空間群聚分析應用於流行病學已行之有年，但國內這方面的研究仍較缺乏，尤其在找出哪些地區有較高疾病發生率的群聚偵測。本文針對台灣鄉鎮市資料的特性，提出一套合適的群聚檢測方法，這個方法使用兩階段的電腦模擬，實證上更容易使用；這個方法除了可找出最大顯著群聚外，也能夠偵測出多個群聚的分佈。本文使用電腦模擬比較本文的方法與目前使用較為廣泛的方法(包括Kulldorff(1995)的spatial scan statistic和Tango(2005)的flexible scan statistic)，以型一誤差、型二誤差及錯誤率三種標準衡量方法的優劣。最後套用台灣癌症死亡率與健保就診次數資料，探討台灣癌症空間群聚與就診情形的變化。 / Spatial cluster analyses have applied in epidemiology for many years. In this topic there still are few researches in Taiwan, especially in detecting the areas which have higher disease intensity. In this paper, we proposed a new cluster detection method which is aimed at Taiwan counties’ data. This method which uses two-stage computer simulation procedures is useful in practice. This method can find the most likely cluster. Besides, it can find multiple clusters. We use computer simulations to compare our method with others (Kulldorff’s spatial scan statistic& Tango’s flexible scan statistic). Type-I error, Type-II error and error rate are criterions of measurement. At last, we use Taiwan cancer mortality data and all the people health insurance data to discuss Taiwan cancer spatial clusters and the change of diagnoses.

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