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題名：花蓮縣偏遠與非偏遠地區民眾對於基層醫療保健服務的使用與需求之比較
書刊名：臺灣公共衛生雜誌
作者：葉婉榆／陳志聖／鄒欣縈／劉宜華／吳柏樺／曹雅琪／呂佳容
作者(外文)：Yeh, Wan-yu／Chen, Chih-sheng／Zou, Xin-ying／Liu, Yi-hua／Wu, Bo-hua／Tsao, Ya-chi／Lu, Chia-rong
出版日期：2012
卷期：31:4
頁次：頁371-387
主題關鍵詞：偏遠地區；基層醫療衛生保健；服務需求；需求評估；Remote area；Primary health care；Service needs；Needs assessment
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(3) 博士論文(1) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:3
  • 共同引用共同引用:48
  • 點閱點閱:38
目標：探討並比較花蓮縣偏遠與非偏遠地區民眾對基層醫療保健的使用情形及服務需求。方法：運用量性調查問卷詢問人口背景、基層醫療使用情形、醫療／預防保健／衛生教育服務之需求程度和原因，於花蓮縣偏遠地區選取六個鄉鎮，非偏遠地區選取三個鄉鎮民眾參與，共回收573份有效問卷（回收率97%）；另邀請10位偏遠／非偏遠村里代表參與訪談，收集質性資料。結果：偏遠民眾對醫療資源充足度有49.3%認為「不足」，非偏遠民眾僅佔16.6%。鄉鎮應強化之醫療科別，偏遠民眾首需「眼科」，非偏遠民眾則為「家庭醫學科」。鄉鎮應加強之醫療服務，偏遠民眾首需「巡迴醫療」，非偏遠民眾則為「降低醫療自付費用」。訪談另發現，村里長積極程度對村里醫療資源多寡影響極大。結論：本研究發現偏遠與非偏遠地區至基層醫療據點的可近性差異不大，但偏遠民眾的服務滿意度明顯較低，建議衛生主管機關對於偏遠地區醫療保健資源的規劃，在服務項目與服務品質方面需考量民眾需求來實質提升。
Objectives: This study compared the utilization of and requirements for primary healthcare services for residents living in remote and non-remote areas of Hualien County. Methods: We used quantitative questionnaires to survey 6 townships in remote areas and 3 townships in non-remote areas of Hualien County. The questionnaire gathered data about demographics, utilization of primary healthcare services, and the needs for medical care, preventive care, and health education services. A total of 573 valid questionnaires were retrieved for a response rate of 97%. In addition, 10 village heads of villages in remote/non-remote areas were invited to participate in qualitative interviews. Results: The results indicated that 49.3% of residents in remote areas thought that medical resources were inadequate, while only 16.6% of the residents in non-remote areas held the same opinion. Results also showed a need to strengthen various departments of healthcare services in villages and townships. Ophthalmology was the most needed medical service in remote areas, while family medicine was the most needed in non-remote areas. Mobile medical services were also needed for residents living in remote areas, while those living in non-remote areas emphasized a need for the reduction in payments for medical care. The qualitative in-depth interviews showed that the attitudes of village or neighborhood leaders were highly correlated with the availability of medical resources. Conclusions: Access to primary health care centers was similar in remote and non-remote areas; however, the residents in remote areas had a relatively lower level of satisfaction with health care services. We suggest that healthcare authorities consider specific service items and quality when determining the deployment of health care services in remote areas.
期刊論文
1.Arcury, Thomas A.、Gesler, Wilbert M.、Preisser, John S.、Sherman, Jill、Spencer, John、Perin, Jamie(2005)。The effects of geography and spatial behavior on health care utilization among the residents of a rural region。Health Services Research，40(1)，135-156。  new window
2.王雲東(20060700)。臺灣地區中老年與老年人醫療服務使用率的影響因素研究。健康城市學刊，4，141-163。  延伸查詢new window
3.Habicht, J.、Kunst, A. E.(2005)。Social Inequalities in Health Care Services Utilization after Eight Years of Health Care Reforms: A Cross-sectional Study of Estonia。Social Science & Medicine，60(4)，777-787。  new window
4.張麟生(20060300)。基層醫療診所的角色與功能。基層醫學，22(3)，99-104。  延伸查詢new window
5.王國羽(19970300)。我國心理衛生政策的回顧與檢討：決策菁英類型之分析。中華心理衛生學刊，10(1)，29-47。new window  延伸查詢new window
6.洪錦墩、葛梅貞、李卓倫、梁亞文(20040800)。影響原住民對巡迴醫療及保健服務利用之因素探討--以仁愛鄉為例。臺灣公共衛生雜誌，23(4)，324-333。new window  延伸查詢new window
7.張慈桂、李燕鳴(20051000)。花蓮地區青少女懷孕之家庭因素探討。臺灣公共衛生雜誌，24(5)，411-419。new window  延伸查詢new window
8.蔡文正、龔佩珍、楊志良、李亞欣、林思甄(20061000)。偏遠地區民眾就醫可近性及滿意度調查。臺灣公共衛生雜誌，25(5)，394-404。new window  延伸查詢new window
9.蔡文正、龔佩珍(20030600)。民眾對基層診所評價與就醫選擇影響因素。臺灣公共衛生雜誌，22(3)，181-193。new window  延伸查詢new window
10.Hu, S.C.、Yen, D.H.T.、Kao, W.F.(2002)。花蓮區緊急醫療救護之特徵及品質保證方法。慈濟醫學，14，27-33。  延伸查詢new window
11.Kirby, B.、Kaneda, T.(2005)。Neighborhood socioeconomic disadvantage and access to health care。J Health Soc Behav，46，15-31。  new window
12.Eberhardt, M.S.、Pamuk, E.P.(2004)。The importance of place of residence: examining health in rural and nonrural areas。Am J Publ Health，94，1682-1686。  new window
13.Strasser, R.(2003)。Rural health around the world: challenges and solutions。Family Pract.，20，457-463。  new window
14.Wang, F.、Luo, W.(2005)。Assessing spatial and nonspatial factors for healthcare access: towards an integrated approach to defining health professional shortage areas。Health & Place，11，131-146。  new window
15.McLaughlin, C.G.、Wyszewianski, L.(2002)。Access to care: remembering old lessons。Health Serv Res，37，1441-1443。  new window
16.Wong, S.T.、Regan, S.(2009)。Patient perspectives on primary health care in rural communities: effects of geography on access, continuity and efficiency。Rural Remote Health，9，1142。  new window
17.Campbell, N.C.、Elliott, A.M.、Sharp, L.、Ritchie, L.D.、Little, J.(2001)。Rural and urban differences in stage at diagnosis of colorectal and lung cancers。Br J Cancer，84，910-914。  new window
研究報告
1.胡杏佳、徐素萍、洪百薰、吳盛良、姚克明(1995)。山地離島地區民眾健康狀況調查與醫療需求研究。  延伸查詢new window
2.蕭正光、張慈桂、尤瑞鴻(1996)。全民健康保險偏遠地區民眾就醫可近性研究調查。臺北：行政院衛生署中央健康保險局。  延伸查詢new window
3.譚秀芬 / Tan, H.F.、曾泓富 / Tseng, H.F.(2001)。整合式醫療服務經營模式(IDS)對偏遠地區醫療利用影響之比較研究—以阿里山、大埔鄉、望安鄉、七美鄉為例。台北。  延伸查詢new window
4.Hurng, B.S.、Wu, M.Y.、Lo, S.Y.(1999)。台灣省山地鄉特殊醫療保健需求之研究。台北。  延伸查詢new window
5.Li, Y.H.、Yu, J.H.、Hsiang, C.M.(1998)。偏遠地區社區醫療保健計劃之評估─門諾醫院在花蓮的嘗試。台北。  延伸查詢new window
學位論文
1.趙怡惠(2003)。台灣地區山地鄉與非山地鄉嬰幼兒死亡率的差異研究(碩士論文)。國立臺灣大學。  延伸查詢new window
2.吳依凡(2004)。醫療資源可近性對個人醫療利用的影響--台灣地區的實證研究(碩士論文)。國立中央大學。  延伸查詢new window
3.楊慧娟 / Yang, H.C.(2005)。醫院與衛生所承辦巡迴醫療的成本效果與成本效益比較評估。中國醫藥大學，台中。  延伸查詢new window
圖書
1.Bradshaw, J.(1972)。“The Concept of Social Need.”。Neil and Specht. Clayton：Statesman & Nation。  new window
2.Putnam, Robert D.、Leonardi, Robert、Nanetti, Raffaella Y.(1993)。Making Democracy Work: Civic Traditions in Modern Italy。Princeton University Press。  new window
3.Jones, C. A.、Parker, T. S.、Ahearn, M.、Mishra, A. K.、Variyam, J. N.(2009)。Health Status and Health Care Access of Farm and Rural Populations。Washington, DC：US Department of Agriculture, Economic Research Service。  new window
其他
1.中華民國99年醫療機構現況及醫院醫療服務量統計年報，http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=11924&class_no=440&level_no=3， 20120410。  延伸查詢new window
2.花蓮縣醫療院所數及各類病床數、救護車輛數按地區別分，http://www.doh.gov.tw/cht2006/index_populace.aspx， 20120410。  延伸查詢new window
3.Huang, C.Y.，Chen, H.C.，Chang, L.Y.，Kuo, C.W.，Yang, C.H.，Liu, Y.C.。鄉村醫療資源之空間分析—以花蓮縣為例，http://210.62.247.10/history2/95tousheng-19.htm， 20111013。  new window
4.Hsieh, W.A.。花蓮縣健康城市白皮書初稿，http://thc.ttshb.gov.tw/upload/prog/花蓮健康白皮書.pdf， 20120215。  延伸查詢new window
5.2010衛生統計系列(一)死因統計，http://www.doh.gov.tw/statistic//EBOOK/2010/2010cod.rar， 20120410。  new window
6.Bureau of National Health Insurance, Department of Health, Executive Yuan, R.O.C.(1999)。全民健康保險山地離島地區醫療給付效益提昇計畫，台北。  延伸查詢new window
7.推動弱勢族群醫療照護計畫，http://ivhp.hohayan.net.tw/file/04188774.doc， 20120131。  延伸查詢new window
8.Research, Development and Evaluation Commission, Executive Yuan, R.O.C.(2002)。偏遠地區設置公共資訊服務站策略規劃報告，台北。  延伸查詢new window
9.健保特約醫事機構查詢，http://www.nhi.gov.tw/Query/query3.aspx?menu=20&menu_id=712&WD_ID=828， 20111127。  new window
10.花蓮縣人口統計月報，http://www1.hl.gov.tw/static/population/pop-index.htm， 20111013。  new window
11.內政統計通報，http://www.moi.gov.tw/stat/news_content.aspx?， 20110501。  new window
 
 
 
 
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