國家施政應以人民結構及其居住等特性為依據，但臺灣的政府統計多以戶籍記錄為主，每十年一次的戶口普查雖能提供常住人口資訊，但其時效性及調查項目有頗多限制。有鑑於此，本文以全民健康保險資料庫探究臺灣常住人口的現況，因全民健保實施已逾20年，納保率接近99%，且因大多數醫療院所均加入全民健保系統，方便民眾就醫，使得感冒等小病（或是上呼吸道感染）往往選擇經常活動地區的醫療院所就醫，預期全民健保就醫資料更能反映各地的常住人口。 除了常住人口之外，本文也分析民眾就醫記錄，嘗試透過全民健保資料庫探討醫療可近性等議題，以重大傷病等就醫資料評估醫療資源的城鄉差距。本研究先以全民健保資料庫中的2005年承保抽樣歸人檔LHID2005（或稱2005年百萬人抽樣檔）估計各地區常住人口，發現抽樣檔在2010年的人口結構與2010年戶口普查結果相近，其中常住人口與戶籍紀錄差異較多的區域，交通多半也較為便利；而民眾就醫習性確實存在城鄉差距，或許與區域級以上醫療院所的分布有關。另外，進一步分析重大傷病患者的就醫記錄，發現選擇就醫的頻率、地區與醫學中心的分布存有關聯。例如：外島地區及部分偏鄉地區（苗栗、雲林等），重大傷病病患的平均就醫距離明顯較長，凸顯偏遠地區的就醫不便，需有合適的對應政策已降低醫療資源的分配不公。

戶口普查的主旨在於瞭解一個國家或地區的人口及其相關特性，國家的政策制訂及人力規劃需仰賴正確的調查結果。但隨著社會變遷等諸多因素，即使增加費用也無法提高普查的完訪率，資料的品質也因民眾配合意願而降低。為提高資料品質與降低調查成本等因素，部份國家積極發展新的普查方法，預計在2010年普查正式實施，取代傳統的戶口普查。 本研究整理新的普查方法，包括登記式普查、登記式普查結合抽樣調查、滾動式普查等方法。其中也包括行政院計畫預計在2010年以登記式普查結合抽樣調查取代傳統的戶口普查，效法新加坡、北歐四國與荷蘭，整合公務登記系統取得普查短表資料，抽樣調查代替國外長表問卷，希冀獲得較為詳細的教育、生育、居家老人照護等社經議題之統計資料。除了整理資料外，本文也將討論2010年台灣的戶口普查，以常住人口為調查目標，可能衍生的問題。 另外，本研究也將整理美國與法國即將採用的調查方法，包括美國社區調查（American Community Survey）的設計與抽樣方法，用於普查以取代長表問卷的可能，並研究抽樣調查蒐集人口的限制，比較普查及調查蒐集資料的優缺點。 / The objective of the population and housing census is to collect the demographic information on the population in a nation or an area which will be used as a reference for government planning and policy making. Because of the dramatic change in the social environment, some problems were generated as a result, such as the increase in survey cost, non-response rate, and data demand. Although many countries are still using the Traditional Census method for the 2010 census, some are active in developing new methods to improve the quality of data collected and to decrease the survey cost. Following the examples of Singapore, Netherland, and the Nordic countries (Denmark, Finland, Norway, and Sweden), the method for conducting the 2010 Taiwan Census will be different, changing from the traditional census to registered-based census with sampling survey. This method will integrate the official registry system to acquire the basic demographic characteristics, and collect more detailed information on the social and economic topics, including the aspects of education, fertility, and elder care by using sampling methods. Consequently, this research will be separated into two parts. The first part will introduce and analyze several common census methods used, including the Traditional Census method, Registered-Based Census, Registered-Based Census with Sampling Survey, and the Rolling Census. In addition, the target population of 2010 Taiwan Census is De Jure population and we shall also discuss its potential problems. In the second part, the research will further examine the survey methods that will be used for the U.S. and French census, including the design concept and the sampling method executed by the American Community Survey (ACS) to replace the long-form questionnaire for the 2010 U.S. Census. Finally, we will discuss the restrictions of using sampling to collect data, compare the strengths and weaknesses of census and the different sampling methods, as well as analyze the problems related to the registered population and the permanent residents.

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.