0 ( 9 . 1 ) 3 2 ( 2 9 . 1 ) 4 3 ( 3 9 . 1 ) 2 3 ( 2 0 . 9 ) 2 ( 1 . 8 ) 3 . 2

⁞㡆 7 4 ( 6 7 . 3 ) 2 ( 1 . 8 ) 6 ( 5 . 5 ) 2 ( 1 . 8 ) 2 6 ( 2 3 . 6 ) 3 . 9

⁞㭒 6 0 ( 5 4 . 5 ) 7 ( 6 . 4 ) 2 2 ( 2 0 . 0 ) 3 ( 2 . 7 ) 1 8 ( 1 6 . 4 ) 3 . 8 㩫₆ ỊṫỖ㰚 2 6 ( 2 3 . 6 ) 2 8 ( 2 5 . 5 ) 8 ( 7 . 3 ) 1 6 ( 1 4 . 5 ) 3 2 ( 2 9 . 1 ) 3 . 0 Ịṫ⽊㫆㔳䛞㎃䀾 8 ( 7 . 3 ) 1 7 ( 1 5 . 5 ) 1 6 ( 1 4 . 5 ) 1 0 ( 9 . 1 ) 5 9 ( 5 3 . 6 ) 2 . 1

Ἒ(䘟‶· 䚲㭖䘎㹾) 3 . 2 2· 0 . 7 0

䚲 5. ⽊Ị㏢⌊ ₆㫊㍲゚㓺㠦 ╖䞲 Ⱒ㫇☚

㍲゚㓺 ⰺ㤆 ⰺ㤆㍲゚㓺

Ⱒ㫇 Ⱒ㫇⽊䐋⿞Ⱒ㫇⿞Ⱒ㫇 ⹱㰖㞠㦢

㰚⬢㍲゚㓺 5 ( 4 . 7 ) 7 9 ( 7 3 . 8 ) 2 2 ( 2 0 . 6 ) 1 ( 0 . 9 ) 0 ( 0 . 0 ) 3( 2.7) ⶒⰂ䂮⬢ 7 ( 2 9 . 2 ) 9 ( 3 7 . 5 ) 7 ( 2 9 . 2 ) 1 ( 4 . 2 ) 0 ( 0 . 0 ) 8 6 ( 7 8 . 2 )

⹿ⶎṚ䢎㍲゚㓺 0 ( 0 . 0 ) 5 ( 7 1 . 4 ) 2 ( 2 8 . 6 ) 0 ( 0 . 0 ) 0 ( 0 . 0 ) 1 0 3 ( 9 3 . 6 ) Ịṫ㌗╊ 0 ( 0 . 0 ) 2 ( 1 . 8 ) 0 ( 0 . 0 ) 0 ( 0 . 0 ) 0 ( 0 . 0 ) 1 0 8 ( 9 8 . 2 )

⽊Ịᾦ㥷 0 ( 0 . 0 ) 6 ( 8 5 . 7 ) 1 ( 1 4 . 3 ) 0 ( 0 . 0 ) 0 ( 0 . 0 ) 1 0 3 ( 9 3 . 6 )

(7)

3.28), Ịṫᾦ㔺(䘟‶ 3.55) 㑲㧊㠞┺(䚲 6).

5 . 噾汾皻穯懺兺汞巒昢捊枪汞穊殚壊櫖堆穢氊凊洇埪渗箒勆把昣

㧊⼖⨟ ⿚㍳ ⹥ ㌗ὖ⿚㍳ ὒ㩫㠦㦮䟊 ☚㿲

♲ 䐋Ἒ㩗㦒⪲ 㥶㦮䞲 ☛Ⱃ⼖㑮✺㦚㭧㕂㦒⪲

⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲㩚㼊㩗㧎䞚㣪☚, ⽊Ị㦮⬢ ⹥ ⽋㰖㡗㡃㦮㍲゚㓺㦮䞚㣪

☚㠦 ṗṗ ⹎䂮⓪ 㩲 ☛Ⱃ⼖㑮✺㦮㍺ⳛ⩻㦚䕢㞛䞮₆ 㥚䞮㡂㥚Ἒ㩗 ┺㭧䣢‖⳾䡫㦚 ῂ㿫䞮㡖┺. ⳾䡫ช㦖㧎ῂ㌂䣢䞯㩗䔏㎇㧎㡆⪏, 䞯⩻(ⶊ䞯/ῃ㫎㧊㌗), Ṗ㫇㥶ⶊ, ㏢✳ ῂ⿚( 1 0 Ⱒ㤦 ⹎Ⱒ/ 1 0 - 4 9Ⱒ㤦/ 5 0Ⱒ㤦㧊㌗)㦚 ☛Ⱃ⼖㑮

⪲ 䞮㡖㦒Ⳇ, ⳾䡫ซ⓪ ㌗₆ ⼖㑮㠦┺ Ịṫὖ

㕂☚, 㔶㼊₆⓻㌗䌲, Ịṫ䟟䌲⯒ 㿪Ṗ䞮㡂 ☛ Ⱃ⼖㑮⪲ ㌂㣿䞮㡖㦒Ⳇ, ⳾䡫ฌ㦖 ⳾䡫ซ㦮⼖㑮㠦㰚⬢Ⱒ㫇☚⯒ 㿪Ṗ䞮㡖┺.

㥚Ἒ㩗 ┺㭧䣢‖⿚㍳ ἆὒ, ⳾䡫ช㧎㧎ῂ㌂

䣢䞯㩗䔏㎇㧊⽊Ị㦮⬢ 㡗㡃㍲゚㓺㦮䞚㣪

☚㦮㽳⼖⨟㭧 4.0%, ⽋㰖㡗㡃㍲゚㓺㦮䞚㣪

☚㦮㽳⼖⨟㭧 7.2%, 㩚㼊㩗㧎㍲゚㓺㦮䞚㣪

☚㦮㽳⼖⨟㭧 6 . 5 %⯒ ㍺ⳛ䞮㡖ἶ, 㧊✺ 䔏㎇

㭧㠦㍲㏢✳Ⱒ㧊㥶㦮䞮Ợ ṗ 䞚㣪☚㠦㡗䟻㦚㭒㠞┺.

⳾䡫ซ⓪ ⽊Ị㦮⬢ 㡗㡃㍲゚㓺㦮䞚㣪☚㦮 3.4%, ⽋㰖㡗㡃㍲゚㓺㦮䞚㣪☚㦮㽳⼖⨟㭧 10.9%, 㩚㼊㩗㧎㍲゚㓺㦮䞚㣪☚㦮㽳⼖⨟㭧 8 . 3 %⯒ ㍺ⳛ䞮㡖┺. 㧊 ⳾䡫㠦㍲⽊Ị㦮⬢ 㡗䚲 6. ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲䞚㣪☚

㍲゚㓺 ⰺ㤆䞚㣪䞮㰖㩚䡖䞚㣪

䞚㣪䞾䞚㣪䞾⽊䐋㞠㦢䞮㰖㞠㦢䘟‶

⽊Ị㦮⬢ 㡗㡃 3 . 6 8· 0 . 3 3

㰗㩧㰚⬢㍲゚㓺 4 . 0 0· 0 . 3 6

ⶒⰂ䂮⬢ 9( 8.2) 8 2 ( 7 4 . 5 ) 1 3 ( 1 1 . 8 ) 6 ( 5 . 5 ) 0 ( 0 . 0 ) 3 . 8 5

⹿ⶎṚ䢎㍲゚㓺 2 0 ( 1 8 . 2 ) 8 3 ( 7 5 . 5 ) 4( 3.6) 2 ( 1 . 8 ) 1 ( 0 . 9 ) 4 . 0 8 Ⱒ㎇㰞䢮ὖⰂ 9( 8.2) 9 9 ( 9 0 . 0 ) 2( 1.8) 0 ( 0 . 0 ) 0 ( 0 . 0 ) 4 . 0 6

⽊Ị㌗╊ ⹥ ⽊Ịᾦ㥷㍲゚㓺 3 . 3 4· 0 . 4 6

㩫㔶⽊Ị㌗╊ 9 ( 8 . 2 ) 8 8 ( 8 0 . 0 ) 1 1 ( 1 0 . 0 ) 2( 1.8) 0( 0.0) 3 . 9 5 ῂṫỖ㰚 ⹥ ㌗╊ 8 ( 7 . 3 ) 7 7 ( 7 0 . 0 ) 1 7 ( 1 5 . 5 ) 8( 7.3) 0( 0.0) 3 . 7 7

㎇㌗╊㍲゚㓺 1 ( 0 . 9 ) 1 1 ( 1 0 . 0 ) 7( 6.4) 6 8 ( 6 1 . 8 ) 2 3 ( 2 0 . 9 ) 2 . 0 8 Ịṫᾦ㔺 9 ( 8 . 2 ) 6 2 ( 5 6 . 4 ) 1 9 ( 1 7 . 3 ) 2 0 ( 1 8 . 2 ) 0( 0.0) 3 . 5 5

Ịṫ㯳㰚㍲゚㓺 3 . 8 5· 0 . 5 2

㡗㟧㰖☚ 3 ( 2 . 8 ) 9 0 ( 8 2 . 6 ) 9( 8.3) 6 ( 5 . 5 ) 1 ( 0 . 9 ) 3 . 8 1 㤊☯㰖☚ 2 ( 1 . 8 ) 8 4 ( 7 6 . 4 ) 1 8 ( 1 6 . 4 ) 6 ( 5 . 5 ) 0 ( 0 . 0 ) 3 . 7 5

㰖㡃㦮⬢₆ὖ 㡆Ἒ 3 . 9 7· 0 . 3 4

䤚㏷㦮⬆㼊Ἒ 4 ( 3 . 6 ) 9 4 ( 8 5 . 5 ) 7 ( 6 . 4 ) 5 ( 4 . 5 ) 0 ( 0 . 0 ) 3 . 8 8

⽋㰖㡗㡃 3 . 6 7· 0 . 5 9

㌳䢲㰖㤦㍲゚㓺 3 . 8 5· 0 . 5 2

㤊㏷(㹾⨟㰖㤦)㍲゚㓺 1 5 ( 1 3 . 6 ) 8 8 ( 8 0 . 0 ) 4( 3.6) 3( 2.7) 0 ( 0 . 0 ) 4 . 0 5 㔳㌂⺆╂㍲゚㓺 7( 6.4) 7 6 ( 6 9 . 1 ) 1 4 ( 1 2 . 7 ) 1 3 ( 1 1 . 8 ) 0 ( 0 . 0 ) 3 . 7 0

⳿㣫㍲゚㓺 6( 5.5) 8 4 ( 7 6 . 4 ) 1 1 ( 1 0 . 0 ) 9( 8.2) 0 ( 0 . 0 ) 3 . 7 9

㡂Ṗ㰖㤦㍲゚㓺 3.50 ·0 . 8 1

⩞䋂Ⰲ㠦㧊㎮ 9 ( 8 . 2 ) 6 7 ( 6 0 . 9 ) 1 6 ( 1 4 . 5 ) 1 7 ( 1 5 . 5 ) 1 ( 0 . 9 ) 3 . 6 0

㌳䢲㼊㫆/╚㓺 9 ( 8 . 2 ) 6 6 ( 6 0 . 0 ) 1 8 ( 1 6 . 4 ) 1 7 ( 1 5 . 5 ) 0 ( 0 . 0 ) 3 . 6 1 㣪Ṗ 8 ( 7 . 3 ) 4 0 ( 3 6 . 4 ) 3 7 ( 3 3 . 6 ) 2 5 ( 2 2 . 7 ) 0 ( 0 . 0 ) 3 . 2 8

㩚㼊(䘟‶· 䚲㭖䘎㹾) 3 . 6 7· 0 . 3 9

(8)

㡃ὒ 㩚㼊㩗㧎㍲゚㓺㦮䞚㣪☚㠦㧞㠊㏢✳

㧊 5 1Ⱒ㤦㧊㌗㧎 ⁎⭏㧊 ⁎⩝㰖㞠㦖 ⁎⭏⽊

┺ 㥶㦮䞮Ợ 䞚㣪☚Ṗ ⏨㞮㦒Ⳇ, ⽋㰖㡗㡃㠦

㍲⓪ ㏢✳㧊 Ⱔ㦚㑮⪳, Ịṫὖ㕂☚Ṗ ⏨㦚㑮⪳

⁎ ㍲゚㓺㦮䞚㣪☚Ṗ 㥶㦮䞮Ợ ⏨㞮┺.

⳾䡫ฌ㦖⽊Ị㦮⬢ 㡗㡃㍲゚㓺㦮䞚㣪☚㦮 5.3%, ⽋㰖㡗㡃㍲゚㓺㦮䞚㣪☚㦮㽳⼖⨟㭧 15.2%, 㩚㼊㩗㧎㍲゚㓺㦮䞚㣪☚㦮㽳⼖⨟㭧 1 2 . 4 %⯒ ㍺ⳛ䞮ἶ 㧞┺. ⽊Ị㦮⬢ 㡗㡃㠦㍲㏢

✳㧊 5 1Ⱒ㤦㧊㌗㧎 ⁎⭏㦮㍲゚㓺䞚㣪☚Ṗ 㥶㦮䞮Ợ ⏨㞮ἶ, ⽋㰖㡗㡃㠦㍲☚ ㏢✳㧊 2 1 Ⱒ㤦- 5 0Ⱒ㤦㧎㰧┾㧊 ⁎⩝㰖㞠㦖 ⁎⭏⽊┺,

㏢✳㧊 5 1Ⱒ㤦㧊㌗㧎㰧┾㧊 ⁎⩝㰖㞠㦖 ⁎

⭏⽊┺ ⁎ ㍲゚㓺䞚㣪☚Ṗ ⏨㞮ἶ, ⡦䞲㰚⬢

Ⱒ㫇☚Ṗ ⏨㦚㑮⪳ 䞚㣪☚Ṗ 㥶㦮䞮Ợ ⏨㞮┺.

㩚㼊㩗㧎㍲゚㓺㦮䞚㣪☚㠦㍲⓪ ㏢✳( 5 1Ⱒ 㤦)ὒ 㰚⬢Ⱒ㫇☚Ṗ 㥶㦮䞮Ợ 㡗䟻㦚㭒㠞┺.

䣢‖⿚㍳㦮㩗䞿☚ ⳾䡫 Ỗ㩫ἆὒ, pṨ㧊㩚㼊㩗㧎㍲゚㓺㦮䞚㣪☚(⳾䡫I: 0.038, ⳾䡫ซ:

0.035, ⳾䡫ฌ: 0.009)㢖⽋㰖㡗㡃㦮㍲゚㓺㦮䞚㣪☚(⳾䡫I: 0.028, ⳾䡫ซ: 0.012, ⳾䡫ฌ:

0 . 0 0 3 )㠦㍲Ⱒ 㥶㦮䞮㡖┺(䚲 7).

処然

㧊㡆ῂ⓪ 㰖㡃㌂䣢 ⌊ ⽊Ị㏢⯒ 㭧㕂㦒⪲

㔲䟟♮ἶ 㧞⓪ 䂮⬢㢖 Ịṫᾦ㥷, Ịṫ㰚┾, ⽊ Ị㰖☚, ⶒⰂ䂮⬢, ⹿ⶎṚ䢎㌂㠛㦮㩲䞲㩦㦚㰖㩗䞮ἶ 㧊⯒ 䟊ἆ䞮₆ 㥚䞲 ╖㞞㦒⪲㍲ ṫ 㤦☚ ⌊ 㧒Ṳ ῆ㦮 ⏎㧎㧎ῂ⯒ ╖㌗㦒⪲ ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㦮䞚㣪☚⯒ 㫆㌂䞮ἶ 㧊㠦㡗䟻㦚 ⹎䂮⓪ ὖ⩾ 㣪㧎㦚 ῂⳛ䞮ἶ㧦䞮㡖┺.

㡆ῂ╖㌗㧦㦮㧎ῂ㌂䣢䞯㩗䔏㎇㦖㤆Ⰲ⋮

⧒ ⏣㽢㦮㩚䡫㩗㧎 ⏎㧎㦮䔏㎇㦚 ⁎╖⪲ ⹮ 㡗䞮ἶ 㧞┺ἶ ⽒㑮㧞┺. 㯟, 㰖㡃㌂䣢䔏䧞

⏣㽢㦮 ⏎㧎㧎ῂ㦮䔏㎇㦖㡂㧦Ṗ ⋾㧦⽊┺

Ⱔ㦒Ⳇ, 70╖㦮㡆⪏䂋㧊 ╖⿖⿚㦚㧊⬾ἶ 㧞㦒Ⳇ, ⁎ 㣎㠦☚ 㩖䞯⩻, ⌄㦖㦮⬢⽊㧻㦮㑮䡲

⁎Ⰲἶ ⌄㦖㏢✳㑮㭖 ❇㦮㟧㌗㦚⽊㧊ἶ 㧞

┺. 㧊✺ ╖㌗㧦㭧 8 4ⳛ㦖 2Ṳ 㧊㌗㦮 Ⱒ㎇㰞䢮㠦 ☯⹮ 㧊䢮♮㠊㧞㠊 ⏎㧎✺㠦㍲㦮 ⏨㦖 Ⱒ㎇㰞䢮㧊䢮ὒ 䞾℮ 2Ṳ 㧊㌗㦮 ☯⹮ ㌗⼧

⮶( c o m o r b i d i t y ) 㦮゚㥾㧊 ⏨㦢㦚㞢㑮㧞㠞

┺. 㧊⩂䞲㰞⼧㟧㌗㦖 ⏎㧎✺㦮⽊Ị㦮⬢㍲

゚㓺㩫㺛㠦㭒㣪䞲㔲㌂㩦㦚㩲Ὃ䞲┺ἶ ⽒䚲 7. ⿚㍳⳾䡫⼚ ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㦮䞚㣪☚㠦 ╖䞲㥚Ἒ㩗䣢‖⿚㍳ ἆὒ

䟃 ⳿ ⽊Ị㦮⬢ 㡗㡃⽋㰖㡗㡃㩚㼊

⳾䡫ช ⳾䡫ซ ⳾䡫ฌ ⳾䡫ช ⳾䡫ซ ⳾䡫ฌ ⳾䡫ช ⳾䡫ซ ⳾䡫ฌ 㡆⪏ - . 0 3 8 - . 0 1 8 - . 0 0 7 - . 1 3 9 - . 1 3 9 - . 1 2 4 - . 0 9 8 - . 0 8 9 - . 0 7 4 䞯⩻( 1 =ῃ㫎㧊㌗) . 0 4 7 . 0 2 3 . 0 2 3 . 0 1 7 - . 0 0 9 - . 0 0 4 . 0 3 1 . 0 0 4 . 0 0 4 Ṗ㫇㥶ⶊ( 1 =Ṗ㫇㧞㦢) . 0 6 9 . 0 5 9 . 0 5 8 . 1 2 6 . 1 0 0 . 0 9 8 . 1 0 8 . 0 8 8 . 0 8 6

㏢✳1 ( 1 = 1 0 - 4 9 Ⱒ㤦) . 1 4 6 . 1 2 5 . 0 9 7 . 2 9 2

^*

. 3 0 9

^*

. 2 7 4

^*

. 2 3 8 . 2 3 6 . 1 9 9

㏢✳2 ( 1 = 5 0Ⱒ㤦㧊㌗) . 3 3 5

^*

. 2 9 1

^*

. 2 9 7

^*

. 3 4 2

^*

. 3 1 4

^*

. 3 2 0

^*

. 3 6 8

^*

. 3 3 0

^*

. 3 3 8

^*

Ịṫὖ㕂☚ . 0 8 0 . 0 6 1 . 2 1 2

^*

. 1 8 7 . 1 6 1 . 1 3 5 㔶㼊₆⓻㌗䌲 - . 0 5 2 - . 0 4 5 - . 1 3 3 - . 1 2 1 - . 1 0 4 - . 0 9 5 Ịṫ䟟䌲 . 1 2 8 . 1 3 6 . 0 7 8 . 0 8 9 . 1 1 1 . 1 2 2

㰚⬢Ⱒ㫇☚ . 1 6 5 . 2 2 3

^*

. 2 1 9

^*

㌗㑮 3 . 6 7 7 3 . 4 1 5 2 . 9 6 8 4 . 2 8 6 3 . 9 9 5 2 . 9 0 7 3 . 9 0 6 3 . 6 4 0 2 . 9 2 8 Adjusted R

²

. 0 4 0 . 0 3 4 . 0 5 3 . 0 7 2 . 1 0 9 . 1 5 2 . 0 6 5 . 0 8 3 . 1 2 4 F 1 . 8 6 8 1 . 4 6 5 1 . 6 4 9 2 . 6 3 8 2 . 6 1 5 3 . 1 0 3 2 . 4 5 5 2 . 1 9 0 2 . 6 4 8 pṨ . 1 0 7 . 1 8 0 . 1 1 2 . 0 2 8 . 0 1 2 . 0 0 3 . 0 3 8 . 0 3 5 . 0 0 9

* p < . 0 5

(9)

㑮㧞┺. 㯟, ⏎㧎✺㦮㰞⼧ὖⰂ⓪ ἶ䡞㞫, ╏

␾⼧㧊⋮ ὖ㩞㡒 ❇ὒ ṯ㧊 Ṳ⼚㩗㧎㰞⼧ὖ Ⰲ㦮 Ṳ⎦⽊┺⓪ ⏎㧎⼧㩚㼊㠦 ╖䞲䐋䞿ὖ ⰂṖ 㩞㔺䧞㣪㼃♮㠊㟒䞾㦚㔲㌂䞮Ⳇ, ⽊Ị 㦮⬢㍲゚㓺㦮㧛㞞ὒ 㔺䟟㔲㠦☚ 㧊⩂䞲 ⶎ 㩲㩦㠦㽞㩦㦚 ⚦㠊㤆㍶㑲㥚Ṗ ἆ㩫♮㠊㟒䞶 ộ㧊┺.

⽊Ị㏢ ⌊ ₆㫊㍲゚㓺㦮 Ⱒ㫇☚ 㫆㌂㠦㍲

⓪ 㰚⬢㍲゚㓺㢖 ⶒⰂ䂮⬢㠦 8 4ⳛ( 7 8 . 5 % )ὒ 1 6ⳛ( 6 6 . 7 % ) 㧊 ṗṗ Ⱒ㫇䞲┺ἶ 㦧╋䞮㡂⿞ Ⱒ㫇゚㥾⽊┺⓪ ⏨㞮㰖Ⱒ Ⱔ㦖⿖⿚㦖㔲㩫

♮㠊㟒䞶䞚㣪㎇㧊㣪㼃♲┺. ⽊Ị㏢㢖⽊Ị 㰖㏢㧊㣿㧦 4 5 9ⳛ㦚 ╖㌗㦒⪲ 䞲 Ⱒ㫇☚ 㡆 ῂ[ 2 8 ]㠦㍲⓪ 䘟‶Ⱒ㫇☚Ṗ 3 . 8⪲ ゚ᾦ㩗 Ⱒ㫇䞮⓪ ἆὒ⯒ ⽊㡂, 㧊㡆ῂ㠦㍲㦮㰚⬢Ⱒ㫇☚

3 . 8ὒ 㥶㌂䞲㑮㭖㧊㠞┺. ⡦䞲, 㧊㎇㑲[ 2 8 ]㦮㡆ῂ㠦㍲⽊Ị㏢㢖⽊Ị㰖㏢½ 㰚⬢㏢㦮 Ⱒ㫇

☚ ゚ᾦἆὒ, ⽊Ị㏢⽊┺ ⽊Ị㰖㏢½ 㰚⬢㏢㠦

㍲㦮 Ⱒ㫇☚Ṗ ▪ ⏨㞮⓪◆, ⽊Ị㏢⓪ 㔶⬆㎇

ὒ ╖㦧㎇㹾㤦㠦㍲, ⽊Ị㰖㏢½ 㰚⬢㏢⓪ ὋṦ

㎇㹾㤦㠦㍲ ṗṗ ⏨㦖 Ⱒ㫇☚⯒ ⽊㡖┺. 䔏䧞,

⽊Ị㰖㏢½ 㰚⬢㏢㦮㩲䞲♲ ㍲゚㓺㢖 ⹎⹎䞲䢮ἓ㠦㍲ ὖ㕂ὒ ἓ㼃, ㌗䢎ᾦṦ㠦㦮䞲 Ⱒ㫇

☚Ṗ ⏨㞮㦒Ⳇ, 㣎䡫㎇㹾㤦㦮 Ⱒ㫇☚⓪ ⌄㞮

┺. 㧒Ṳ ⽊Ị㏢ 6 0㎎㧊㌗㧊㣿㧦 1 8 0ⳛ㦚 ╖

㌗㦒⪲䞲 ⏎䧂㑯[ 2 9 ]㦮㡆ῂ㠦㍲⓪ ⽊Ị㏢㦮

㍲゚㓺㠦 ╖䞲 Ⱒ㫇☚Ṗ 䘟‶ 7 2 . 8⪲ 㩚⹮㩗㦒

⪲ Ⱒ㫇㓺⩂㤊 ἆὒ⯒ ⽊㡖㦒Ⳇ, ㏢✳㑮㭖㧊㩗㦖 ⏎㧎㧊㏢✳㑮㭖㧊 Ⱔ㦖 ⏎㧎⽊┺ ⿞Ⱒ 㫇䞮ἶ 㧞㠞┺. 3㹾㡞⹿㠦㭒⪲ 䂮㭧䞮㡂 ὖ Ⰲ 㤊㡗♮▮ ὒỆ㦮⽊Ị㏢㦮㡃䞶㧊㰖㡃㌂

䣢㭒⹒㦮 Ịṫ㯳㰚㦮䢫╖⪲ 㩦㹾䢫╖♮Ⳋ

㍲⽊Ị㏢㭧㕂㦮㰖㡃㌂䣢 Ịṫ㯳㰚㌂㠛㦮㭧㣪㎇㧊 ╖⚦♮ἶ 㧞㦒Ⳇ, 䔏䧞㾲⁒㦮 ⏎⪏

䢪䡚㌗㦒⪲ 㧎䞲 ⏎㧎⽊Ị㦮 ⶎ㩲✺㧊⽊Ị

㏢ Ịṫ㯳㰚㌂㠛㦮㭒㣪㌂㠛㦒⪲ 㧎㔳♮ἶ 㧞㦢㦚 Ṧ㞞䞶 ➢, ⏎㧎✺㦚 ╖㌗㦒⪲ 䞲㰚⬢

㍲゚㓺 Ṳ㍶㧊㩞㔺䧞㣪㼃♲┺.

䡚㨂㤆Ⰲ⋮⧒ 㩚ῃ ⽊Ị㏢㠦㍲⓪ ⏎㧎⽊Ị

㌂㠛㦚㥚䟊 ┺㟧䞲㌂㠛㦚㔲䟟䞮ἶ 㧞㰖Ⱒ

㧊⩆ ⏎㧎⽊Ị㡗㡃㧊⽋㰖㡗㡃ὒ 㰗㩧㡆Ἒ♮

㠊㧞㰖㞠┺. 㯟, ☯㧒 ╖㌗㧎 ⏎㧎㠦 ╖䞲⽊ Ị㦮⬢㢖㌂䣢⽋㰖Ṗ ⼚Ṳ㦮㡗㡃㦒⪲ ┺⬾㠊㰖⓪ ἓ䟻㧊㧞ἶ, 㔺ⶊ㠦㍲☚ ⽊Ị㦮⬢㩚╂㼊 Ἒ㢖㌂䣢⽋㰖㩚╂㼊ἚṖ ⼚☚⪲ 㤊㡗♮ἶ 㧞㦚㈦Ⱒ 㞚┞⧒ ⚦ 㩚╂㼊Ἒ ㌂㧊㠦㌗䢎䡧㫆 ⹥ 䐋㩲㼊㩲☚ ⹎゚䞮㡂㍲゚㓺㩲Ὃ㠦㧞㠊㍲゚䣾㥾ὒ ⌃゚⯒ Ṗ㪎㡺ἶ, ㍲゚㓺㑮䡲㧦㧎㰖㡃㭒⹒㦮㧛㧻㠦㍲⽎┺Ⳋ 䣾ὒ㩗㧎

㍲゚㓺㦮㩚╂㦚 ⹿䟊䞮⓪ 㣪㏢Ṗ ♶ 㑮☚ 㧞

┺[30]. 㧊⩆ 䔏㎇㦚 Ṧ㞞䞮㡂䞲 ⏣㽢㰖㡃㌂

䣢⌊ ⏎㧎㦮 Ịṫ㯳㰚ὒ ㌌㦮㰞䟻㌗㦚㥚䟊

╖㞞㦒⪲ 㩲㔲♲ ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㠦

╖䞲䞚㣪☚⓪ 㩚㼊䘟‶㧊 3 . 6 7㩦㧊㠞ἶ, ⽊Ị 㦮⬢ 㡗㡃㦮 ⹿ⶎṚ䢎㍲゚㓺(䘟‶ 4.08), Ⱒ㎇

㰞䢮ὖⰂ(䘟‶ 4.06), ⁎Ⰲἶ ⽋㰖㡗㡃㦮㤊㏷

㍲゚㓺(䘟‶ 4.05) 㑲㦒⪲ ⁎ 䞚㣪☚Ṗ ⏨㞮┺.

㯟 ⏎㧎✺㦖 ┺⯎ ㍲゚㓺⽊┺☚ Ệ☯㦮⿞䘎䞾ὒ ⏎㧎⼧ ❇㦮 ⶎ㩲⪲ 㧎䞲䐋䞿㍲゚㓺㩲 Ὃ㦮䞚㣪㎇㦚 Ṗ㧻 ⏨Ợ 㣪ῂ䞮ἶ 㧞㦢㦚㞢㑮㧞┺.

╖ῂ㔲㦮⽊Ị㏢㢖 ⏎㧎㫛䞿⽋㰖䣢ὖ, ⽊Ị

⽋㰖㎒䎆㦮 6 5㎎㧊㌗㧊㣿㧦 2 8 8ⳛ㦚 ╖㌗㦒

⪲ 䞲㕂⵮㡻[ 3 1 ]㦮㡆ῂ㠦㦮䞮Ⳋ ⽊Ị㍲゚

㓺㢖⽋㰖㍲゚㓺Ṗ 䐋䞿♲ 㔲㍺㠦㍲㦮 Ⱒ㫇☚

Ṗ ⿚Ⰲ♲ 㔲㍺㠦㍲⽊┺ ⏨㞮┺. 㧊㡗㑯[ 3 2 ]㦮㡆ῂ㠦㦮䞮Ⳋ, ⽊Ị㏢㍲゚㓺㭧㭒⹒㧊 Ṗ㧻

㍶䢎䞮⓪ ㍲゚㓺⓪ 䢮㧦㰚⬢(71.1%), Ⱒ㎇䑊䟟

㎇㰞䢮ὖⰂ( 2 3 . 9 % ) 㧊㠞㦒Ⳇ, 㡗㟧Ṳ㍶㌂㠛, 㩫㔶⽊Ị㌂㠛, ṗ㫛㔺䠮 ⹥ Ỗ㌂㌂㠛, 㨂䢲⽊Ị

㌂㠛㠦㍲ ⌄㦖 ὖ㕂㦚⽊㡖┺. 㧊⩝Ợ ⏎㧎㦮㔺㩲䞚㣪⯒ ⹮㡗䞲⽊Ị㦮⬢㢖⽋㰖㠦 ╖䞲㑮㣪⯒ 㿿㫇㔲䋺₆ 㥚䟊㌂䣢 ṗ ⿚㟒㠦㍲ ⏎ 㧎⽊Ị㦮⬢㍲゚㓺㢖 ⏎㧎⽋㰖 ⶎ㩲⯒ ┺ṗ☚

⪲ Ỗ䏶䞮㡂⽊┺ 㼊Ἒ㩗㧊ἶ 䣾㥾㩗㧎㔲㓺䎲㠦㦮䞲㫛䞿㩗㧎 ὖⰂṖ 䞚㣪䞮┺. 䞲㡞⯒

✺Ⳋ, 㩫₆㩗㧎 ⹿ⶎ Ṛ䢎㍲゚㓺㦮䢫╖ 㔲䟟

ὒ 䞾℮ Ệ☯ ⿞䘎 ⏎㧎✺㦚㥚䞲㰖㡃 ⌊㦮

ⶊ⬢ ㎪䔖⻚㓺㦮㤊䟟 ❇㦚㩗⁏㩗㦒⪲ 㔲䟟

䞶䞚㣪㎇㧊㣪㼃♲┺.

(10)

⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲䞚㣪☚ ὖ

⩾ 㣪㧎㦚 ῂⳛ䞮₆ 㥚䟊㥚Ἒ㩗 ┺㭧䣢‖⿚

㍳㦚㔲䟟䞲 ἆὒ, ⏎㧎㦮䐋䞿⽊Ị⽋㰖㍲゚㓺㠦㡗䟻㦚㭒⓪ 㣪㧎㦒⪲⓪ ㏢✳㑮㭖ὒ Ịṫ ὖ㕂☚, ⁎Ⰲἶ 㰚⬢Ⱒ㫇☚ ❇㧊Ⳇ, ⶊ㠝⽊┺

☚ 㞞㩫㩗㧎㏢✳㑮㭖㧊㩲Ὃ♮㠊㟒䞶 ộ㦒

⪲ ⽎┺. 㯟 ⏎㧎✺⪲ 䞮㡂⁞ Ịṫ㧊⧖ 㧦㔶㦮

⏎⩻ὒ ὖ㕂㡂䞮㠦 ➆⧒ 㠒Ⱎ✶㰖㫡㞚㰞㑮㧞┺⓪ 㔶⎦㦚 Ṭ☚⪳ 㥶☚䞮㡂㟒䞮Ⳇ, ⏎㧎

✺㦮 Ịṫⶎ㩲⯒ 䟊ἆ䟊㭚㑮㧞⓪ 㩗㩞䞲

⽊Ị㦮⬢㦮㔲䡲㢖䞾℮ ἓ㩲㩗㧎㰖㤦㧊⼧䟟♮㠊㟒䞶 ộ㦒⪲ ⽎┺.

㧊㡆ῂ⓪ ṫ㤦☚ ' H 'ῆ⽊Ị㏢⯒ 㔺㩲⪲ 㧊㣿䞮⓪ ⏎㧎㦚 ╖㌗㦒⪲ Ⱒ㫇☚⯒ 䁷㩫䞮ἶ,

⽊Ị㦮⬢㡗㡃㈦Ⱒ㧊㞚┞⧒ ⽋㰖㡗㡃㦮䞚㣪

☚⯒ 䕢㞛䞾㦒⪲㖾䟻䤚⽊Ị㏢㭧㕂㦮 ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺⯒ Ṳ⹲䞮⓪◆ ₆㽞㧦⬢⯒

㩲Ὃ䞶㑮㧞┺⓪ 㩦㠦㍲㫛㩚㦮㥶㌂㡆ῂ㢖

゚ᾦ䞮㡂⽒ ➢, 㡆ῂ╖㌗ ⹥ 㡆ῂ⹿⻫㠦㍲㍶䟟㡆ῂ㦮㩲䞲㩦㦚 ⁏⽋䞲㡆ῂ⪲ 䘟Ṗ♶ 㑮㧞㦚 ộ㧊┺.

⁎⩂⋮ ⽎㡆ῂ㦮 ἆὒ⯒ 㧒⹮䢪䞮⓪ ◆㠦

┺㦢ὒ ṯ㦖㩲䞲㩦㧊㩲₆♶ 㑮㧞┺.

㼁㱎, 㧒Ṳ 㰖㡃㌂䣢㦮⽊Ị㏢㧊㣿㧦⯒ ╖

㌗㦒⪲ 䞮㡖㦒⸖⪲ 㤆Ⰲ⋮⧒ 㩚㼊 ⏎㧎㦚 ╖ 䚲䞲┺ἶ 䞶㑮㠜┺. ⡦䞲゚ᾦ㩗゚㔍䞲㌂䣢ἓ㩲㩗䔏㎇㦚 Ṭ⓪ ⏎㧎✺㦚 ╖㌗㦒⪲ 㫆

㌂♮㠞₆ ➢ⶎ㠦㧊㡆ῂ㠦㍲ ☚㿲♲ ἆὒ⯒

Ṗ㰖ἶ 㤆Ⰲ⋮⧒ 㩚㼊 ⏎㧎㦮⽊Ị㏢㭧㕂㦮䐋䞿⽊Ị㍲゚㓺㠦 ╖䞲䞚㣪☚⧒ἶ 䟊㍳䞮⓪

◆㠦⓪ ┺㏢ ⶊⰂṖ ➆⯎┺. 䟻䤚 ╖☚㔲 ⹥ 㭧㏢☚㔲 Ệ㭒 ⏎㧎✺㠦 ╖䞲㕂䂋㩗㧎㡆ῂ Ṗ 㑮䟟♮㠊㟒䞶 ộ㧊┺.

⚮㱎, 㡆ῂ ⿚㍳㠦䞚㣪䞲㧦⬢⯒ 㭒⪲ ⏎ 㧎✺㦮㭒ὖ㩗㧎㦧╋㠦㦮㫊䞮㡖₆ ➢ⶎ㠦

⁎ ╏㔲㦮 Ịṫ㌗䌲⋮ Ṳ㧎㩗㌗䢿㠦 ➆⧒ ὒ

╖ὒ㏢䘟Ṗ♮㠊㰞 Ṳ㡆㎇㦚㞞ἶ 㧞┺. 㧊⩂

䞲 ⶎ㩲㩦㦮䟊㏢⯒ 㥚䞮㡂 2ⳛ㦮㦮㌂Ṗ 㰚

┾㦚䐋䞮㡂㩗㩞䞲䘟Ṗ⯒ 䞮⩺ἶ 䞮㡖㰖Ⱒ 㡂㩚䧞 ⁎ ṳὖ㎇㦮 ⶎ㩲㩦㧊 ☚㿲♶ 㑮㧞㦚

ộ㧊┺.

㎡㱎, 㧊㡆ῂ㠦㍲⓪ ⏎㧎䐋䞿⽊Ị㍲゚㓺䞚㣪☚㠦 ὖ㡂䞶㑮㧞⓪ Ṳ㡆㎇㧞⓪ 㡞䁷㧎㧦✺㧊㡆ῂ 㽞₆┾Ἒ㠦㍲⿖䎆㻶㩖䞮Ợ Ỗ䏶

♮㰖 ⴑ䞮㡖ἶ, ➆⧒㍲䣢‖⿚㍳ ἆὒ㠦㍲⽒㑮㧞❅㧊 ☛Ⱃ⼖㑮✺㦮 ⌄㦖㍺ⳛ⩻㦖㩲䞲㩦㦒⪲ ⋾Ợ ♮㠞┺. ⡦䞲㭒ὖ㩗㧎㔶㼊₆⓻

㌗䌲⋮ Ịṫ䟟䌲 ❇㧊䣢‖⿚㍳㠦㍲㥶㦮䞲㣪㧎㦒⪲ 䕢㞛♮㰖㞠㦖㧊㥶⪲⓪ 㰽㦖㡆ῂ

₆Ṛ㦒⪲ 㧎䞲㡆ῂ╖㌗㧦㦮㑮( 1 1 0ⳛ)Ṗ 㩗㠞Ệ⋮ 7Ṳ㦮 Ịṫ䟟䌲㍺ⶎⶎ䟃Ṛ ㌗ὖ㎇㧊

㍲⪲ 㟓䟊㍲㧎㰖 ⌊㩗㔶⬆☚⯒ ⹮㡗䞮⓪ C r o n b a c h ˄ s alpha Ṩ( 0 . 4 4 9 ) 㧊 ⌄㦖㩦 ❇㦚 ✺ 㑮㧞┺. 䟻䤚㧊⩂䞲 ⶎ㩲㩦✺㦚⽊㢚䞲㡆ῂ

㍺Ἒ⹿⻫㠦㦮䞲㥶㌂ ⏎㧎⽊Ị㡆ῂ⯒ 䐋䟊 ὖ⩾ 㣪㧎✺㧊 ῂⳛ♮₆⯒ ⹪⧖┺.

㧊㡆ῂ㠦㍲㦮㡆ῂἆὒ⯒ ₆⹮㦒⪲ ┺㦢ὒ ṯ㧊㩲㠎䞮ἶ㧦䞲┺.

㼁㱎, ⽊Ị㏢㦮 ⏎㧎✺㦚 ╖㌗㦒⪲ 䞲㍲゚

㓺⓪ ╖㌗㧦㦮䞚㣪☚⯒ ⹮㡗䞮㡂⽊Ị㦮⬢㡗㡃ὒ ⽋㰖㡗㡃㧊䐋䞿♮㠊䙂὚㩗㦒⪲ Ὃ ♮ 㠊㟒䞲┺. 㧊⯒ 㥚䟊⽊Ị㏢㦮㭒㿫㧊 ♮⓪ 㦮⬢㰚㦖 ⶒ⪶ 㧒㍶₆ὖ, 㰖㡃⽋㰖㎒䎆, 㰖㡃

㌂䣢, 㩫⿖ ❇ ⳾✶ ㍲゚㓺㩚╂㦮㭒㼊⓪ ⊠ 㧚㠜㧊䣾ὒ㩗㧎䐋䞿䝚⪲⁎⧾㦚 Ṳ⹲䞮㡂㟒䞲┺.

⚮㱎, ⽊Ị㦮⬢㡗㡃㦮㣪ῂ☚Ṗ 䞯⩻ ⹥ ㏢

✳㠦 ➆⧒㍲㥶㦮䞲㹾㧊⯒ ⽊㧎㩦㦚 Ṧ㞞䞶

➢, ⽊Ị㏢㦮䐋䞿⽊Ị㦮⬢㍲゚㓺㍶㩫㔲㰖㡃㭒⹒㦮䞯⩻ὒ ㏢✳㦚 ἶ⩺䞮㡂䞚㣪䞲㍲゚

㓺⯒ ㍶䌳㩗㦒⪲ 㔲䟟䞶䞚㣪Ṗ 㧞┺.

㎡㱎, ⽊Ị㏢㦮㍲゚㓺㔲䟟㔲⽋㰖㡗㡃㦮㣪ῂ☚Ṗ ἶ⪏㧊 ♶㑮⪳ ⌄㞚㰖⓪ 㩦㦚㭒㰖䞮㡂㰖㡃㭒⹒㦮㡆⪏⿚䙂⯒ ἶ⩺䞮㡂㰖㡃⽊

Ị㦮⬢Ἒ䣣㦚㑮Ⱃ䞶䞚㣪Ṗ 㧞┺.

殚檃

䞲 ⏣㽢㰖㡃㦮㧒⿖ ⏎㧎㧎ῂ⯒ ╖㌗㦒⪲

䐋䞿⽊Ị㦮⬢㍲゚㓺㦮䞚㣪☚㢖 ⁎ ὖ⩾ 㣪㧎

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㦚䕢㞛䞮ἶ㧦㔲䟟䞲㧊㡆ῂ╖㌗㦖 2 0 0 5⎚

1 1㤪⿖䎆 2Ṳ㤪㡂☯㞞 ṫ㤦☚˄ H 'ῆ⽊Ị㏢⯒

⌊㤦䞲 6 0㎎㧊㌗ ⏎㧎㦒⪲ 㰚⬢╊╏ 㦮㌂㢖

⽊Ị㣪㤦( 2ⳛ)㠦㦮䟊㍺ⶎ㫆㌂Ṗ 㔺㔲♮㠞⓪

◆, 㽳 1 1 0ⳛ㧊㺎㡂䞮㡖┺. 㡆ῂ☚ῂ㧎㍺ⶎ㰖

⓪ ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲 ῃ⌊㣎

㍶䟟㡆ῂ㦮 ⶎ䠢ἶ㺆㦚䏶╖⪲ Ṳ⹲䞲䤚㡞

゚㫆㌂⯒ Ệ㼦 5Ṳ 㡗㡃㦮 6 8Ṳ ⶎ䟃㦒⪲ 㑮㩫, ⽊㢚䞮㡖┺. 㑮㰧♲ 㧦⬢⓪ SPSS P C

⁺

(Version 12.0)⯒ 㧊㣿䞮㡂 ◆㧊䎆⻶㧊㓺⯒

ῂ㿫䞮㡂 ╖㌗㧦㦮㧎ῂ㌂䣢䞯㩗䔏㎇, Ⱒ㎇㰞䢮㦮㧊䢮㌗䌲 ❇㦚䕢㞛䞮㡖ἶ, 㡗䟻㣪㧎 ῂ ⳛ㦚㥚䟊㥚Ἒ㩗 ┺㭧䣢‖⿚㍳㦚㔲䟟䞮㡖㦒 Ⳇ, ⁎ ἆὒ⓪ ┺㦢ὒ ṯ┺.

㼁㱎, Ⱒ㎇㰞䢮㧊䢮㥾⪲⓪ ἶ䡞㞫㧊 7 6 . 4 % ( 8 4 ⳛ)⪲ Ṗ㧻 ⏨㞮㦒Ⳇ, ╖㌗㧦㭧 8 4ⳛ 㦖 2Ṳ 㧊㌗㦮 Ⱒ㎇㰞䢮㠦 ☯⹮ 㧊䢮♮㠊㧞㠞┺.

⚮㱎, ⽊Ị㏢⌊ ₆㫊㍲゚㓺㦮 Ⱒ㫇☚㫆㌂㠦

㍲⓪ 㰚⬢㍲゚㓺㢖 ⶒⰂ䂮⬢㠦 8 4ⳛ( 7 8 . 5 % ) ὒ 1 6ⳛ( 6 6 . 7 % ) 㧊 ṗṗ˄ Ⱒ㫇䞲┺'ἶ 䞮㡖┺. ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲䞚㣪☚⓪ 㩚㼊䘟

‶㧊 3 . 6 7㩦㧊㠞ἶ, ⽊Ị㦮⬢ 㡗㡃㦮 ⹿ⶎṚ䢎

㍲゚㓺(䘟‶ 4.08), Ⱒ㎇㰞䢮ὖⰂ(䘟‶ 4.06) ⹥

⽋㰖㡗㡃㦮㤊㏷㍲゚㓺(䘟‶ 4.05) 㑲㦒⪲ ⁎ 䞚㣪☚Ṗ ⏨㞮┺.

㎡㱎, 㡗㡃⼚㍲゚㓺䞚㣪☚㦮㡗䟻㣪㧎㦚䕢㞛䞮₆ 㥚䟊㥚Ἒ㩗 ┺㭧䣢‖⿚㍳㦚㔺㔲䞲 ἆὒ, ⳾䡫ช(㧎ῂ㌂䣢䞯㩗䔏㎇)㠦㍲⽋㰖㡗㡃㍲゚㓺㦮䞚㣪☚(㑮㩫 R

²

= 7 . 2 % )㢖㩚㼊 (⽊Ị㦮⬢+⽋㰖) 㡗㡃㍲゚㓺㦮䞚㣪☚(㑮㩫 R

²

= 6 . 5 % )㠦㏢✳ ⼖㑮Ⱒ㧊䐋Ἒ㩗㦒⪲ 㥶㦮䞮㡖┺. ⳾䡫ซ(㧎ῂ㌂䣢䞯㩗䔏㎇㠦 Ịṫὖ㕂

☚, 㔶㼊₆⓻㌗䌲㢖 Ịṫ䟟䌲䙂䞾)㠦㍲☚ ⽋㰖㡗㡃㍲゚㓺㦮䞚㣪☚(㑮㩫 R

²

= 1 0 . 9 % ) Ṗ 㩗䞿䞮㡖ἶ, ㏢✳㧊 Ⱔ㦚㑮⪳, Ịṫὖ㕂☚Ṗ

⏨㦚㑮⪳ 䐋Ἒ㩗㦒⪲ 㥶㦮䞮㡖┺. 㰚⬢Ⱒ㫇☚

Ṗ 㿪Ṗ♲ ⳾䡫ฌ㠦㍲⓪ ⽊Ị㦮⬢ 㡗㡃㍲゚

㓺(㑮㩫 R

²

=5.3%), ⽋㰖㡗㡃㍲゚㓺(㑮㩫 R

²

=15.2%) ⹥ 㩚㼊㡗㡃㍲゚㓺(㑮㩫

R

²

= 1 2 . 4 % )㦮䞚㣪☚Ṗ ⳾⚦ 㩗䞿䞮♮ ㏢✳

⼖㑮Ⱒ㧊 ṗṗ 䐋Ἒ㩗㦒⪲ 㥶㦮䞮㡖┺.

➆⧒㍲⽊Ị㦮⬢㦮䁷Ⳋ㠦㍲ ⏎㧎✺㠦 ╖䞲䣾ὒ㩗㧊ἶ ┺㟧䞲⽊Ị㦮⬢㍲゚㓺㦮㩲Ὃ㧊㔲 䞮Ợ 㣪ῂ♮ἶ 㧞㦒Ⳇ, 㧊⯒ 㿿㫇㔲䌂㑮㧞⓪ 䐋䞿㩗㧎 Ὃ 㼊Ἒ⯒ 䢫Ⱃ䟊㟒䞶 ộ㧊

┺. ▪㤇㧊 ἶ⪏䢪Ṗ ▪㤇㕂䢪♶ ⏣㽢㰖㡃㦖

⏎㧎 ṲṲ㧎㦮䞚㣪☚ 㭧㕂㠦㍲㿲⹲䞮♮ 㧊

✺㧊 Ệ㭒䞮⓪ Ṗ㫇䢮ἓ ⹥ ㌂䣢䢮ἓ㦚䙂὚

䞮⓪ 㹾㤦㠦㍲㦮㰖㡃⽊Ị, Ⱒ㎇㰞䢮㦮䂮⬢㢖㔶㼊 ₆⓻㦮䣢⽋㦚㥚䞲㦮⬢, ἓ㩲㩗㰖㤦ὒ Ṗ㣿㧦㤦㦮䢲㣿㦚 ☚㢖㭒⓪ ⽋㰖 Ṳ⎦㧊㡆 Ἒ♲ 䐋䞿⽊Ị㦮⬢㍲゚㓺⯒ ┺䞯㩲㩗䕖㩧⁒

㠦㦮䟊㰖㏣㩗㦒⪲ 㩲Ὃ䞶䞚㣪Ṗ 㧞┺. 䔏䧞, 㤆Ⰲ⋮⧒㦮 ἓ㤆㡞⹿⽊┺ 䂮⬢ 㭧㕂㦮㦮⬢

㩚╂㼊Ἒ⪲ ♮㠊㧞㠊 ┺⹲㎇㦮 Ⱒ㎇䑊䟟㎇

㰞䢮㠦㧊䢮♲ ⏎㧎✺㠦Ợ 㫛䞿㩗㦒⪲ 㑮㣿䞶㑮㧞⓪ 㧻₆Ṛ㦮 Ṛ䢎⋮ 㨂䢲㍲゚㓺⯒ 㩲Ὃ 䞶㑮㧞⓪ 䝚⪲⁎⧾㧊㤆㍶㩗㦒⪲ 㩲Ὃ♮㠊㟒䞲┺ἶ ⽎┺.

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description and impressions of a capitated model of long-term care for the elderly. Care Manag J 1999; 1(1):

6 2 - 7 0

2 2 .Robinson J, Karon SL. Modeling medicare costs of PACE (Program of All-Inclusive Care for the Elderly) populations. Health Care Financ Rev 2 0 0 0 ; 2 1 ( 3 ) : 1 4 9 - 1 7 0

2 3 .Temkin-Greener H, Meiners MR, Gruenberg L. PACE and the medicare+choice risk-adjusted payment model. Inquiry 2 0 0 1 ; 3 8 ( 1 ) : 6 0 - 7 2

2 4 .Nadash P. Two models of managed

(13)

long-term care: comparing PACE with a medicaid-only plan. Milbank Q 2 0 0 4 ; 8 2 ( 2 ) : 2 5 7 - 2 8 2

2 5 .Leutz WN. Five laws for integrating medical and social services: lessons from the United States and the United Kingdom. Milbank Q 1 9 9 9 ; 7 7 ( 1 ) : 7 7 - 1 1 0 , iv-v

2 6 .Mui AC. The Program of All-Inclusive Care for the Elderly (PACE): an innovative long-term care model in the United States. J Aging Soc Policy 2 0 0 1 ; 1 3 ( 2 - 3 ) : 5 3 - 6 7

2 7 .National PACE Association. Available at h t t p : / / w w w . n p a o n l i n e . o r g / w e b s i t e / a r t i c l e . a s p

2 8 .㧊㎇㑲. ὋὋ⽊Ị₆ὖ㦮⽊Ị㦮⬢㍲゚㓺㩲 Ὃ㧦㢖㑮䡲㧦 Ṛ㦮㍲゚㓺 Ⱒ㫇☚ 㡆ῂ.

㞚㭒╖䞯ᾦ ὋὋ㩫㺛╖䞯㤦㍳㌂䞯㥚⏒ⶎ, 2 0 0 4

2 9 .⏎䧂㑯. ⏎㧎㦮⽊Ị㦮⬢㍲゚㓺 Ⱒ㫇☚㠦㡗䟻㦚 ⹎䂮⓪ 㣪㧎㠦 ὖ䞲㡆ῂ-ὧⳛ㔲

⽊Ị㏢⯒ 㭧㕂㦒⪲-. ἓ₆╖䞯ᾦ 䟟㩫╖䞯㤦㍳㌂䞯㥚⏒ⶎ, 2003

3 0 .ₖἓ⹎. ⏎㧎⽊Ị㦮⬢㢖⽋㰖㍲゚㓺㦮㡆 Ἒ ⹿㞞㠦 ὖ䞲㡆ῂ(ἶ㟧㔲 ▫㟧ῂ ⽊Ị

㏢⯒ 㭧㕂㦒⪲). ㌗ⳛ╖䞯ᾦ 㩫䂮ἓ㡗╖䞯㤦㍳㌂䞯㥚⏒ⶎ, 2003

3 1 .㕂⵮㡻. ⏎㧎⽊Ị⽋㰖㍲゚㓺㦮䐋䞿ὖⰂ㠦 ὖ䞲㡆ῂ. 㡗⋾╖䞯ᾦ 䟟㩫╖䞯㤦㍳㌂䞯㥚⏒ⶎ, 2004

3 2 .㧊㡗㑯. ⏣㠊㽢⽊Ị㏢㦮⬢㍲゚㓺 Ṳ㍶⹿

㞞㠦 ╖䞲㡆ῂ. 㑲㻲䟻╖䞯ᾦ ἓ㡗䟟㩫╖

䞯㤦㍳㌂䞯㥚⏒ⶎ, 2003

Need of Health Center-based Integrated Healthcare Services for the Elderly in Rural Area

M e t h o d s: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly.

Income was a significant variable in increasing the need of health care and welfare services.

C o n c l u s i o n s: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

Key words : Health center, Integrated health care service, Elderly

㤦㦖㑯

, ₖ㿮⺆

, 㧻㎎㰚

, ⹫㫛ῂ

, 䡚㑯㩫

ṫ㤦☚ 䢣㻲ῆ⽊Ị㏢

, 㡆㎎╖䞯ᾦ 㤦㭒㦮ὒ╖䞯 㡞⹿㦮䞯ᾦ㔺

Eun-Sook Won

, Chun-Bae Kim

, Sei-Jin Chang

, Jong-Ku Park

, Sook-Jung Hyun

Kangwondo Hongcheongun Public Health Center

,

D e p a rtment of Preventive Medicine, Yonsei University Wonju College of Medicine

୙ABSTRACT୙

昢 嵦

㑮ⳛ㦮 㡆㧻ὒ 㧎ῂ㦮 ἶ⪏䢪⓪ 㩚 ㎎Ἒ ㍶ 㰚ῃὒ Ṳ⹲☚㌗ῃ✺㦮 㩚⹮㩗㧎 㿪㎎⪲㍲ 㧊 㠦 ➆⯎ Ⱒ㎇㰞䢮㦮 㯳Ṗ⓪ ṗ㫛 ㌳䢲⓻⩻㦮 㩖䞮㢖 䟟☯㦮 㩲䞲㦚 Ṗ㪎┺㭒㠊 㩦㹾 ⏎㧎

✺㦮 㧦Ⱃ㌳䢲㦚 ⿞Ṗ⓻䞮Ợ 䞮ἶ 㧞┺. 㧊⩆

㌗䢿䞮㠦㍲ ⏎㧎✺㦮 Ịṫⶎ㩲⓪ ⽊Ị䞯㩗㧎 䁷Ⳋ㈦Ⱒ㧊 㞚┞⧒ ㌂䣢㩗, ἓ㩲㩗㧎 䁷Ⳋ㠦㍲

☚ ⰺ㤆 㭧㣪䞲 㦮⹎⯒ Ṗ㰚┺.

㍶㰚ῃὒ ṯ㧊 㤆Ⰲ⋮⧒☚ 2 0 0 5⎚㠦 ⏎㧎㧎 ῂṖ 9 . 1 %⪲ ㏣䞲 ⏎⪏䢪 ㌂䣢⪲ ⼖䢪䞮ἶ 㧞⓪ Ṗ㤊◆, Ⱒ㎇㰞䢮 㧊䢮㧦Ṗ 㯳Ṗ䞮ἶ 㧞 㠊 ⏎㧎⽊Ị㦮 ⶎ㩲Ṗ ⽊Ị㦮⬢㦮 㭒㣪 ⶎ㩲

⪲ ╖⚦♮ἶ 㧞┺[1]. 䔏䧞 㤆Ⰲ⋮⧒ ⏎㧎㦮 ἓ㤆˄ 䟟㥚㦮 㑮䟟 䁷Ⳋ㦮 ㌌㦮 㰞˅ ὖⰂṖ 㔲 䞲 㔺㩫㦒⪲, 65㎎ 㧊㌗ ⏎㧎㦮 Ⱒ㎇㰞䢮 㥶⼧⮶㦖 㟓 8 6 %㧊Ⳇ, 99.7%Ṗ 㰖㡃㌂䣢㠦㍲

㌳䢲䞮ἶ 㧞⓪ ⏎㧎㧊┺[2]. 㧊⩂䞲 ⏎⪏㧎ῂ 㦮 㯳Ṗ⓪ ㌂䣢 㩚⹮㠦 Ỏ㼦 Ⱔ㦖 ⼖䢪㢖 ⶎ 㩲㩦㦚 Ṗ㪎㡺ἶ 㧞㦒Ⳇ, ⏎㧎㧎ῂ㦮 㯳Ṗ㠦

➆⧒ Ⱒ㎇㰞䢮 㥶⼧⮶㧊 ⏨㞚㰦㦒⪲㖾 ⏎㧎✺

㦮 ㌌㦮 㰞㦚 Ṧ㏢㔲䋺ἶ 㦮⬢゚㣿 ⡦䞲 Ⱏ╖

䞮Ⰲ⧒ 㡞㌗♲┺.

㰖⋲ 1 9 7 1⎚⿖䎆 ⹎ῃ ㌢䝚⧖㔲㓺䆪㭒㦮 ⿗

⿖䟊㞞 㭧ῃ㧎㧊 Ệ㭒䞮⓪ On Lok㰖㡃㠦㍲

⏎㧎㦚 㥚䞲 䐋䞿⽊Ị㦮⬢㍲゚㓺 䝚⪲⁎⧾㧎 PACE(Program of All-inclusive Care for the Elderly) ⳾◎㧊 㔲㧧♮㠞┺[3-10]. PACE ⳾◎

㦖 㰖㡃㌂䣢⌊ ⽊Ị㦮⬢㧎㦚 㭧㕂㦒⪲ 䂮⬢, Ṗ㩫Ṛ䢎㍲゚㓺, 㭒Ṛ Ịṫ䝚⪲⁎⧾㦚 䐋䞿㩗 㦒⪲ 㤊㡗䞾㦒⪲㖾 㰖⁞₢㰖 ㎇Ὃ㩗㦒⪲ 㔲䟟

⁎ ☯㞞 㤆Ⰲ⋮⧒㦮 ⽊Ị⽋㰖 䐋䞿㍲゚㓺㠦

╖䞲 䝚⪲⁎⧾㦖 ⽋㰖⯒ 㭒㿫㦒⪲ 䞮♮ ⽊Ị

㦚 ⁎ 䞲 㿫㠦 ⚦ἶ ⳾䡫 Ṳ⹲ ❇㦚 䞲 㡆ῂ Ṗ ╖⿖⿚㧊㠞┺. ⁎⩂⋮, ⏎㧎㦮 ㌌㦮 㰞㦖 㧊

✺㦮 Ⱒ㎇㰞䢮ὖⰂ ❇ Ịṫ㌗䌲㢖 ⰺ㤆 ⹖㩧 䞲 ὖἚṖ 㧞㠊 㦮⬢㦮 㩚ⶎ㎇㦚 Ṧ㞞䞲┺Ⳋ

⽊Ị㏢⯒ 㭧㕂㦒⪲ 䞲 䐋䞿⽊Ị㦮⬢㍲゚㓺㦮 㩲Ὃ ⳾䡫 Ṳ⹲㧊 㔲 䧞 㣪ῂ♲┺ἶ ⽎┺.

➆⧒㍲ 㧊 㡆ῂ㦮 ⳿㩗㦖 ⹎ῃ㠦㍲ 㔲䟟♮

ἶ 㧞⓪ PACE ⳾䡫㦚 ⁒Ệ⪲ Ṳ⹲♲ ㍺ⶎ㰖

⪲ ṫ㤦☚ ⌊ 㧒Ṳ ῆ㦮 ⏎㧎㧎ῂ⯒ ╖㌗㦒⪲

⽊Ị㦮⬢ 㡗㡃ὒ ⽋㰖 㡗㡃㦚 䙂䞾䞲 䐋䞿⽊

Ị㦮⬢㍲゚㓺㦮 䞚㣪☚⯒ 㫆㌂䞮㡂 ⏎㧎✺㦮 Ⱒ㎇㰞䢮 ⹲㌳㦚 㡞⹿䞮ἶ ㌌㦮 㰞㦚 䟻㌗㔲 䌊㦒⪲㖾 ⏎䤚⯒ ⽊┺ Ịṫ䞮Ợ ㌊ 㑮 㧞⓪

╖㞞㦚 㩲㔲䞮ἶ㧦 䞮㡖┺.

堆旇 愕 愯憛

1. 櫶割堆旇 愕 沖巒朞滗愯憛

㧊 㡆ῂ⓪ ṫ㤦☚ Hῆ ⽊Ị㏢㠦 ❇⪳♲ 6 0

㎎ 㧊㌗ ⏎㧎 㭧 䘎㦮㿪㿲⹿⻫( c o n v e n i e n c e s a m p l i n g ) 㠦 㦮䟊 ㍶㩫♲ 㽳 1 1 0ⳛ㦚 ╖㌗㦒⪲

2 0 0 5⎚ 1 1㤪⿖䎆 1 2㤪₢㰖 2Ṳ㤪㡂☯㞞㠦 Ỏ㼦 㧦⬢⯒ 㑮㰧䞮㡖┺. 㧦⬢㑮㰧㦖 㰚⬢ ╊╏ 㦮

㌂㢖 㡆ῂ⳿㩗ὒ ㍺ⶎ⌊㣿㦚 ㌂㩚ᾦ㥷㦒⪲ 㿿

⿚䧞 䤞⩾♲ 2ⳛ㦮 ⽊Ị㣪㤦㠦 㦮䟊 㧦₆₆㧛 㔳 ㍺ⶎὒ Ⳋ㩧㦚 䐋䟊 㧊⬾㠊㪢┺.

2. 櫶割壊割 愕 猧洛愯憛

㡆ῂ☚ῂ⓪ 䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ὖ䞲 ῃ

⌊½ 㣎㦮 ㍶䟟㡆ῂ ⹥ ⶎ䠢ἶ㺆㦚 䏶╖⪲ ἶ 㞞䞲 ῂ㫆䢪♲ ㍺ⶎ㰖⪲ 䞮㡖㦒Ⳇ, 2005⎚ 1 1 㤪 㽞㑲㠦 㡞゚㫆㌂⯒ Ệ㼦 ⽊㢚½ 㑮㩫䞮㡖┺.

㧊⓪ 䋂Ợ 5Ṳ 㡗㡃㦒⪲ ⿚⮮䞮♮ 6 8Ṳ ⶎ䟃 㦒⪲ 㾲㫛 ῂ㎇䞮㡖┺. 㧊 㡆ῂ㠦㍲ ㍶㩫䞲 ṗ

⼖㑮✺㦮 䁷㩫㦚 㥚䟊 㧊㣿♲ 㡂⩂ 䟃⳿✺㦮 㔶⬆㎇㦚 Ỗ㩫䞮₆ 㥚䞮㡂 㔶⬆☚ ⿚㍳㦚 䞲 ἆὒ, Cronbach ˄ s alpha⓪ 㭒ὖ㩗㧎 㔶㼊₆⓻㌗

䌲 0.748 Ịṫ䟟䌲 0.449 ⽊Ị㦮⬢㡗㡃㦮 ㍲゚

㓺 䞚㣪☚ 0.679 ⽋㰖㡗㡃㦮 ㍲゚㓺 䞚㣪☚

0 . 8 5 3㦒⪲ Ịṫ䟟䌲⯒ 㩲㣎䞮ἶ⓪ ゚ᾦ㩗 Ⱒ㫇

䞶 Ⱒ䞲 㑮㭖㧊㠞┺.

1) Ịṫ㌗䌲

Ịṫ㌗䌲⓪ Ⱒ㎇㰞䢮 㧊䢮㥾, 㭒ὖ㩗㧎 㔶㼊

₆⓻㌗䌲⪲ ⋮⑚㠊 䁷㩫䞮㡖┺. Ⱒ㎇㰞䢮 㧊䢮 㥾㦖 (ὒỆ㠦 ⽊Ị㦮⬢₆ὖ⿖䎆 㰚┾⹱㞚) ㍺ ⶎ㫆㌂ ╏㔲 䡚㨂 (㦮㌂⪲⿖䎆 䢫㧎♮㠊) 㞢 ἶ 㧞⓪ Ⱒ㎇㰞䢮㧊 㧞⓪㰖⯒ 1 7Ṳ ⶎ䟃㦒⪲

ῂ⿚䞮㡂 䁷㩫䞮㡖┺. 㭒ὖ㩗㧎 㔶㼊₆⓻㌗䌲

⓪ 㔲⩻, 㼃⩻, 㦢㔳ⲏ₆, ╖/㏢⼖⽊₆, ọ₆, 㩫 㔶㌗䌲, 㩚㼊㩗㧎 Ịṫ㌗䌲㦮 5Ṳ 䟃⳿㦚 䘟Ṗ 䞮㡖┺.

2) Ịṫ䟟䌲

Ịṫ䟟䌲⓪ 㿿⿚䞲 㑮Ⳋ, ′䂯㩗 㤊☯, ‶䡫 㧞⓪ 㔳㌂, ⁞㡆, ⁞㭒, 㩫₆Ỗ㰚, Ịṫ㔳䛞 ㎃ 䀾 㡂⿖㦮 7Ṳ 䟃⳿㦒⪲ 䁷㩫䞮㡖㦒Ⳇ, ˄ ⹮✲

㔲 䞲┺˅ 5㩦㠦㍲˄ 㩚䡖 ⴑ䞲┺˅ 1㩦㦒⪲ ♲ 5 㩦 㻯☚⪲ 䁷㩫䞮㡂 㩦㑮Ṗ ⏨㦚㑮⪳ ṗṗ㦮 Ịṫ䟟㥚⯒ 㔺㻲䞮ἶ 㧞⓪ ộ㦒⪲ 䕦┾䞮㡖┺.

3) ⽊Ị㏢㦮 ㍲゚㓺 Ⱒ㫇☚

⽊Ị㏢㦮 ㍲゚㓺 Ⱒ㫇☚⓪ 㫆㌂ ╏㔲 䟊╏

㍲゚㓺⯒ ⹱㦖 ἓ䠮㧊 㧞▮ ⏎㧎㦚 ╖㌗㦒⪲

4) ⏎㧎 䐋䞿⽊Ị㦮⬢㍲゚㓺 䞚㣪☚

㡆ῂ╖㌗㧦㦮 䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲 䞚㣪☚⯒ 㞢㞚⽊₆ 㥚䞮㡂 ⽊Ị㦮⬢ 㡗㡃ὒ

⽋㰖 㡗㡃㦖 ㌳䢲㰖㤦㍲゚㓺( 3Ṳ ⶎ䟃)㢖 㡂

Ṗ㰖㤦㍲゚㓺( 3Ṳ ⶎ䟃)㦒⪲ ⋮⑚㠊 䁷㩫䞮㡖 㦒Ⳇ, 㣪ῂ㩫☚㠦 ➆⧒˄ ⰺ㤆 䞚㣪䞮┺˅ 5㩦㠦

㍲˄ 㩚䡖 䞚㣪䞮㰖 㞠┺˅ 1㩦㦒⪲ ♲ 5㩦 㻯☚

⪲ 䁷㩫䞮㡂 㩦㑮Ṗ ⏨㦚㑮⪳ 䟊╏ ㍲゚㓺㠦

, 㡆㎎╖䞯ᾦ 㤦㭒㦮ὒ╖䞯㡞⹿㦮䞯ᾦ㔺

昢嵦

㑮ⳛ㦮㡆㧻ὒ 㧎ῂ㦮 ἶ⪏䢪⓪ 㩚㎎Ἒ ㍶㰚ῃὒ Ṳ⹲☚㌗ῃ✺㦮㩚⹮㩗㧎㿪㎎⪲㍲㧊㠦 ➆⯎ Ⱒ㎇㰞䢮㦮㯳Ṗ⓪ ṗ㫛㌳䢲⓻⩻㦮㩖䞮㢖䟟☯㦮㩲䞲㦚 Ṗ㪎┺㭒㠊㩦㹾 ⏎㧎

✺㦮㧦Ⱃ㌳䢲㦚⿞Ṗ⓻䞮Ợ 䞮ἶ 㧞┺. 㧊⩆

㌗䢿䞮㠦㍲ ⏎㧎✺㦮 Ịṫⶎ㩲⓪ ⽊Ị䞯㩗㧎䁷Ⳋ㈦Ⱒ㧊㞚┞⧒ ㌂䣢㩗, ἓ㩲㩗㧎䁷Ⳋ㠦㍲

☚ ⰺ㤆㭧㣪䞲㦮⹎⯒ Ṗ㰚┺.

㍶㰚ῃὒ ṯ㧊㤆Ⰲ⋮⧒☚ 2 0 0 5⎚㠦 ⏎㧎㧎 ῂṖ 9 . 1 %⪲  ㏣䞲 ⏎⪏䢪㌂䣢⪲ ⼖䢪䞮ἶ 㧞⓪ Ṗ㤊◆, Ⱒ㎇㰞䢮㧊䢮㧦Ṗ 㯳Ṗ䞮ἶ 㧞㠊 ⏎㧎⽊Ị㦮 ⶎ㩲Ṗ ⽊Ị㦮⬢㦮㭒㣪 ⶎ㩲

⪲ ╖⚦♮ἶ 㧞┺[1]. 䔏䧞㤆Ⰲ⋮⧒ ⏎㧎㦮 ἓ㤆˄ 䟟㥚㦮㑮䟟䁷Ⳋ㦮㌌㦮㰞˅ ὖⰂṖ 㔲 䞲㔺㩫㦒⪲, 65㎎㧊㌗ ⏎㧎㦮 Ⱒ㎇㰞䢮㥶⼧⮶㦖㟓 8 6 %㧊Ⳇ, 99.7%Ṗ 㰖㡃㌂䣢㠦㍲

㌳䢲䞮ἶ 㧞⓪ ⏎㧎㧊┺[2]. 㧊⩂䞲 ⏎⪏㧎ῂ 㦮㯳Ṗ⓪ ㌂䣢㩚⹮㠦 Ỏ㼦 Ⱔ㦖⼖䢪㢖 ⶎ 㩲㩦㦚 Ṗ㪎㡺ἶ 㧞㦒Ⳇ, ⏎㧎㧎ῂ㦮㯳Ṗ㠦

➆⧒ Ⱒ㎇㰞䢮㥶⼧⮶㧊 ⏨㞚㰦㦒⪲㖾 ⏎㧎✺

㦮㌌㦮㰞㦚 Ṧ㏢㔲䋺ἶ 㦮⬢゚㣿 ⡦䞲 Ⱏ╖

㰖⋲ 1 9 7 1⎚⿖䎆 ⹎ῃ ㌢䝚⧖㔲㓺䆪㭒㦮⿗

⿖䟊㞞㭧ῃ㧎㧊 Ệ㭒䞮⓪ On Lok㰖㡃㠦㍲

⏎㧎㦚㥚䞲䐋䞿⽊Ị㦮⬢㍲゚㓺䝚⪲⁎⧾㧎 PACE(Program of All-inclusive Care for the Elderly) ⳾◎㧊㔲㧧♮㠞┺[3-10]. PACE ⳾◎

㦖㰖㡃㌂䣢⌊ ⽊Ị㦮⬢㧎㦚㭧㕂㦒⪲ 䂮⬢, Ṗ㩫Ṛ䢎㍲゚㓺, 㭒Ṛ Ịṫ䝚⪲⁎⧾㦚䐋䞿㩗㦒⪲ 㤊㡗䞾㦒⪲㖾㰖⁞₢㰖㎇Ὃ㩗㦒⪲ 㔲䟟

⁎ ☯㞞㤆Ⰲ⋮⧒㦮⽊Ị⽋㰖䐋䞿㍲゚㓺㠦

╖䞲䝚⪲⁎⧾㦖⽋㰖⯒ 㭒㿫㦒⪲ 䞮♮ ⽊Ị

㦚 ⁎ 䞲㿫㠦 ⚦ἶ ⳾䡫 Ṳ⹲ ❇㦚䞲㡆ῂ Ṗ ╖⿖⿚㧊㠞┺. ⁎⩂⋮, ⏎㧎㦮㌌㦮㰞㦖㧊

✺㦮 Ⱒ㎇㰞䢮ὖⰂ ❇ Ịṫ㌗䌲㢖 ⰺ㤆 ⹖㩧䞲 ὖἚṖ 㧞㠊㦮⬢㦮㩚ⶎ㎇㦚 Ṧ㞞䞲┺Ⳋ

⽊Ị㏢⯒ 㭧㕂㦒⪲ 䞲䐋䞿⽊Ị㦮⬢㍲゚㓺㦮㩲Ὃ ⳾䡫 Ṳ⹲㧊㔲 䧞㣪ῂ♲┺ἶ ⽎┺.

➆⧒㍲㧊㡆ῂ㦮 ⳿㩗㦖 ⹎ῃ㠦㍲㔲䟟♮

⽊Ị㦮⬢ 㡗㡃ὒ ⽋㰖㡗㡃㦚䙂䞾䞲䐋䞿⽊

Ị㦮⬢㍲゚㓺㦮䞚㣪☚⯒ 㫆㌂䞮㡂 ⏎㧎✺㦮 Ⱒ㎇㰞䢮 ⹲㌳㦚㡞⹿䞮ἶ ㌌㦮㰞㦚䟻㌗㔲䌊㦒⪲㖾 ⏎䤚⯒ ⽊┺ Ịṫ䞮Ợ ㌊㑮㧞⓪

╖㞞㦚㩲㔲䞮ἶ㧦䞮㡖┺.

堆旇愕愯憛

1. 櫶割堆旇愕沖巒朞滗愯憛

㧊㡆ῂ⓪ ṫ㤦☚ Hῆ ⽊Ị㏢㠦 ❇⪳♲ 6 0

㎎㧊㌗ ⏎㧎㭧䘎㦮㿪㿲⹿⻫( c o n v e n i e n c e s a m p l i n g ) 㠦㦮䟊㍶㩫♲ 㽳 1 1 0ⳛ㦚 ╖㌗㦒⪲

2 0 0 5⎚ 1 1㤪⿖䎆 1 2㤪₢㰖 2Ṳ㤪㡂☯㞞㠦 Ỏ㼦㧦⬢⯒ 㑮㰧䞮㡖┺. 㧦⬢㑮㰧㦖㰚⬢ ╊╏ 㦮

㌂㢖㡆ῂ⳿㩗ὒ ㍺ⶎ⌊㣿㦚㌂㩚ᾦ㥷㦒⪲ 㿿

⿚䧞䤞⩾♲ 2ⳛ㦮⽊Ị㣪㤦㠦㦮䟊㧦₆₆㧛㔳㍺ⶎὒ Ⳋ㩧㦚䐋䟊㧊⬾㠊㪢┺.

2. 櫶割壊割愕猧洛愯憛

⌊½ 㣎㦮㍶䟟㡆ῂ ⹥ ⶎ䠢ἶ㺆㦚䏶╖⪲ ἶ 㞞䞲 ῂ㫆䢪♲ ㍺ⶎ㰖⪲ 䞮㡖㦒Ⳇ, 2005⎚ 1 1 㤪㽞㑲㠦㡞゚㫆㌂⯒ Ệ㼦⽊㢚½ 㑮㩫䞮㡖┺.

㧊⓪ 䋂Ợ 5Ṳ 㡗㡃㦒⪲ ⿚⮮䞮♮ 6 8Ṳ ⶎ䟃㦒⪲ 㾲㫛 ῂ㎇䞮㡖┺. 㧊㡆ῂ㠦㍲㍶㩫䞲 ṗ

⼖㑮✺㦮䁷㩫㦚㥚䟊㧊㣿♲ 㡂⩂ 䟃⳿✺㦮㔶⬆㎇㦚 Ỗ㩫䞮₆ 㥚䞮㡂㔶⬆☚ ⿚㍳㦚䞲 ἆὒ, Cronbach ˄ s alpha⓪ 㭒ὖ㩗㧎㔶㼊₆⓻㌗

䌲 0.748 Ịṫ䟟䌲 0.449 ⽊Ị㦮⬢㡗㡃㦮㍲゚

㓺䞚㣪☚ 0.679 ⽋㰖㡗㡃㦮㍲゚㓺䞚㣪☚

䞶 Ⱒ䞲㑮㭖㧊㠞┺.

Ịṫ㌗䌲⓪ Ⱒ㎇㰞䢮㧊䢮㥾, 㭒ὖ㩗㧎㔶㼊

₆⓻㌗䌲⪲ ⋮⑚㠊䁷㩫䞮㡖┺. Ⱒ㎇㰞䢮㧊䢮㥾㦖 (ὒỆ㠦⽊Ị㦮⬢₆ὖ⿖䎆㰚┾⹱㞚) ㍺ ⶎ㫆㌂ ╏㔲䡚㨂 (㦮㌂⪲⿖䎆䢫㧎♮㠊) 㞢 ἶ 㧞⓪ Ⱒ㎇㰞䢮㧊㧞⓪㰖⯒ 1 7Ṳ ⶎ䟃㦒⪲

ῂ⿚䞮㡂䁷㩫䞮㡖┺. 㭒ὖ㩗㧎㔶㼊₆⓻㌗䌲

⓪ 㔲⩻, 㼃⩻, 㦢㔳ⲏ₆, ╖/㏢⼖⽊₆, ọ₆, 㩫㔶㌗䌲, 㩚㼊㩗㧎 Ịṫ㌗䌲㦮 5Ṳ 䟃⳿㦚䘟Ṗ 䞮㡖┺.

Ịṫ䟟䌲⓪ 㿿⿚䞲㑮Ⳋ, ′䂯㩗㤊☯, ‶䡫㧞⓪ 㔳㌂, ⁞㡆, ⁞㭒, 㩫₆Ỗ㰚, Ịṫ㔳䛞㎃䀾㡂⿖㦮 7Ṳ 䟃⳿㦒⪲ 䁷㩫䞮㡖㦒Ⳇ, ˄ ⹮✲

㔲䞲┺˅ 5㩦㠦㍲˄ 㩚䡖 ⴑ䞲┺˅ 1㩦㦒⪲ ♲ 5 㩦㻯☚⪲ 䁷㩫䞮㡂㩦㑮Ṗ ⏨㦚㑮⪳ ṗṗ㦮 Ịṫ䟟㥚⯒ 㔺㻲䞮ἶ 㧞⓪ ộ㦒⪲ 䕦┾䞮㡖┺.

3) ⽊Ị㏢㦮㍲゚㓺 Ⱒ㫇☚

⽊Ị㏢㦮㍲゚㓺 Ⱒ㫇☚⓪ 㫆㌂ ╏㔲䟊╏

㍲゚㓺⯒ ⹱㦖 ἓ䠮㧊㧞▮ ⏎㧎㦚 ╖㌗㦒⪲

4) ⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺䞚㣪☚

㡆ῂ╖㌗㧦㦮䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲䞚㣪☚⯒ 㞢㞚⽊₆ 㥚䞮㡂⽊Ị㦮⬢ 㡗㡃ὒ

⽋㰖㡗㡃㦖㌳䢲㰖㤦㍲゚㓺( 3Ṳ ⶎ䟃)㢖㡂

Ṗ㰖㤦㍲゚㓺( 3Ṳ ⶎ䟃)㦒⪲ ⋮⑚㠊䁷㩫䞮㡖㦒Ⳇ, 㣪ῂ㩫☚㠦 ➆⧒˄ ⰺ㤆䞚㣪䞮┺˅ 5㩦㠦

㍲˄ 㩚䡖䞚㣪䞮㰖㞠┺˅ 1㩦㦒⪲ ♲ 5㩦㻯☚

⪲ 䁷㩫䞮㡂㩦㑮Ṗ ⏨㦚㑮⪳ 䟊╏ ㍲゚㓺㠦

╖䞲䞚㣪☚Ṗ ⏨㦖 ộ㦒⪲ 䕦┾䞮㡖┺.

5) 㧎ῂ㌂䣢䞯㩗䔏㎇

㡆ῂ╖㌗㧦㦮㧎ῂ㌂䣢䞯㩗䔏㎇㦚㎇, 㡆⪏, ᾦ㥷㩫☚, 㫛ᾦ, 㦮⬢⽊㧻䡫䌲, Ṗ㫇㌂䟃, ㏢✳

㧊㡆ῂ㠦㍲⓪ 㑮㰧♲ 㧦⬢㦮䐋Ἒ⿚㍳㦚㥚䟊 SPSS PC

ゞ☚⿚㍳㦚䐋䞮㡂㡆ῂ╖㌗㧦㦮㧎ῂ㌂䣢䞯㩗䔏㎇, Ⱒ㎇㰞䢮㦮㧊䢮㌗䌲, ⽊㫆㔳䛞 ⹥ ⽊㫆₆ῂ ㌂㣿㡂⿖, Ịṫ䟟㥚 ❇㦚䕢㞛䞮㡖┺.

⏎㧎䐋䞿⽊Ị㦮⬢㍲゚㓺㠦 ╖䞲㩚㼊㩗㧎䞚㣪☚, ⽊Ị㦮⬢ ⹥ ⽋㰖㡗㡃㦮㍲゚㓺䞚㣪☚

㠦 ⹎䂮⓪ 㩲 ☛Ⱃ⼖㑮✺㦮㍺ⳛ⩻㦚䕢㞛䞮

₆ 㥚䞮㡂 t-test, ⿚㌆⿚㍳ ⹥ ㌗ὖ⿚㍳ ┾Ἒ 㠦㍲㥶㦮䞲㧎ῂ㌂䣢䞯㩗䔏㎇ ❇㦮 ☛Ⱃ⼖

㑮✺㦚㭧㕂㦒⪲ 㥚Ἒ㩗 ┺㭧䣢‖⿚㍳㦚㔺㔲䞮㡖┺.

冶刂

1. 櫶割堆旇沖汞汾割斲箒穟洇瞿昷

㫆㌂╖㌗ ⏎㧎✺㦮㧎ῂ㌂䣢䞯㩗䔏㎇㠦㍲

㧦⎖㠦㦮㫊䞮⓪ ⏎㧎㧊 36.4%, ⺆㤆㧦 ⹥ 㧦

⎖㢖䞾℮ ㌳䢲䞮⓪ ⏎㧎㧊 4 1 . 8 %㡖┺. 㤪䘟

2. 櫶割堆旇沖汞廒昷滎筞決筞愕兺儛旇痢

╖㌗㧦㦮 Ⱒ㎇㰞䢮㧊䢮㌗䌲⓪ ἶ䡞㞫㧊 8 4 ⳛ( 7 6 . 4 % )㦒⪲ Ṗ㧻 Ⱔ㞮ἶ, ╏␾⼧㧊 3 1ⳛ (28.2%), ὖ㩞㡒㧊 2 8ⳛ(25.5%), Ἶ┺Ὃ㯳㧊 2 5 ⳛ(22.7%) 㣪䐋㧊 2 1ⳛ(19.1%) 㑲㧊㠞┺. ⏎㧎䂮ⰺ, 㞢⩞⯊₆, 㞞ὒ 㰞䢮, 㧊゚㧎䤚ὒ 㰞䢮㦖

ⳛ( 7 6 . 4 % ) 㦖 2Ṳ 㧊㌗㦮 Ⱒ㎇㰞䢮㠦㧊䢮♮㠊㧞㠊㩚㼊 ╖㌗㧦㦮㧊䢮♲ 䘟‶ Ⱒ㎇㰞䢮㑮

╖/㏢⼖⽊₆⓪ 5 3ⳛ( 4 8 . 2 % )㠦㍲㧮䞮㡖ἶ, 3 4ⳛ( 3 0 . 9 % )㦖㫡㰖㞠㞮┺. ọ₆⓪ 4 1ⳛ 䚲 1. ╖㌗㧦㦮㧎ῂ㌂䣢䞯㩗䔏㎇

䔏㎇ ῂ⿚㑮(ⳛ) %

╖㫎㧊㌗ 3 2 . 6

㦮⬢ 㡂( 1㫛) 1 3 1 1 . 8

㦮⬢ 㡂( 2㫛) 3 2 . 7

( 3 7 . 2 % ) 㠦㍲ ⶎ㩲㠜㠞㦒⋮, 49ⳛ( 4 4 . 6 % ) 㠦㍲

Ệ☯䞮₆Ṗ ⿞䘎䞮┺ἶ 䞮㡖ἶ, 㩫㔶㌗䌲⓪ 5 0ⳛ( 4 5 . 5 % )㠦㍲ Ịṫ䞮㡖ἶ, 25ⳛ( 2 2 . 7 % )㦖 Ịṫ䞮㰖㞠㞮┺. ⏎㧎✺㦮㩚㼊㩗㧎 Ịṫ㌗䌲

⓪ 3 6ⳛ( 3 2 . 7 % )㦮 ⏎㧎㦖 Ịṫ䞮㡖㦒⋮, 39ⳛ ( 3 5 . 7 % ) 㧊 Ịṫ䞮㰖㞠㞮┺. 㡆ῂ╖㌗㧦㦮㭒 ὖ㩗㧎㔶㼊₆⓻㌗䌲㠦㍲㦢㔳 ⲏ₆Ṗ 4 . 0㦒⪲

Ṗ㧻 ⏨㞮㦒Ⳇ, ọ₆Ṗ 3 . 0㦒⪲ Ṗ㧻 ⌄㞚⽊䟟㦮㠊⩺㤖㧊 Ṗ㧻䋆 ộ㦒⪲ 䕢㞛♮㠞┺(䚲 3 ) .