全民健康保險於民國84年3月1日起開始實施,本著「預防勝於治療」、「早期發現早期治療」的保健精神,自民國八十五年逐步實施四項預防保健服務:婦女子宮頸抹片檢查、孕婦產前檢查、兒童健康檢查及成人健康檢查。然而預防保健服務實施給付以來,調查預防保健服務的利用率或滿意度的研究仍在少數。因此本文以大高雄地區三家醫學中心以系統隨機抽樣選取294名門診病人,探討民眾對四項預防醫療保健服務的利用情形、民眾預防保健行為的利用與求醫行為的相關性、民眾未利用預防保健服務的原因、了解民眾對預防保健知識的獲得來源管道、以及民眾對於預防保健的服務滿意度。研究結果發現第一、大高雄地區三家醫學中心的四項健康檢查除在利用率並無顯著差異。除子宮頸抹片檢查外,三家醫院在其餘三項檢查的滿意度並無顯著差異。第二、民眾預防保健行為的利用與求醫行為的相關性並無顯著相關。第三、私立的醫院在健康檢查的利用率及滿意度大致高於公立醫院。第四、醫學中心門診病人之子宮頸抹片篩檢率為33.3%至55.6%。成人健康檢查受檢率為35.8%至50%。第五、門診病人未作檢查的原因主要為不知全民健康有給付、沒有時間、不知道去那裡做。第六、門診病人預防保健資訊來源主要為醫院或衛生所衛教訊息、媒體廣告及親友介紹。第七、四項健康檢查的受檢者大致上都願意將該項預防保健的訊息告知親友。
This paper investigates the utilization level of four preventive services by out patients in Kao-Hsiung area under Taiwan National Health Insurance. These four preventive services include children's preventive service, prenatal checkups, Pap smear, and adult preventive service. The study results indicate that (1) except for the Pap smear, there is no significant difference of the utilization of preventive service among three medical centers in Kao-Hsiung areas, (2) The satisfaction toward preventive services of private hospital is significantly higher than the public hospital. (3) The utilization rates for Pap smear are from 33.3% to 55.6%. The utilization rates for adult preventive service ranges from 35.8% to 50%. (4) The causes that out patient did not utilize the preventive services are as follow, don't know it is free, they are busy, and they don't know where to use the service. (5) All the out patients have used the preventive service are willing to tell the message to their family member or friends.