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題名 Urban-Rural Disparity in Geographical and Temporal Availability of Pediatric Clinics: A Nationwide Survey in Taiwan
作者 周麗芳
Leu, Hsin I.
Chang, Wei Ting
Lin, Ming Hwai
Chen, Tzeng Ji
Hwang, Shinn Jang
Chou, Li Fang
Jeng, Mei Jy
貢獻者 財政系
關鍵詞 child; child care; human; major clinical study; national health insurance; outpatient department; pediatric hospital; pediatrician; pediatrics; rural area; rural health care; Taiwan; urbanization
日期 2017-08
上傳時間 31-Aug-2017 13:47:39 (UTC+8)
摘要 Background: The shortage and maldistribution of pediatricians affected after-hours pediatric services, especially in rural areas. Our study aimed to examine the urban-rural disparity in geographical and temporal availability of the pediatrician workforce in Taiwan by analyzing opening time schedules of all pediatric clinics throughout the country. Methods: The opening time schedules of nonhospital pediatric clinics were downloaded from the website of the National Health Insurance Administration in Taiwan for analysis. The geographical and temporal availability of pediatric clinics was calculated and stratified by urbanization level and opening time, which was divided into daytime and evening sessions over 1 week. Each of 368 towns in Taiwan was also regarded as a unit of measurement to estimate the local availability of at least one pediatric clinic open in after-hours sessions. Results: Among 1483 nonhospital pediatric clinics in Taiwan, the overwhelming majority were situated in urban (65.8%) and suburban (30.6%) areas. On average, a pediatric clinic provided 16.3 (standard deviation = 3.04) sessions of services per week. One-third (34.7%, n = 50) of 144 suburban towns and over three-fourths (77.4%, n = 120) of 155 rural towns had no pediatric clinic. Most pediatric clinics remained open on weekday evenings (91.1%) and during Saturday daytime (91.8%). The percentage of open clinics gradually decreased over the weekend: Saturday evening (58.1%), Sunday daytime (33.4%), and Sunday evening (19.4%). Rural pediatric clinics remained closed mostly on weekends. On Sunday evenings, pediatric clinics were open only in 5.2% of rural towns, with a decline of 77.1%, whereas they were open in 78.3% of urban towns, with a decline of 18.2%. Conclusion: Pediatric clinics in Taiwan were unevenly distributed between urban and rural areas. The disparity of pediatric services became more obvious at weekends. The consequences of undersupplied rural pediatric care deserve further investigation.
關聯 Pediatrics and Neonatology, 58(4), 344-349
資料類型 article
DOI http://dx.doi.org/10.1016/j.pedneo.2016.07.008
dc.contributor 財政系zh_TW
dc.creator (作者) 周麗芳zh_TW
dc.creator (作者) Leu, Hsin I.en_US
dc.creator (作者) Chang, Wei Tingen_US
dc.creator (作者) Lin, Ming Hwaien_US
dc.creator (作者) Chen, Tzeng Jien_US
dc.creator (作者) Hwang, Shinn Jangen_US
dc.creator (作者) Chou, Li Fangen_US
dc.creator (作者) Jeng, Mei Jyen_US
dc.date (日期) 2017-08
dc.date.accessioned 31-Aug-2017 13:47:39 (UTC+8)-
dc.date.available 31-Aug-2017 13:47:39 (UTC+8)-
dc.date.issued (上傳時間) 31-Aug-2017 13:47:39 (UTC+8)-
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/112440-
dc.description.abstract (摘要) Background: The shortage and maldistribution of pediatricians affected after-hours pediatric services, especially in rural areas. Our study aimed to examine the urban-rural disparity in geographical and temporal availability of the pediatrician workforce in Taiwan by analyzing opening time schedules of all pediatric clinics throughout the country. Methods: The opening time schedules of nonhospital pediatric clinics were downloaded from the website of the National Health Insurance Administration in Taiwan for analysis. The geographical and temporal availability of pediatric clinics was calculated and stratified by urbanization level and opening time, which was divided into daytime and evening sessions over 1 week. Each of 368 towns in Taiwan was also regarded as a unit of measurement to estimate the local availability of at least one pediatric clinic open in after-hours sessions. Results: Among 1483 nonhospital pediatric clinics in Taiwan, the overwhelming majority were situated in urban (65.8%) and suburban (30.6%) areas. On average, a pediatric clinic provided 16.3 (standard deviation = 3.04) sessions of services per week. One-third (34.7%, n = 50) of 144 suburban towns and over three-fourths (77.4%, n = 120) of 155 rural towns had no pediatric clinic. Most pediatric clinics remained open on weekday evenings (91.1%) and during Saturday daytime (91.8%). The percentage of open clinics gradually decreased over the weekend: Saturday evening (58.1%), Sunday daytime (33.4%), and Sunday evening (19.4%). Rural pediatric clinics remained closed mostly on weekends. On Sunday evenings, pediatric clinics were open only in 5.2% of rural towns, with a decline of 77.1%, whereas they were open in 78.3% of urban towns, with a decline of 18.2%. Conclusion: Pediatric clinics in Taiwan were unevenly distributed between urban and rural areas. The disparity of pediatric services became more obvious at weekends. The consequences of undersupplied rural pediatric care deserve further investigation.en_US
dc.format.extent 333248 bytes-
dc.format.mimetype application/pdf-
dc.relation (關聯) Pediatrics and Neonatology, 58(4), 344-349en_US
dc.subject (關鍵詞) child; child care; human; major clinical study; national health insurance; outpatient department; pediatric hospital; pediatrician; pediatrics; rural area; rural health care; Taiwan; urbanizationen_US
dc.title (題名) Urban-Rural Disparity in Geographical and Temporal Availability of Pediatric Clinics: A Nationwide Survey in Taiwanen_US
dc.type (資料類型) article
dc.identifier.doi (DOI) 10.1016/j.pedneo.2016.07.008
dc.doi.uri (DOI) http://dx.doi.org/10.1016/j.pedneo.2016.07.008