南臺灣偏遠地區中醫醫療服務滿意度及病患就診特性之研究

目的：探討南部某醫學中心在南台灣的偏遠地區設置的醫療照護服務中心，中醫就醫民眾的罹患疾病趨向，醫療的運用狀況，以及對治療的滿意和接受度。方法：本研究以南部某醫學中心長照計畫之結案報告資料為主體，為二次資料分析。選取民國101年1月至12月於南台灣的某一偏遠地區定點，在提供每週兩診的中醫針灸治療下，中醫門診就醫民眾的病歷資料和問卷滿意度調查進行分析。結果：研究地區中醫使用的男女性別比為4：6，就診人次每月每診平均約27.3人；病患的年紀則多分佈於50-80歲，60歲以上的人次佔初診人數的52.3%。就醫的疾病種類以「骨關節和軟組織疾患」所造成的慢性疼痛為主，病痛部位以腰背和肩關節佔多數。一年的中醫針灸治療中，回診人次以1-10次最多，回診的男女性別比則為3:7。病患對治療的手法和醫師的滿意度皆有9成以上，對治療前後身體的滿意度則有74.8%。結論：中醫在南台灣偏遠地區民眾的利用率和治療滿意度頗高，尤其是對於飽受慢性疼痛所困擾的老人。若能強化服務效能、治療的多元性和成效，則中醫在偏鄉醫療照護的推廣和運用將更值得期待。

關鍵字

偏遠地區；醫療照護；中醫；針灸

並列摘要

Background: To explore the acceptance of traditional Chinese medicine (TCM) in rural areas, we have explored the commonly encountered diseases, the use of healthcare resource, and the satisfaction at a fixed Chinese medical service by rural area residents. Methods: This study investigated service utilization patterns in usage of TCM among rural residents in AD 2012. It was analyzed secondary from a healthcare project of Medical Center Hospital in rural areas. Results: There was average 27.3 patients visit TCM service monthly, gender (male and female) ratio 4:6 and the age was 67 to 74 years old. There were 52.3% of the residents who elder than 60 years old. The most common diseases that residents had been managed were chronic pain related to osteoarthropathy and soft tissue diseases, especially located around back and shoulder. The frequency of every resident back to TCM service was 7.94 in one year. The satisfaction of TCM practitioners and their skills were up to nine-tenths. 74.8% of patients felt their physical condition was improving after seeking the TCM care. Conclusion: Most rural residents felt the TCM was convenient, especially for elder with chronic pain. Therefore, how TCM might be used to care for the future aging population will be an important topic for health policy planning and health services research in Taiwan.

並列關鍵字

Rural area ； healthcare ； traditional Chinese medicine ； acupuncture

參考文獻

蔡文正、龔佩珍、楊志良、李亞欣、林思甄(2006)。偏遠地區民眾就醫可近性及滿意度調查。台灣衛誌。25，394-404。

洪錦墩、葛梅貞、李卓倫、梁亞文(2004)。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。台灣衛誌。23，324-333。

鄭宇真、胡文龍、蔡明諺、黃升騰、陳志文、洪裕強(2014)。南部某醫學中心中醫常見疾病與處方用藥探討。中醫藥雜誌。25，83-96。

行政院衛生署國民健康局，老人健康促進計畫：http://www.hpa.gov.tw/BHPNet/Portal/File/ThemeDocFile/201110210145126095/980327%E8%80%81%E4%BA%BA%E8%A8%88%E7%95%AB(%E6%A0%B8%E5%AE%9A%E7%89%88).pdf