Utilization and Provider Choice in Maternal and Child Health Care in Hsintien City: A Review of the Role of the Health Station

新店市婦幼衛生服務使用與供給者選擇之研究：衛生所角色之重探

季瑋珠(Wei-Chu Chie) ； 符春花(Chun-Hua Fu)

《中華公共衛生雜誌》 14卷3期 (1995/06) Pp. 237-245

https://doi.org/10.6288/CJPH1995-14-03-04

摘要

本研究以按人口比例機率抽樣法，自台北縣新店市13至16個月大之嬰兒1102人中，抽得320人為研究對象，由8名經過訓練之訪員於1990年9月對其母親進行家庭訪視，以瞭解該市母親與嬰兒接受婦幼衛生服務情況及供給者的選擇。總共有222人完成訪視。結果發現：產前檢查，產後檢查，與目前避孕的比率分別為99.1%，78.8%與77.0%，但孕期中子宮頸抹片接受比率僅31.1%。新生兒先天代謝異常篩檢比率為81.5%，健兒門診檢查實施比率為77.9%。一歲內各類疫苗的預防接種率均在90%以上。幾乎所有的孕產婦照顧都由醫院或診所提供；嬰兒保健照顧方面，衛生所使用的比例隨嬰兒月齡而上升：無一新生兒代謝異常篩檢在衛生所進行，一個月內的預防接種只有30%由衛生所提供，一個月以上的頂防接種則高達70%以上由衛生所提供。逐步複迴歸分析顯示：完成接種嬰兒使用衛生所總次數與母親對衛生所的瞭解程度，衛生所地點的可近性，以及要求服務便宜或免費的程度呈正相關，與要求服務態度良好及同時提供接生服務的程度呈負相關，依變項的變異量有38.7%可被此模型解釋。根據本研究的結果，吾人建議類似研究社區之都會區衛星城市，應重新評估衛生所的角色，並重組各個可用資源，建立整合性的婦幼衛生照顧體系。

關鍵字

婦幼衛生 ； 衛生所

並列摘要

A probability proportional to size (PPS) sample of 320 infants was drawn from 1102 infants between 13 and 16 months of age from the city of Hsintien, a satellite city of Taipei. Home visits and questionnaire interviews were conducted for all of the mothers by eight trained interviewers in September, 1990. Utilization and provider choice of maternal and child health care of these infants were investigated. Most of the mothers had had prenatal care and postnatal care and were currently using contraceptive methods, the rates were 99.1%, 78.8%, and 77.0% respectively. Only 31.1% had had Pap smears in the past year. In all, 81.5% of the infants had had neonatal screening, and 77.9% had had well baby examinations. The rate for completion of all immunizations before one year of age exceeded 90%. Almost all maternal care was provided in hospitals or clinics. Health stations were used more often for infant care, and usage increased as the baby grew older. None of the neonatal screening was provided in health stations. About 30% of the immunizations within one month and over 70% of the immunizations after one month were given in health stations. Stepwise multiple regression analysis shows that total use of health stations by completely immunized babies was positively related to the understanding of health stations, accessibility, and the need for cheap or free care, while being negatively related to requirements of good attitude and of attending delivery. The authors suggest a review the role of health stations and thedevelopement of an integrated health care system to organize all possible resources.

並列關鍵字

Maternal and child health ； health station