醫療技術的進步以及生活品質的提升，預計人類平均壽命將持續延長，以臺灣為例，男、女性平均壽命將從2011年的75.98歲、82.65歲，增加到2060年的82.0歲、88.0歲（資料來源：行政院經濟建設委員會2012年推估）。壽命延長意謂更長的退休生活，世界各國在21世紀均面對需求日殷的老年生活照顧，包括退休金制度以及老人醫療等，這些社會福利及保險勢必增加國家財務負擔，因此壽命是否繼續延長或存有極限成為大家關心的議題。近年來，不少研究透過死亡壓縮(Mortality Compression)連結壽命議題，亦即探討死亡年齡是否將集中至更窄的範圍，但因為資料及研究方法的限制，死亡壓縮是否成立仍無定論。 本研究以統計方法、分配假設、資料品質，三個面向來探討死亡壓縮與延壽之間的關係。本研究提出三種數值優化方法：加權最小平方法(Weighted Least Squares；WLS)、非線性極值法(Nonlinear-Maximization；NM)及最大概似估計法(Maximal Likelihood Estimation；MLE)，透過電腦模擬衡量方法優劣，與過去常見的方法比較（Kannisto的SD(M+)），探討何者具有較小的均方誤差(Mean Squared Error；MSE)。其次若死亡年齡之真實死亡分配為t分配時，探討以常態假設代入計算所產生的偏誤；最後則是套入各國實際死亡資料，使用上述較佳的估計方法，檢視死亡壓縮是否存在。 研究結果顯示，NM具有不偏性質且具有較小的均方誤差，過去研究常用的SD(M+)反而有明顯偏誤，且隨著觀察值越多變異數反而增加。而若真實死亡分配若為t分配時，以原先利用常態假設所計算的年金險保費皆有低估的情形，分配的重要性可見一斑，進而探討在實務上常態分配之假設，發現與仍與實際情形有明顯之差異，不論是NM及SD(M+)在死亡壓縮的探討下，皆受到資料的限制而有待商榷。 / Due to the advance in medical technology and the change of life style, the human life expectancy has been increasing since the end of the Second World War II and it is expected to continue the pace of increment. Longer life expectancy also means a longer life after retirement. People living in the 21st century are faced with growing demand for the retirement life, such as the pension funds and medical needs to the individuals, as well as the social welfare and insurance for the elderly to the government. Thus, the issue whether the lifespan has a limit receives a lot of attention. In particular, many studies focus on the topic of mortality compression, which means that the expectancy of lifespan has a limit and variance of lifespan converge. However, due to the availability of elderly data, there is still no consensus if the mortality compression is true. In this study, we propose estimation methods to estimate modal age and variance of the age-at-death. Three types of methods are involved: weighted least squares (WLS) method, nonlinear maximization (NM) method, and maximum likelihood estimation (MLE) method, and they are compared to the method proposed by Kannisto, namely SD(M+), in 2000. We found that the NM method has a smaller MSE, and we cannot decide the mortality compression is true based on the data from Human Mortality Database. We also applied the normality and t distribution assumption to the age-at-death and compute the pure premiums for annuity products. We found that normality distribution would produce larger premiums than using the empirical mortality rates. Similarity, the bankruptcy probability would be higher if the t distribution is used.

臺灣各縣市人口結構差異明顯，各縣市的人口出生、老化程度都不盡相同，而且在醫療分配及社會資源的使用也有很大的差異，因此各縣市應因應各地特性發展不同的小區域人口推估方法。由於樣本數與變異數成反比，人數較少者的死亡率（像是高齡人口）通常震盪較大，藉由適當的修勻(Graduation)調整，通常可降低年齡層間的死亡率震盪。然而，當縣市層級的人數太少時，只依賴修勻往往不足，多半會再參考人口較多的大母體之死亡率。例如：傳統的的貝氏修勻，使用Lee-Carter之類的參數死亡模型(Lee and Carter, 1992)，或是透過小區域及大母體的死亡率比值（王信忠, 2012）。然而過去研究較少全面性的比較這些方法，尤其是用於人數較少（如：十萬人）的地區。 本文以探討小區域生命表及死亡率推估為目標，著眼於人數不多於五萬人，尋求較為適合臺灣及類似國家的死亡率編算方法。由於修勻或貝氏等方法可視為增加樣本數，本文將擴大樣本分為四種方式：「同地同時」、「同地異時」、「異地同時」、「異地異時」，亦即將死亡資料的整併分成是否限定於小區域，以及是否可擴及其他年度。本文藉由電腦模擬測試，提供在各種限制之下，最合適小區域生命表建構的準則。其中，本文假設大、小區域的死亡率間存有三種情境的關係：定值、遞增、V字型，藉由調整大小區域死亡率比值間的幅度，探討大母體及小區域間的差異對實務使用的影響。研究發現，Partial SMR方法是一個值得參考的方法，當大小區域死亡率類型接近時的效果不錯，甚至可用於人數小於一萬人，但若死亡率類型差異過大，修勻方法會有限制，使用時需格外謹慎。 / The population structure, life expectancy (and age-specific mortality rates), and the speed of population aging vary a lot in different county of Taiwan. Each county has its own policy planning according to the needs. However, the county level population is usually not enough to provide stable estimates, such as of the life expectancies and mortality rates at the county level. Thus, certain graduation methods are applied to stabilize these estimates. However, only a few studies focus on comparing different types of graduation methods, including traditional graduation methods, Bayesian methods, and parametric mortality models. In this study, we separate the graduation methods into four types, according to if using only the small area data and if one year or multiple years of data are used, and explore which methods are appropriate to the areas with population fewer than 100,000. We use computer simulation to evaluate the graduation methods. We found that the Standard Mortality Ratio is promising when the mortality profiles of small and large populations are similar, and it is a feasible solution even for the areas with population fewer than 10,000. However, if the mortality profiles differ significantly, all graduation methods need to be applied with care.

壽命延長及生育率下降使得人口老化日益明顯，成為全球多數國家在21世紀必須面對的議題，由於各區域人口老化的速度不同，必須根據各地特性而調整因應對策。其中研究死亡率變化為面對人口老化的必備課題，尤其是高齡族群的死亡率，這也是近年高齡死亡模型廣受重視的主因之一。因為樣本數與變異數成反比，人口較少的區域或是高齡人口，死亡率的觀察值通常會有較大震盪，為了降低震盪多半會經過修勻，以取得較為穩定的死亡率推估值（王信忠等人，2012）。此外，Li and Lee (2005)的Coherent Lee-Carter模型也是另一種可行方法，透過參考大區域的資訊降低小區域的估計誤差。 本文探討結合上述修勻、死亡率模型的可能，希冀能綜合兩者的優點，提高小區域死亡率推估的精確性。因為Coherent Lee-Carter模型的想法類似增加小區域的人數（加入大區域的人數），本文探討人口數與Lee-Carter模型參數估計值的關係，再以修勻調整大小區域的差異，透過電腦模擬及資料分析，驗證本文提出方法是否有效。其中，仿造王信忠等人的作法，假設小區域與大區域死亡率間的七種可能情境，以平均絕對百分誤差(Mean Absolute Percentage Error)為衡量標準，找出調整修勻、相關模型的方法。另外，本文也以臺灣縣市為研究區域，驗證本文方法的估計結果。研究發現適當地使用修勻方法，可降低小區域的死亡率估計值，其效果優於Coherent Lee-Carter模型。

在人口統計領域中，早期習慣將人口變化視為時間的函數，企圖以Deterministic Function來刻劃，例如：1798年Malthus提出的Malthusian Growth Model ；1825年Gompertz提出的Gompertz Model以及1838年Verhulst主張以Logistic Function描述人口成長。而近年來則是傾向於逐項分析各種因素的隨機性模型，例如：1983年Holford加入世代的APC模型；1992年Lee 和Carter提出的Lee-Carter死亡率模型以及2003年Renshaw與Haberman提出改善Lee-Carter死亡率模型的Reduction Factor模型。 人口變化主要分成自然增加與社會增加，而自然增加是為出生扣掉死亡，社會增加則為移入扣掉移出。首先，本文先不考慮遷移的部分，各別以出生與死亡人口的變化為研究對象，視其變化為一隨時間變動的動態系統，以常微分方程來刻劃。由台灣地區人口統計資料顯示，出生率或死亡率都有逐年下降的趨勢，而且隨著時間而變化加劇的傾向，使得以往使用的模型不易捕捉變化，因此我們提出「二次逼近法」，從出生、死亡人數對時間的變化率與曲度利用數值分析的方式來估計出生與死亡數，進而從中找出在此動態系統背後隱藏的規則。而後再同時考慮其他各種變項，以偏微分方程來刻劃，最後即可建立台灣地區人口變化模型。 / In early population statistics, the population changes were regarded as a function of time so that people tended to describe the variations by deterministic functions. For instance, Malthus proposed the Malthusian Growth Model in 1798; Gompertz presented Gompertz Model in 1825; Verhulst advocated using logistic function to describe an increase in population. In recent years, people tend to use the stochastic forecast method to analyse every factor term by term. For instance, the Age-Period-Cohort (APC) Model which was proposed by Holford in 1983; Lee and Carter proposed the Lee-Carter Mortality Model in 2003; and Renshaw and Haberman proposed the Reduction Factor Model in 2003 that improve the Lee-Carter Mortality Model. The population changes equal to nature and social increase, where the nature increase is the difference between birth and death population, and the social increase is the difference between immigrants and emigrants. First, we focus on natural increase rather than social increase. Moreover, we use ordinary differential equation to decribe the variation as a dynamic system over time. From the data obtained from the Ministry of Interior Taiwan, we know that the fertility and mortality has been decreasing, and the change is getting more violent year by year. Under the consideration that previous models are not able to accurately present the changes of birth and death, we proposed "second-order (or parabola) approximation method." From the variation rates and curvatures of birth and death population, we estimated the population size. Furthermore, we want to find the rule in the dynamic system. Later we will consider other factors simultaneously, and describe them by partial differential equation. Finally, the population model is constructed.

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.

No description available.

近來，由於詐領人壽保險死亡保險金之情況甚為嚴重，使得政府及保險人不得不對人壽保險人免責事由之規範加以留意。而此亦為本文撰寫靈感來源。 故本文乃試從保險法及保險學之角度，對人壽保險人免責事由之意義及內容加以界定，進而於提出各國立法例後，探究目前我國人壽保險人之法定免責事由，並以人壽保險單示範條款為意定免責事由之中心，探究相關之法令規定。 對於人壽保險人免責事由之主要問題乃出自保險法第一百零九條及第一百二十一條，雖現行人壽保險單示範條款第十四條之規定亦源自於此二法條而來。然而，對於其中之爭議點，人壽保險單示範條款仍未加以解決。此外，本文亦兼論有關戰爭、內亂及其他類似的武裝變亂和核子反應造成之損害，保險人是否得以免責。 最後，對於前述之問題，本文建議除了從我國保險法第一百零九條、一百二十一條、第三十二條之內容加以修正之外，亦可從保險犯罪防制中心之成立，進行危險控制之工作。 / Defrauding death benefits of life insurance has become more and more serious recently, so the government and insurers must keep their eyes open about the liability exception of life insurers. This is also the inspiration source of this essay. This essay tries to describe the definition and contexts of the liability exception of life insurers from the insurance law and insurance theories points of view. After bringing the cases and laws in different countries forward, the writer will proceed to the next step: to investigate into the statutory liability exception of life insurers; and then, to center on Model Provisions of Life Insurance Policy, studying the related regulations about the exceptions or exclusions of life policy. The main issues of the liability exception of the life insurers arise from Sections 109 and 121 of the Insurance Law of R. O. C.. Although the Model Provisions of Life Insurance Policy S.14 also came from these rules, the main issues still remain unsolved. Moreover, this essay will also discuss about whether or not the insurers should be liable for the insurance events caused by the wars, civil strifes, other armed forces and nuclear reaction. Finally, this essay suggests amending the Insurance Law of R.O.C., S.109, 121, and 32 to solve the issues mentioned above as well as establishing the Crime Prevention Center of Insurance Institute to carry out the work of risk control.

本論文研究渥雷‧索因卡《死亡與國王的侍衛長》一劇，以及本劇對約魯巴（Yoruba）人孤注一擲抵制西化卻徒勞無功的境遇所做的關注。本劇改編真實歷史，重演一九四五年在奈及利亞奧約（Oyo）城發生的動亂。當時應舉行侍衛長（Horseman）自殺儀式，然而英國殖民者以武力中斷。本劇一方面解釋這個儀式在約魯巴社會的重要性，另一方面揭露侍衛長心不甘情不願了結生命，並斷言活人獻祭這類殘忍的傳統必然要革除，特別是在因英國殖民而致的動盪時刻。 / 論文分為四個章節，依據米哈依爾‧巴赫汀（Mikhail Bakhtin）的時空型（chronotope）理論，探究《死亡與國王的侍衛長》其社會歷史背景與戲劇表演手法。第一章介紹作者和劇本，並回顧評論，以及說明接下來討論的議題和理論架構。第二章分析文本與現實世界相互輝映的關係。艾瑞克‧霍布斯邦（Eric Hobsbawm）在〈發明傳統〉（"Inventing Traditions"）的見解用以闡明傳統是因時制宜的產物。比爾‧阿希克洛夫特（Bill Ashcroft）等三人提出的後殖民典型，有助於瞭解約魯巴人為了阻擋外來影響竭力奮戰，儘管殖民政府的干預相當強勢。第三章詮釋劇中人物的性格特徵，以弗朗茲‧法農（Frantz Fanon）告誡不可畫地自限的觀點為鑑。無法順應社會變異因此冥頑不靈的人，失去了看世界的洞察力。而那些猶豫不決者，為了遵從老一套的價值觀，受煎熬得筋疲力盡。第四章總結本文，認為本劇主張靈活性和果斷力以進行改變。 / This thesis studies Wole Soyinka's Death and the King's Horseman and its concerns for the Yoruba people's desperate but futile resistance to Westernization. Adapted from a real historical event, this play reenacts the disturbance in the Oyo city of Nigeria in 1945, when the ritual of the Horseman's suicide was interrupted by the British colonial force. While the play explains the importance of the ritual in the Yoruba society, it reveals the Horseman's reluctance to end his life and asserts that cruel tradition like human immolation must be reformed especially at the fluctuating moment caused by the British colonization. / Consisting of four chapters, this thesis relies on Mikhail Bakhtin's chronotope to explore the socio-historical context and theatrical representation of Death and the King's Horseman. Chapter one introduces the dramatist and the play, reviews critical opinions, and illustrates the purpose and theoretical framework of the following discussion. Chapter Two, which analyzes the interrelationship between textual and actual worlds, adopts Eric Hobsbawm's "Inventing Traditions" to clarify tradition as produced according to specific circumstances. The postcolonial models proposed by Ashcroft et al helps understand the Yoruba people's struggle for no foreign impact despite powerful intervention by the colonial government. Chapter Three interprets the roles' characterization with the aid of Frantz Fanon's warning of self-confinement. Unable to adjust to social variances, the obstinate people blind their vision of the world, while those procrastinating become dead exhausted by difficult conformity to old values. Chapter Four concludes that this play argues for resilience and resolution to make difference.

本研究的內容，主要是以居住在大台北地區20歲以上之就業者為研究對象，藉著問卷調查的方式，從需求面來探討消費者對重大疾病保險的看法與期許。分析方法分別為次數分配、因素分析、Cronbach α、單因子變異數分析、交叉分析。 本研究將保險購買評估準則，利用因素分析將之區分為「公司狀況與產品利益」、「過去與週遭經驗」、「保費及公司型態」、「感情與服務態度」及「專業能力」等五個因素。並探討各因素在購買經驗及人口統計變數上是否具顯著差異。另外分別針對購買和理賠經驗、購買動機、購買意願、資訊來源、人口統計變數與產品利益屬性等方面做卡方（χ2）獨立性檢定。研究發現： 1.就保險購買評估準則方面： 最受重視的是「公司狀況與產品利益」，其次則為「過去與週遭經驗」，而最不受重視的則為「保費及公司型態」。 2. 購買重大疾病保險之經驗、原因與資訊管道 （1）受訪者中投保重大疾病保險的比例有六成以上，整體而言，已婚者購買的比例大於未婚者；而隨著收入的增加其購買重大疾病保險的比例也增加。 （2）未購買及中斷購買原因主要是「保費負擔太重」、「對保障內容不滿意或不瞭解」以及「已有全民健保就足夠」。 （3）購買資訊管道以「保險業務人員的推銷」、「親友的介紹」以及「公司的團體保險」為主。 3. 產品利益屬性 （1）對於重大疾病保險未來發展方向的選擇，以「增加重大疾病的項目」、「結合其他醫療功能的保單」以及「增加給付方式的選擇」等三項為大部分受訪者的選擇。 （2）保險金給付的偏好方式，以一次金給付、分次終身給付及代付醫療費用三者之接受度最高。 （3）適當的重大疾病給付額度，大多數的受訪者認為應在101∼300萬之間。 / This study focus on labor people aged from 20 in metropolitan Taipei arena. By questionnaire interviews, we will study the customers' opinions and expectations to dread disease insurances from market demand. The analytical methods will be described as followings: Frequency Distribution, Factor Analysis, Cronbach α, One-Way Anova Analysis and Crosstable. The study classifies the purchasing evaluation criteria of insurance as five factors such as “Cooperation situation and product profit margin”, “Past and surrounding experiences”, “Insurance premium and cooperate types”, “Emotion and service attitudes” and “Professional”. And explores the possibilities of the apparent differences for each factor to purchasing experiences and demographic variables. On the other hand; we try to make χ2 independence evaluation to purchasing & reimbursement experiences, purchasing motivation, purchasing intention, information resources, demographic variables and product profit properties. We found: 1.The evaluation criteria of buying insurance: People more emphasize on “Cooperation situation and product profit margin” and followings by “Past and surrounding experiences”. And less emphasis on “Insurance premium and cooperate types” 2.The experiences, results and information channels for purchasing serious disease suffered insurance: (1)The proportion of holding policy for serious disease is 60% or above. Generally speaking, the proportion of married people policyholder is larger that the one of single people. And the more the income increases;the more the proportion of purchasing disease suffered insurance increases. (2)The main reasons of not purchasing or quitting are “Premiums are too expensive”, “Not really satisfy or understand the contents of insurance covered”, and “It’s quite enough for having public healthy insurance”. (3)The main information channels to purchase insurances are “The promotion of insurance sales people”, “Relatives & friends introduction”, and “Cooperation group insurance”. 3.Product profit properties: (1)For the options of dread disease insurance development, generally, there would be three items to be acceptable such as “Additional benefits of dread diseases”, “Combine with policies of other medical functions”, and “Additional options of payment mode”. (2)The preferred payment way of premiums will be “Pay off”, “Life Amortization ”, and “Pay medical expenses by agent” and more acceptable. (3)Most interviewees think that the reasonable benefit amount for dread disease insurance will target on between NT$1 million and NT$3 million.

人口政策是政府的重要政策之一，而總人口數則是政府制定政治、經濟、社會及文化發展計畫之主要參考依據，因此如何準確地預測未來的總人口數就成為政府相關部門重要的課題。 本論文試圖為台灣地區總人口數建立時間數列預測模式。我們考慮下列模式：單變量自我迴歸整合移動平均介入模式、時間數列迴歸模式、轉換函數介入模式與指數平滑法，其中轉換函數介入模式中所考慮的投入變數包括育齡婦女總生育率、粗出生率及粗死亡率。我們同時以平均絕對百分誤差 (MAPE) 、根均方百分誤差 (RMSPE) 來評估各模式的預測能力，結果顯示以育齡婦女總生育率為投入變數的轉換函數介入模式最佳，而以粗出生率為投入變數的轉換函數介入模式次之，若以這兩個模式進行未來十年總人口數之預測，並與行政院經建會人力規劃處所作的人口預測中推計值比較，其平均絕對百分誤差分別為0.138%，0.156%，顯示時間數列預測模式有相當佳的預測能力。 / In this thesis, we plan to construct various time series models for the total population in Taiwan. The following time series models are considered: ARIMA intervention model, time series regression model, transfers founction intervention model and exponential smoothing method. The input variable considered in the transfer function intervention model include total fertility rate, crude birth rate and crude death rate. We also compare the prediction performance of these models by using mean absolute percentage error (MAPE) and root mean square percentage error (RNSPE). It turns out that the transfer function intervention model with total fertility rate as input is the best model. While the transfer function intervention model with crude birth rate as input ranks the second best. Finally we forecast the total population of the next ten years by using the above two best models and compare with the middle population projection by Manpower Planning Department in Executive YUAN-Council for Economic Planning and Development. The mean absolute percentage error are 0.138% and 0.165% respectively. This result justifies that the time series model has excellent predictive ability and should be considered for total population prediction.