本文以內生成長模型為架構，探討預防性醫療支出的投入對疾病發生率以及效用調整後存活人年的影響。研究發現：政府投入預防性醫療支出能有效的使發病率下降，進而增進民眾的真實健康。然而，預防性醫療支出消長對經濟成長與社會福利的影響，並非單一的線性關係；當預防性醫療支出佔GDP比例高過最適值時，將排擠到政府對建設性支出的投入，進而阻礙經濟成長。再而，利用效用調整後健康壽命(Utility-Adjusted-Life-Expectancy ,UALE)，將終生效用與存活函數結合，得到當預防性醫療支出增加至最適值時，對民眾效用調整後健康壽命具有改善效果。現行預防性醫療支出佔GDP比例為0.25%，研究顯示提高至0.475%時，將增加0.59UALY，經濟成長達極大；提高至0.55%時，將增加0.62UALY，對社會福利有最大效益。

Based on the endogenous economic growth model, this study aims to investigate the influence of preventive expenditure on incidence rates and the population’s utility-adjusted-life-expectancy(UALE). Analytical results indicate that preventive expenditure can effectively lower incidence rates, and thus enhance the population’s health status. Theoretical analysis finds that an increase in preventive expenditure might promote economic growth rates and social welfare. However, the relationship between preventive expenditure and economic growth or social welfare are nonlinear. When the ratio of preventive expenditure to GDP exceeds the optimum, the economy grows slowly since infrastructure inputs are crowded out. This research further conducts sensitivity analysis and numerical simulations to calibrate the policy effects. Incorporating utilities from consumption and health with life expectancy, the concerned population’s UALE could increase 0.62 utility-adjusted-life-years(UALYs) when the ratio of preventive expenditure to GDP increases from current share, 0.25 per cent, to the optimum for maximizing social welfare, 0.55 per cent. For maximizing economic growth, the ratio of preventive expenditure to GDP should increase from current share, 0.25 per cent, to the optimum, 0.475 per cent, and the UALE increases by 0.59 UALYs.

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王榮德:流行病學方法論，(藝軒圖書出版社，二版，2010年8月)

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