本研究旨在探討莫拉克颱風造成的水災對受災地區居民在個人生理健康上以及對健保在生理疾病醫療支出上之影響，並且更進一步將災害相關生理疾病再區分為：蟲媒傳染性疾病、囓齒動物傳染性疾病、水媒接觸傳染性疾病以及水災相關（眼睛、皮膚、胃腸道）疾病，探究災害相關生理疾病的「發病率」、「就診率」以及「支出率」在不同傳染性疾病類別中是否存在差異。國內外不乏探討水災對人類健康造成影響之相關文獻，然而其中多數研究著重在水災前後發病率之差異，且並未控制非水災地區之趨勢。本研究利用全民健康保險研究資料庫2008年至2010年之承保資料檔、門診處方及治療明細檔、醫事機構基本資料檔等檔案，結合莫拉克颱風災情報告、縣市重要統計指標等外部資料，建構出縱橫資料，以差異中之差異法（difference-in-differences, DID）固定效果迴歸模型進行分析。實證結果發現：莫拉克颱風造成的水災，使受災地區居民在災害相關生理疾病的發病率、就診率以及支出率上，分別提高0.1823%、0.2439%以及0.2568%，表示莫拉克颱風對受災地區居民在個人生理健康上產生負面之影響，並增加健保在生理疾病醫療支出上之損失。本研究之貢獻在於─估計颱風對災害相關生理疾病的個人就診次數與健保醫療支出之影響，可作為未來減災政策之成本效益分析。此外，針對各類別災害相關生理疾病發病率之估計結果，可作為降低颱風對健康造成負面影響之政策的制定依據。

This study analyzes the impact the flooding caused by typhoon Morakot had on outpatient care visits and expenditures due to natural hazard related physiological diseases. Using the research database, we analyzed the morbidity rate, number of visits, and the expenditures on outpatient care for natural hazard related physiological diseases includes vector-borne diseases, rodent-borne diseases, waterborne diseases and flood-related eye, skin and gastrointestinal tract diseases. We examined the panel data of the 2008 to 2010 National Health Insurance outpatient claims using the difference-in-differences (DID) fixed effect regression model. The results show that the flood caused by typhoon Morakot increased the morbidity rate from natural hazard related physiological diseases by 0.1823% per 10,000 people, the rate of outpatient care visits increased by 0.2439% and the rate of expenditure for outpatient care increased by 0.2568%, indicating that the flood caused by typhoon Morakot had a negative impact on the physical health of residents in the flooded areas while also increasing the physiological diseases’ health care National Health Insurance expenditures. The contribution of this study is to be used as cost-benefit analysis of disaster mitigation policies which explore whether the preventive measures’ cost for natural hazard related physiological diseases is less than the increase in health care expenditures caused by the typhoon.

一、中文部份
1. 李欣輯、郭彥廉、蕭代基、黃德秀（2008），「易淹水地區水患治理工程之家戶效益評估：以嘉義新塭示範區為例」，農業與資源經濟，頁41-58。
2. 李欣輯、陳怡臻、郭玫君（2013），「臺灣颱洪災損評估系統之建置與應用」，農業工程學報，第五十九卷第四期，頁42-55。
3. 吳珮瑛、曾筱芬、傅祖壇（2009），「心臟血管疾病門診醫療需求及其預防效益之評估：納入異質性病患與就醫相關時間成本」，應用經濟論叢，第八十五期，頁155-193。
4. 林民浩、楊安琪、溫在弘（2011），「利用地區差異與人口學特徵評估全民健保資料庫人口居住地變項之推估原則」，台灣公共衛生雜誌，第三十卷第四期，頁347-361。
5. 林美絨（2013），「宣示課徵證所稅對台股成交金額之影響」，臺灣大學經濟學研究所學位論文。
6. 邱淑君、邱詩惠、王琇儀、慕蓉蓉（2011），「2009-2010年台灣地區鉤端螺旋體病監測調查分析」，疫情報導，第二十七卷第十六期，頁199-204。
7. 陳厚任（2004），「藥品部分負擔政策對癲癇病人之影響」，臺灣大學醫療機構管理研究所學位論文。
8. 陳宗梧（2009），「偏遠地區民眾之醫療照顧政策成效分析」，政治大學財政研究所學位論文。
9. 陳振川、洪世益（2012），「大規模災害家園重建策略─以莫拉克颱風重建為例」，災害防救科技與管理學刊，第一卷第一期，頁 63-79。
10. 陳一德（2015），「以 DID 計量方法分析：現股當沖政策對標的個股成交量提升及活絡股市有效性」，臺灣大學經濟學研究所學位論文。
11. 徐開泰（2017），「以 DID 計量方法分析：大股東占比對除息日前後之股價報酬率影響」，臺灣大學經濟學研究所學位論文。
12. 連賢明（2008），「如何使用健保資料進行經濟研究」，經濟論文叢刊，第三十六卷第一期，頁115-143。
13. 連賢明（2011），「如何使用健保資料推估社經變數」，人文及社會科學集刊，第二十三卷第三期，頁371-398。
14. 廖偉秀（2015），「外國專利權保護改善對臺灣製造業出口的影響：差異中的差異法之應用」，中正大學經濟系國際經濟研究所學位論文。
15. 劉介宇、洪永泰、莊義利、陳怡如、翁文舜、劉季鑫、梁賡義（2006），「台灣地區鄉鎮市區發展類型應用於大型健康調查抽樣設計之研究」，健康管理學刊，第四卷第一期，頁1-22。
16. 陳美霞、謝文紘（2001），「醫藥分業政策推行對藥師專業的影響」，台灣公共衛生雜誌，第二十卷第五期，頁395-411。
17. 關秉寅、李敦義（2010），「國中生數學補得愈久，數學成就愈好嗎？傾向分數配對法的分析」，Bulletin of Educational Research，第五十六卷第二期，頁105-139。
二、英文部份
1. Abadie, A., Diamond, A., & Hainmueller, J. (2010). Synthetic control methods for comparative case studies: Estimating the effect of California’s tobacco control program. Journal of the American Statistical Association, 105(490), 493-505.
2. Ahern, M., Kovats, R. S., Wilkinson, P., Few, R., & Matthies, F. (2005). Global health impacts of floods: epidemiologic evidence. Epidemiologic Reviews, 27(1), 36-46.
3. Ahmed, Z., Khan, A. A., & Nisar, N. (2011). Frequency of infectious diseases among flood affected people at district Rajanpur, Pakistan.
4. Alderman, K., Turner, L. R., & Tong, S. (2012). Floods and human health: a systematic review. Environment International, 47, 37-47.
5. Angrist, J. D., & Keueger, A. B. (1991). Does compulsory school attendance affect schooling and earnings?. The Quarterly Journal of Economics, 106(4), 979-1014.
6. Ashenfelter, O. C., & Card, D. (1984). Using the longitudinal structure of earnings to estimate the effect of training programs.
7. Caliendo, M., & Kopeinig, S. (2008). Some practical guidance for the implementation of propensity score matching. Journal of Economic Surveys, 22(1), 31-72.
8. Caminade, C., McIntyre, M. K., & Jones, A. E. (2016). Climate change and vector-borne diseases: Where are we next heading?.
9. Carlton, E. J., Eisenberg, J. N., Goldstick, J., Cevallos, W., Trostle, J., & Levy, K. (2013). Heavy rainfall events and diarrhea incidence: the role of social and environmental factors. American Journal of Epidemiology, 179(3), 344-352.
10. Curriero, F. C., Patz, J. A., Rose, J. B., & Lele, S. (2001). The association between extreme precipitation and waterborne disease outbreaks in the United States, 1948–1994. American Journal of Public Health, 91(8), 1194-1199.
11. David, C., & Krueger Alan, B. (1994). Minimum wages and employment: a case study of the fast-food industry in New Jersey and Pennsylvania. American Economic Review, 84(4), 772-793.
12. Di Giacomo, M., Piacenza, M., Siciliani, L., & Turati, G. (2017). Do public hospitals respond to changes in DRG price regulation? The case of birth deliveries in the Italian NHS. Health Economics, 26, 23-37.
13. Du, W., FitzGerald, G. J., Clark, M., & Hou, X. Y. (2010). Health impacts of floods. Prehospital and Disaster Medicine, 25(3), 265-272.
14. Frakes, M., & Jena, A. B. (2016). Does medical malpractice law improve health care quality?. Journal of Public Economics, 143, 142-158.
15. Fu, H., Li, L., Li, M., Yang, C., & Hsiao, W. (2017). An evaluation of systemic reforms of public hospitals: the Sanming model in China. Health Policy and Planning, 32(8), 1135-1145.
16. Funari, E., Manganelli, M., & Sinisi, L. (2012). Impact of climate change on waterborne diseases. Annali dell'Istituto Superiore di Sanita, 48, 473-487.
17. Gaynor, K., Katz, A. R., Park, S. Y., Nakata, M., Clark, T. A., & Effler, P. V. (2007). Leptospirosis on Oahu: an outbreak associated with flooding of a university campus. The American Journal of Tropical Medicine and Hygiene, 76(5), 882-886.
18. Gao, L., Zhang, Y., Ding, G., Liu, Q., & Jiang, B. (2016). Identifying flood-related infectious diseases in Anhui Province, China: a spatial and temporal analysis. The American Journal of Tropical Medicine and Hygiene, 94(4), 741-749.
19. Gubler, D. J., Reiter, P., Ebi, K. L., Yap, W., Nasci, R., & Patz, J. A. (2001). Climate variability and change in the United States: potential impacts on vector-and rodent-borne diseases. Environmental Health Perspectives, 109(Suppl 2), 223.
20. Herr, A., & Suppliet, M. (2017). Tiered co-payments, pricing, and demand in reference price markets for pharmaceuticals. Journal of Health Economics, 56, 19-29.
21. Huang, L. Y., Wang, Y. C., Liu, C. M., Wu, T. N., Chou, C. H., Sung, F. C., & Wu, C. C. (2011). Water outage increases the risk of gastroenteritis and eyes and skin diseases. BMC Public Health, 11(1), 726.
22. Huang, L. Y., Wang, Y. C., Wu, C. C., Chen, Y. C., & Huang, Y. L. (2016). Risk of flood-related diseases of eyes, skin and gastrointestinal tract in Taiwan: A retrospective cohort study. PloS One, 11(5), e0155166.
23. Hunter, P. R. (2003). Climate change and waterborne and vector‐borne disease. Journal of Applied Microbiology, 94, 37-46.
24. Iizuka, T., & Uchida, G. (2017). Promoting innovation in small markets: Evidence from the market for rare and intractable diseases. Journal of Health Economics, 54, 56-65.
25. Klopfer, J. (1989). Effects of environmental air pollution on the eye. Journal of the American Optometric Association, 60(10), 773-778.
26. Maskey, M., Shastri, J. S., Saraswathi, K., Surpam, R., & Vaidya, N. (2006). Leptospirosis in Mumbai: post-deluge outbreak 2005. Indian Journal of Medical Microbiology, 24(4), 337.
27. Nichols, G., Lane, C., Asgari, N., Verlander, N. Q., & Charlett, A. (2009). Rainfall and outbreaks of drinking water related disease and in England and Wales. Journal of Water and Health, 7(1), 1-8.
28. Ni, W., Ding, G., Li, Y., Li, H., Liu, Q., & Jiang, B. (2014). Effects of the floods on dysentery in north central region of Henan Province, China from 2004 to 2009. Journal of Infection, 69(5), 430-439.
29. Ohl, C. A., & Tapsell, S. (2000). Flooding and human health: the dangers posed are not always obvious. BMJ: British Medical Journal, 321(7270), 1167.
30. Paterson, D. L., Wright, H., & Harris, P. N. (2018). Health Risks of Flood Disasters. Clinical Infectious Diseases, ciy227.
31. Pellizzer, P., Todescato, A., Benedetti, P., Colussi, P., Conz, P., & Cinco, M. (2006). Leptospirosis following a flood in the Veneto area, North-east Italy. Annali di igiene: medicina preventiva e di comunita, 18(5), 453-456.
32. Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1), 41-55.
33. Rubin, D. B. (2001). Using propensity scores to help design observational studies: application to the tobacco litigation. Health Services and Outcomes Research Methodology, 2(3-4), 169-188.
34. Schwartz, B. S., Harris, J. B., Khan, A. I., Larocque, R. C., Sack, D. A., Malek, M. A., Faruque, A. G., Qadri, F., Calderwood, S. B., Luby, S. P., & Ryan, E. T. (2006). Diarrheal epidemics in Dhaka, Bangladesh, during three consecutive floods: 1988, 1998, and 2004. The American Journal of Tropical Medicine and Hygiene, 74(6), 1067-1073.
35. Su, H. P., Chan, T. C., & Chang, C. C. (2011). Typhoon-related leptospirosis and melioidosis, Taiwan, 2009. Emerging Infectious Diseases, 17(7), 1322.
36. Veenema, T. G., Thornton, C. P., Lavin, R. P., Bender, A. K., Seal, S., & Corley, A. (2017). Climate Change–Related Water Disasters’ Impact on Population Health. Journal of Nursing Scholarship, 49(6), 625-634.
37. Zhang, F., Liu, Z., Zhang, C., & Jiang, B. (2016). Short-term effects of floods on Japanese encephalitis in Nanchong, China, 2007–2012: A time-stratified case-crossover study. Science of the Total Environment, 563, 1105-1110.