重大傷病是我國全民健康保險的重要特色之一，透過社會保險的風險分擔機制，病患享有免部分負擔等優惠，降低因為罹病帶來的財務負擔，但重大傷病同時也成為全民健保的主要支出項目。民國102年領取重大傷病證明者不過98餘萬人（約總人口的4%），但其一年的醫療費用多達一千五百多億元（接近總支出的27%），平均每位重大傷病患者的醫療費用約為平均值的7.34倍，其中癌症又是重大傷病中人數最多者，大約佔了49%（資料來源：衛生福利部中央健康保險署）。因為許多重大傷病的發生率、盛行率與年齡成正比（黃泓智等人，2004），未來隨著人口老化，全民健保支出也將跟著上升。 　　本文使用全民健保資料庫，探討近十年重大傷病（尤其是癌症）趨勢，估計重大傷病的年齡別發生率、死亡率，評估人口老化對全民健保造成的影響，其中承保資料檔（ID）、重大傷病檔（HV）為本研究主要的依據資料。而由於健保資料庫的資料種類及數量龐雜，在初期資料的偵錯及處理上非常重要但也相當費時，至於發生率、死亡與否的判斷亦十分棘手，因此過程中我們將一一說明資料分析步驟及注意事項。本文發現癌症及重大傷病的盛行率逐年上升，但發生率並沒有明顯變化，加上近年癌症死亡率幾乎不變（但台灣全體國民的死亡率逐年遞降），因為台灣的人口老化，預期未來罹患癌症人數會逐年增加，癌症將繼續蟬聯十大死因之首，但罹癌死亡率的下降也可發現近年醫療進步所造成的影響。此外，我們也考量隨機死亡模型（Lee-Carter Model），發現無論是癌症死亡率、或是罹癌死亡率都有不錯的估計結果。而在文末也提出癌症病患的就醫行為以供後續研究者參考。 / Catastrophic illness (CI) is one of the key features of Taiwan’s National Health Insurance (NHI). Through risk-sharing mechanisms of social insurance, it can reduce the financial burden of the CI patients since treating the CI is usually expensive. However, the CI also becomes a major expenditure item of NHI. The people receiving the CI card are just 0.98 million in 2013 (about 4% of the total population), but their smedical costs are over 150 billion NT dollars (nearly 27% of total expenditures). The average medical cost per CI patient is about 7.34 times of the national average. (Source: Department of Health and National Health Insurance Agency). Because the incidence and prevalence rates increase with age (Huang et al, 2004), the total NHI expenditure is expected to increase in the future due to population aging. This study intends to use the NHI database, including the records of personal identification and out-patient visit from all CI patients, to explore the incidence and mortality rates, for example, of CI patients. Because the NHI database is big and messy, we shall first debug and clean them. Also, since the death of CI patients are not fully reported in the NHI database, we propose a method to identify the deaths and use the official statistics to evaluate. The results show that the prevalence rates of all CI increased every year, but their incidence rates did not change significantly. The mortality rates of cancer patients also did not change much. Based on these findings, we expect the proportion of CI patients and their size will continue to grow. In addition, we applied the Lee-Carter model to the cancer mortality rates, and the fit is pretty good.

臺灣在二十世紀中完成了人口轉型，特別是生育轉型的幅度與速度最為劇烈。也正因為生育轉型過於成功，臺灣此刻正面臨超低生育率導致的人口衰滅危機。近年來，人口學界針對生育率變遷，熱中於探討生育率的步調（tempo）與數量（quantum）效應，藉此瞭解時期生育率變遷的趨勢。 生育步調與數量的分析，本質上仍是時期性測量，未能真正瞭解年輪生育率的變遷，以致對於時期生育率趨勢的分析無法解決根本問題。這個現象，對於臺灣生育率研究特別必須加以處理。然而，臺灣雖然是人口資料的「寶庫」，有關生育的人口統計，卻只有存在於二十世紀下半葉，亦即，二十世紀前半葉的完整生育統計已經無法獲取。本研究試圖結合人口普查、戶籍統計，以及抽樣調查資料，運用參數式模型（parametric mode）和人口轉換（demographic translation）等人口分析方法，嘗試重建二十世紀完整的時期與年輪生育率，藉此，分析年輪生育率與時期生育率之間的變遷關係，最終瞭解未來生育率發展的可能後果。 / Demographic Transition has been completed during the middle of 20th century in Taiwan, and the extent and speed of transition are spectacularly rapid. Due to the over succeed of the demographic transition, lowest-low fertility pattern has stricken Taiwan society and probably led to a horrible extinction. Recently, in order to project the pattern of fertility rate, demographers endeavored to figure out how tempo and quantum effects contribute to fertility rate. Unfortunately, analysis of tempo and quantum effects is essentially periodic measurement. It leads no way to understand the pattern of cohort fertility in Taiwan. However, although Taiwan’s demographic statistics is well known as the world’s treasure trove, the fertility statistics are available for only 50 years. It means that we are not capable of having the first half 20th century’s fertility rate in Taiwan. We use demographic analytic methods such as parametric mode and demographic translation to analyze combined data which is constituted of census data, vital statistics, and survey data. The object of this research is to re-build the 20th century’s fertility rate in Taiwan. Once we have the intact fertility rate in 20th century, we could realize the pattern of period and cohort fertility transition. Furthermore, we will have a better chance to project Taiwan’s fertility rate in the future.

資料分類的應用在時間數列的分析與預測過程相當重要。而模糊資料近年來更受到重視，其應用的範圍包含：財金、社會、生醫、電機等各個領域。本研究欲運用模糊資料分類法，對區間時間數列的轉折偵測與模式建構做一個深入探討。主要應用平均累加模糊熵(average of the sum of fuzzy entropies)， 找出其結構性改變的區間。並針對區間型時間數列進行模式建構診斷與預測。最後我們以單身人口數與失業率為實列做一個詳細的探討。結果顯示，失業率對單身人口數有顯著的影響而孤鸞年的效應並不顯著。 / The application of data classifications in time series analysis and forecasting is rather important. The fuzzy data classification has received much attention recently. It can be applied on various fields such as finance, sociology, biomedicine, electrical engineering and so on. This study is to use the fuzzy data classification to perform an intensive research on the change periods detection and model construction of the interval time series. We use average of the sum of fuzzy entropies to find out interval of the structural changes. Focusing on the time series of intervals, we build a model and make prediction about it. At the end, based on the case study on the population of singles versus, we thoroughly discuss this topic. The result shows that the unemployment rate does significantly correlate with the population of singles, but the "widow's year" does not .

生育率的降低是影響台灣地區近年來人口老化的顯著因素，因其變化幅度通常高於死亡率，對人口結構的影響較大。過去台灣地區生育率研究多為整體生育(如：總生育率、年齡別生育率)趨勢的模型，較少探討台灣各地區的特色。為能更深入瞭解台灣生育行為變化的特性，本文將生育率的研究層面由整體的資料，延伸至全台灣地區的各鄉鎮市區（不含離島地區有350個鄉鎮市區），希冀能更精確地找出與台灣地區生育率持續下降的相關因素。本文分為兩個部份，以鄉鎮市區的年齡別婦女生育率與年齡別有偶婦女生育率為研究對象，資料時間為1991、1992、2001、2002年：第一部份探討各鄉鎮市區的生育率數值間是否存在空間相關性，並進一步瞭解生育率較高（或較低）的地區是否有聚集的現象。第二部份則套用空間迴歸模型探討與生育率數值有關的因素（例如：人口密度、教育程度等），更精確且客觀地提供生育率未來趨勢的建議。 關鍵字：生育率、人口老化、空間統計、空間群聚、空間迴歸 / Both the fertility rates and mortality rates, especially the fertility rates, have been experiencing dramatic decreases in recent years, and the population aging thus has become one of the major concerns in Taiwan area. In order to identify the factors that are related to the decrease of fertility rates, unlike the previous works that deal with the aggregate national data, we will study the fertility pattern in township level. We will use the data of age-specific fertility rates and total fertility rates in 1991, 1992, 2001, and 2002 in 350 townships of Taiwan area. This study will be separated into two parts. First, we shall explore if there is spatial correlation among 350 townships of Taiwan area and detect if there are spatial clusters for higher fertility townships. The second part of this project will be focused on the spatial regression model. We will use this model to determine the factors that are highly correlated to the dropping of fertility rates. Key Words: Fertility Rates, Aging Population, Spatial Statistics, Spatial Clustering, Spatial Regression

本文探討的主題是人口因素對國家競爭力的影響。首先將檢視歷來重要的國家競爭力理論中關於人口因素的論述，包括IMD的「世界競爭力年報」、WEF的「全球競爭力報告」以及波特的「鑽石體系理論」，綜合整理這些理論關於人口因素影響國家競爭力的層面，來研析兩岸各自的人口現況及特徵對兩岸競爭力的影響。 本論文全文分為陸章，分析架構與章節安排如下： 第壹章「緒論」。說明研究動機與目的，研究途徑與方法、研究範圍與限制，研究架構以及國內外相關文獻回顧與評述。 第貳章「國家競爭力中的人口因素」。本章擬以「人口問題」為主軸，探討「國家競爭力」中的人口因素，建構形成「人口問題與「國家競爭力」研究構面。首先回顧重要的國家競爭力理論，接著再逐一檢視國家競爭力理論中有關人口因素的論述、人口因素如何影響國家競爭力的形成，以作為下文分析兩岸人口條件對各自競爭力影響的基礎。 第參章「中國大陸人口政策、現況及問題」。本章論述探討中國大陸之人口政策、人口概況，並對人口問題所造成之影響行基本分析，以簡要說明其人口現況。 第肆章「我國人口政策、現況及問題」。本章論述探討我國之人口政策、人口概況，並對人口問題及影響行基本分析。 第伍章「兩岸人力及人才資源之互動及比較」。比較分析當前兩岸在人力資源、人才素質層面的優劣，以及加入世界貿易組織後對兩岸人力及人才的影響，並比較兩岸的人力資源政策之良窳。 第陸章「人口因素對兩岸競爭力之影響」。分析當前兩岸人口現況及問題對各自競爭力造成的影響，分別探討兩岸各別具有的優勢及劣勢，以及增強競爭力的機會和對未來發展的挑戰。 第柒章「結論與建議」。就本研究做一綜合結論。藉由前面章節的探討提出研究發現及未來發展建議，及後續研究方向。

公務人員考績制度設計的良窳勢將影響受考人對組織信任的程度及工作士氣，考試為改善公務人員單向考核之缺失，於公務人員考績法修正草案中，增列「考績面談」新措施，提供主管與部屬溝通討論機關的績效目標與工作表現的機會，希望藉此提升考績結果的信度及效度，改善部屬工作績效，達到提升我國文官行政效能的目的，其立意雖好，然而組織革新成功與否最重要的關鍵因素，在於組織成員的信任程度，因為組織成員間若缺乏信任，所有的改革工作都將流於形式或遭遇阻礙。 是以，本研究目的在探討組織信任對考績面談制度成效的影響，其中組織信任係採McAllister的分類，將組織信任區分為認知型信任及情感型信任，而考績面談制度成效則有公平性、滿意度接受度、工作投入、組織承諾。另一項研究目的則在探討人口統計變項（性別、年齡、教育程度、官等、年資、機關規模及主管職位）對組織信任與考績面談制度成效間是否會產生調節效果。 本研究以問卷調查的方式，於106年8月5日起至8月21日止，按臺北市各區公所106年5月份薦任、委任公務人員比例，以分層抽樣的方式進行抽測，共發出300份題本式問卷，回收問卷276份，有效問卷為230份，所得資料以SPSS統計分析，研究結果如下： 1.臺北市區公所同仁對主管的認知型信任及情感型信任達中度以上的水準。 2.臺北市區公所同仁對考績面談制度持中度以上的認同程度。 3.組織信任對考績面談制度具有顯著的正向影響力。 4.人口統計變項中除教育程度外，其他人口統計變項對組織信任與考績面談制度成效會產生削弱或增強的調節效果。 最後，依據此分析結果，對組織信任與考績面談制度提出實務上的具體建議，及未來的研究建議，為爾後全面實施考績面談預作準備。 / The positive or negative aspects of the setup of a system of performance evaluation of civil servants is bound to influence the level of trust of the evaluated personnel in the system as well as their work motivation. Examinations are supposed to amend the shortcomings from one-way evaluations of civil servants. In the draft for the Civil Service Performance Evaluation Act a new measure named “Evaluation Interview” was added. This provides superiors and subordinates with the opportunity to communicate and discuss performance targets and the work performance in public authorities. There was the expectation that this measure would raise the level of trust and validity of the evaluation results , improve the work performance of subordinate personnel and reach the goal of raising the administrative efficiency of civil servants in Taiwan. While the intention of introducing this measure is positive, the key factor to determine success or failure of organisational changes lies in the level of trust from the members of the organisation. If the members of an organisation lack a certain level of trust, reform measures will merely result in formal changes or may be met with obstruction. Therefore, the goal of this research is to study the influence of organisational trust on the efficiency of the system of evaluation interviews. McAllister classification is used for analysing organisational trust, which is differentiated by cognitive trust and emotional trust. The effect of the system of evaluation interviews is based on fairness, satisfaction, acceptance, work engagement and loyalty towards the organisation. A further goal of this research is to study whether the variables of demographic statistics (gender, age, educational level, official rank, length of service, size of public authority and position of superior) have a regulating effect on the efficiency of the relationship between organisational trust and the system of evaluation interviews. This research carried out the study between 5 August and 21 August 2017 in the form of questionnaires. According to the proportion of promoted and appointed civil servants in the district offices of Taipei City in May 2017 a stratified sample test was carried out and 300 itemised questionnaires were sent out. The return rate was 276 questionnaires, of which 230 were valid. The obtained data was analysed with SPSS and produced the following research results: 1.the civil servants in the District Offices of Taipei City maintain a level of cognitive and emotional trust in their superiors which is above the medium level, 2.the level of acceptance of the system of evaluation interviews by the civil servants in the District Offices of Taipei City is above the medium level, 3.organisational trust has a significant positive influence on the system of performance evaluation interview, 4.Except for the variable of the level of education, all other demographic statistical variables have a weakening or intensifying regulating effect on organisational trust and the system of evaluation interviews. Finally, practical and specific proposals to enhance organisational trust and to improve the system of evaluation interviews are made on the basis of the results of this analysis as well as suggestions for further future research in order to be prepared for full-scale implementation of the system of evaluation interviews.

蘇聯解體後，有大量的俄羅斯人生活在前蘇聯加盟共和國內。像是愛沙尼亞與拉脫維亞在獨立過後，有三分之一的人口是俄裔人口。而大多數的俄裔人口都仍偏好使用俄語作為生活用語。此時，便延伸出一個問題，是否應針對這些少數民族俄裔人口之語言權利而增加官方語言。因此，在語言政策方面，便是一個極為關鍵的議題。 本論文將會先從歷史背景，亦即蘇聯時期開始討論。將各階段的語言政策一一分析，接著依序討論愛沙尼亞及拉脫維亞的語言政策之背景以及語言法之分析，最後從中找出結論。 / Many Russians lived former Soviet republics after the dissolution of the Soviet Un- ion. Therefore, one third of the population was still Russian after Estonia and Latvia independence. Most of the Russians still prefer to use Russian for daily basis. The lan- guage policy was becoming a crucial topic to discuss whether those countries should add Russian for official language. This policy would strongly relate to the language rights of minority Russians. This paper will discuss the Soviet Union historical background which analyze the lan- guage policies of different period, and then discuss the background of linguistic poli- cies and language law in order in Estonia and Latvia.

儒家思想長期影響了臺灣的性別角色以及家庭價值觀。然而儘管儒家思想持續影響， 生育率仍下降至低於人口替代率，晚婚或不婚，男性與女性就讀大學的百分比幾乎相等而職場上與公家機關的女性比例亦有提升。其中一個解釋的角度便是台灣也正跟隨歐洲的腳步，歷經第二次人口轉型。如果台灣的人口轉型是與歐陸價值體系的轉型有所關連，那麼台灣女性勢必可以從中得到更大的自由去選擇他們的人生道路以及達到性別平等。本研究的目的便是企圖找到與此論點相關的證據以及探討這種人口轉型對於女性有什麼意義。我將運用「多元邏輯式回歸方法」(multinomial logistic regression)來分析1985到2015年之間問卷的交叉數據(cross-sectional data)以及2011年由中研院主導的台灣社會變遷調查計畫中所做的家庭調查，試圖在價值導向與家庭型態當中找出潛在關聯性。在回歸分析法當中，證據不足以顯示台灣正在歷經第二次人口轉型，然則，這些證據卻足以證明台灣社會當中的價值轉變。除了數據分析，本論文也試圖融合對台灣女性的深入訪談進行研究，探討伴侶型態與不同生命歷程選擇的成因和影響。訪問數據顯示一部份的社群確實正在經歷人口轉型，其餘則不然。再者，這些女性描述了在追求自我的路途上，職場與家庭之間做出平衡的困難。最後，本研究總結台灣的性別平等之路仍須更多努力。 / Confucianism has long influenced gender roles and family values in Taiwan. Yet despite Confucianism’s continued influence, fertility rates have dropped below replacement level, marriage is being postponed or rejected, percentages of men and women attending university are roughly equal, and women’s participation in the workforce and the government has increased. One proposed explanation is that Taiwan is following in the footsteps of Europe and undergoing the Second Demographic Transition. If Taiwan’s demographic changes were connected to similar value shifts as in Europe, women in Taiwan would benefit from greater freedom to choose their own life course and greater gender equality. This research sought to determine if there is evidence to support that Taiwan is undergoing the Second Demographic Transition and what the implications are for women. Cross-sectional data from 1985 and 2015 general questionnaires and the 2011 family questionnaire of the Taiwan Social Change Survey was analyzed for a potential link between value orientation and household type using multinomial logistic regression. In regression analyses, evidence did not support that Taiwanese society as a whole is experiencing the SDT, though evidence did support value shift over time. Survey data was supplemented with in-depth interviews with Taiwanese women to determine the reasons behind and impact of their union formation and life course choices. Interview data suggested that some sectors of society are undergoing the SDT while others are not. Furthermore, women reported gender equality and difficulty balancing their work and family life as barriers to following their desired life courses. Finally, this research concludes that further efforts are required to attain women’s freedom and equality in Taiwan.

我國每十年進行一次人口普查，以取得國人經常活動地區的資訊，作為中央及地方政府政策規劃的參考。然而，十年一次的人口普查無法即時反映各地區人口特質及其活動，隨著普查完訪率逐年下降、個人資料保護法意識抬頭等趨勢，普查的涵蓋率及其資料品質愈加受到質疑，近年各國思考以其他資料蒐集方式取代傳統普查。我國實施全民健康保險制度已逾20年，民眾納保率超過99%，因此本文以全民健保資料庫為研究素材，透過個人就醫行為探討國人經常活動地區，透過剖析各種疾病的就醫行為，可作為政府評估醫療資源規劃的參考。 本文以全民健保資料庫為依據，探討我國國民選擇醫療地點的特性，作為經常活動地區（或是常住地）的輔助參考。過去研究大多利用上呼吸道感染（俗稱感冒）作為估計常住地的依據，但每年平均只有接近70%國人會因感冒而就醫，其中青壯年、老年人因感冒而就醫的比例明顯較低，以此作為常住地的估計基礎恐有涵蓋率不足之虞。本文依據健保資料庫中的2005年百萬人抽樣檔，包括就醫門診處方及治療明細檔(CD)、承保資料檔(ID)等資料，比較數種常住地判斷的參考準則（包括感冒就醫），分析各方法所觀察到資料的特性及限制，評估以這些準則作為判斷常住地的可行性。 結論：本文提出除了感冒就醫之外的三種常住地推估準則，分別為：因為感冒或是消化就醫、單次健保補助金額較低、基層院所就醫。以樣本涵蓋率量而言，三種準則都能改善感冒就醫涵蓋率的不足，其中以單次金額與基層院所就醫的樣本數增加最多。另外，如果與所有門診資料、普查資料的人口資料比較，發現單次金額與基層院所就醫推估的人口年齡結構最為接近，但單次金額的縣市（地區）結構與普查資料的差異較大。 限制：受限於青壯年人口就醫率較低，本文提出的幾種常住地判斷準則在20歲至44歲的涵蓋率仍然偏低，建議未來研究可經由權數調整修正樣本的年齡等人口結構及比例，或是仰賴就醫以外的紀錄推估，但須考量資料串連及品質等問題。 / Many countries conduct population census every 10 years to acquire the information of population structure and its trend, but the information is not likely to updated since the 10-years period is usually too long. Moreover, the low response rate of questionnaire and the enforcement of Personal Information Protection Act further jeopardize the population census and many question its data quality. Thus, quite a lot of countries are seeking alternatives for collecting the information of de jure population, replacing the regular population census. In this study, we explore the possibility of using the data from National Health Insurance (NHI) Research Database for acquiring the information of de jure population in Taiwan. Taiwan started the NHI in 1995 and more than 99% of Taiwan population are covered. Since the medical accessibility created by the NHI, Taiwan’s people tend to visit medical institutions near to where they live, when they have minor diseases. Past studies showed that the upper respiratory tract infection (or cold) is a popular choice of minor diseases. We will evaluate if the cold is a good candidate and propose alternative criteria for the definition of minor diseases. We found that the proportion of populations with upper respiratory tract infection is about 70% and it is age dependent, with the elderly the lowest. On contrary, the records of smaller amounts and the records of physician clinics (or general practice clinics) can cover more than 90% population, much better than the records of upper respiratory tract infection. The records of digestive system diseases and upper respiratory tract infection can also increase the coverage of elderly population. We recommend using the medical records of smaller amounts to acquire the de jure population.

政府為促進國人健康,並以社會保險的形式分攤弱勢團體的就醫需求,於民國84年開始實施全民健康保險,實施至今超過20年,而且納保率已高達99%。重大傷病證明是全民健保的主要特色之一,持有重大傷病證明卡的病患就醫時可免除部分負擔,減輕罹患重病患者的醫療負擔。截至106年2月約有4%國人領有重大傷病證明卡,但其醫療費用佔健保支出超過 27%,預期這兩個數值會因人口老化而逐年上升,使得重大傷病的相關議題越來越受到重視。 本文以全民健保資料庫中的重大傷病證明明細檔(HV)為基礎,以2005年百萬人抽樣檔之承保紀錄檔(ID)、門診處方及治療明細檔(CD)及住院醫療費用清單明細檔(DD)輔助,探究罹患重大傷病發生及死亡議題,提出判定發生、死亡的準則,並且依此分析各種疾病發生率與死亡率的關係。另外,本文也使用資料庫內容驗證重大傷病患者與非重大傷病患者之間醫療費用的差異,研究也發現新發生的病患就醫率偏低,並以國際疾病分類代碼驗證重大傷病門診處方及治療明細檔(HV_CD)資料抓取的準確性。 / Taiwan started National Health Insurance (NHI) in 1995, for more than 20 years, and more than 99% people are covered in this social insurance plan. It is believed that the NHI has further enhanced the health of Taiwan’s people.Catastrophic illness(CI)card is one of the key features in the NHI and people with this card can enjoy waiver of copayment and other medical benefits which reduce the financial burden of CI patients. For example, about 4% Taiwan’s population were with the CI card and they spend more than 27% of total medical expenditure of NHI. Since the probability with CI increases with age, the population aging and prolonging life are expected to worsen the financial burden of the NHI. Our goal is to explore the medical need and its trend of CI patients, via the data from the NHI Database, including Registry for catastrophic illness patients(HV), Registry for beneficiaries(ID), Inpatient expenditures by admissions(DD)and HV’s Ambulatory care expenditures by visits(HV_CD). Since the medical records do not cover all the required information, we propose several criteria for data analysis, such as the rules of judging whether the patients incur CI and the CI patients passed away. We found that the incidence rates and mortality rates of CI patients decrease with time. Also, there are questions about the data quality regarding the HV_CD database and more than 50% new CI patients do not have medical records of CI diseases.