偏遠地區民眾就醫可近性及滿意度調查

Accessibility to and Satisfaction with Healthcare by Rural Area Residents

蔡文正(Wen-Chen Tsai) ； 龔佩珍(Pei-Tseng Kung) ； 楊志良(Chin-Liang Yaung) ； 李亞欣(Ya-Hsin Li) ； 林思甄(Szu-Chen Lin)

《台灣公共衛生雜誌》 25卷5期 (2006/10) Pp. 394-404

https://doi.org/10.6288/TJPH2006-25-05-08

摘要

目標：為促進醫療資源分佈之均衡，近年來衛生署紛紛推動獎勵醫師人力進入偏遠地區服務之措施，本研究欲瞭解偏遠地區民眾醫療可近性與滿意度，並比較在獎勵計畫下有無醫師執業介入之鄉鎮其民眾之感受差異如何。方法：本研究以2002年至2004年衛生署公告之160個醫療資源缺乏鄉鎮，針對家戶以分層隨機比例抽樣方法，用結構式問卷透過電話訪問調查，包含就醫經驗、醫療可近性、就醫滿意度等資料，共計有效樣本519份。應用複迴歸統計分析，探討影響民眾對鄉鎮內之就醫滿意度之相關因素。結果：偏遠地區民眾對西醫、中醫與牙醫就醫表示「方便」者分別有90.29%、63.83%與81.81%，而有7.92%、25.53%與14.54%表示「不方便」。在西醫、中醫與牙醫之滿意度方面，分別有68.01%、25.82%及36.99%之民眾表示「滿意」。複迴歸分析發現，「鄉鎮內西醫門診時段之滿意度」、「與去年相比今年就醫方便性」、「擔心就醫即時性」會影響偏遠地區民眾之西醫滿意度；「鄉鎮內中醫門診時段滿意度」、「鄉鎮外中醫方便性」則影響中醫滿意度；而影響牙醫滿意度之因素為「鄉鎮內牙醫師語言溝通能力滿意度」、「與去年比較今年就醫方便性」、「有無定期就醫之需求」。結論：有六成以上偏遠地區民眾表示就醫方便，說明了偏遠地區民眾就醫情況比獎勵計畫前有所改善。

關鍵字

偏遠地區 ； 就醫可近性 ； 就醫滿意度

並列摘要

Objective: In order to balance the distribution of healthcare resources, the public health office has proposed a policy encouraging physicians to offer healthcare services in rural areas. Accordingly, we have explored the accessibility to and satisfaction with healthcare by rural area residents. We also compared the differences in patients' experiences with and without the physician's practice under the encouragement program. Methods: The residents were chosen from 160 townships, which were defined as lacking physicians or dentists by the Department of Health between 2002 and 2004. After using a stratified proportional sampling method for households, the healthcare experience, accessibility, and satisfaction by rural area residents were investigated by telephone interview. A total of 519 samples were collected. Multiple regression analysis was used to examine the factors associated with healthcare satisfaction for the rural area residents. Results: With respect to accessibility, 90.29%, 63.83%, and 81.81% of rural residents considered their visits to physicians, Chinese medicine physicians, and dentists to be convenient, respectively. In contrast, 7.92%, 25.53%, and 14.54% of the residents considered their respective visits inconvenient. Of the sample, 68.01%, 25.82%, and 36.99% of the residents expressed satisfaction with the services of Western medicine, Chinese medicine, and dental care, respectively. A multiple regression model indicated that 'satisfaction in the outpatient schedule,' 'improving the convenience of seeking medical care,' and 'worrying about getting medical services in time,' affected the satisfaction with Western medical services. 'Satisfaction in the outpatient schedule' and 'seeking Chinese medical care outside of town' determined the satisfaction with Chinese medical services. The satisfaction of dental care was most influenced by 'satisfaction with the dentist's ability to communicate' and 'improving the convenience of seeking medical care.' Conclusions: Greater than 60% of rural residents felt it was convenient to visit physicians. The accessibility to and satisfaction with medical services have been improved in rural areas as a result of the physician encouragement program.

並列關鍵字

Rural Area ； Accessibility ； Healthcare Satisfaction