全民健保兒童健檢服務施行初期評估

A Preliminary Report of Children's Physical Examinations in the National Health Insurance

黃月桂(Yueh-Guey Huang) ； 林勤豐(Chin-Feng Lin)

《中華公共衛生雜誌》 18卷2期 (1999/04) Pp. 116-122

https://doi.org/10.6288/CJPH1999-18-02-05

摘要

為了解全民健保兒童健檢服務的使用情形，本研究於1996年5月至7月間使用結構性問卷，依醫療院所之評鑑等級，比例隨機抽出醫療院所訪問5歲以下受檢兒童之家長，共訪問863位，其內容包含社經地位、小孩看診次數及滿意度。另外並參酌受檢「兒童健康手冊」之紀錄資料，以了解全民健康保險兒童健檢的服務內容。在有效的837份問卷中，有63%的小孩接受1-2次的服務，平均看診時間為5-10分鍾，約有60%的父母並無接受衛生教育。但滿意度在5分左右（總分7分）。父親學歷越高者，對兒童健檢服務滿意度之要求越高。對於兒童健檢之提供之選擇主要以方便性和熟悉度為考量。本次研究發現，兒童健檢的利用率偏低，滿意度方面尚可。故中央健保局在兒童預防保健政策改善方面應著重於父母和提供者之間的溝通。

關鍵字

兒童健康檢查 ； 利用率 ； 滿意度

並列摘要

A survey of parental satisfaction was conducted to determine also frequency and factors associated with the use of Children's Physical Examination (CPE), National Health Insurance Program for children under the age of five years. Medical facilities with pediatric care were stratified according to accreditation level and randomly selected into the sample pool. Parents (n=863) were interviewed at the waiting areas of pediatric clinics by public health students. The interview covered parents' social demographic status, number of children's visits at the clinics and satisfaction of care provided. The CPE information specified in ”children's health handbook” was also extracted for the analyses of examination domains. Data analysis was based on questionnaires with complete information (n=837). Most children (63%) received CPE service for once or twice, compared to the recommended 6 times by the age of five. The average time spent in each service by a physician was 5-10 minutes. Approximately 60% of the parents received no health education. However, the average satisfaction score was 5 in a scale of 7. The education level of fathers was negatively correlated with the satisfaction score. Convenience and familiarity with a specific clinic were considered in the selection of CPE providers. Besides, many clinicians complained about the insufficient reimbursement. In conclusion, the CPE utilization rates were lower than the designated estimates, even though parental satisfaction level was above average. Effective strategies that focus on the promotion of CPE should be communicated to parents and care providers.

並列關鍵字

children's physical exam ； utilization rate ； satisfaction