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題名 No gynecologist in town: the gynecological care of women in rural Taiwan 作者 Chou, Li-Fang
周麗芳貢獻者 財政學系 日期 2015 上傳時間 23-Oct-2015 17:20:19 (UTC+8) 摘要 Background: A shortage of gynecologists exists in many countries. Even within an affluent country, gynecological clinics might not be evenly distributed. The purpose of the study was to investigate the disparity in gynecological care between adult women living in towns with and without gynecologists in Taiwan. Methods: Data sources were the cohort datasets of the National Health Insurance Research Database, with claims data of 1 million beneficiaries in 2010. A woman`s residency was operationally inferred from the locations where she had most frequently visited physicians` clinics or local community hospitals within the year. Results: In Taiwan, 145 (39.4%) of 368 towns had no practicing gynecologist. Of 382,167 women with health care use in the datasets, 21,794 (5.7%) lived in towns without a gynecologist. The overwhelming majority of these towns lay in sparsely populated, rural areas. During the year, 132,702 women (34.7%) had sought medical help for gynecological diseases and 113,698 (29.8%) had visited gynecologists for gynecological diseases. Women in towns without a gynecologist were less likely to consult for gynecological diseases (23.8% versus 35.4%; P<0.001) and visit gynecologists (18.7% versus 30.4%; P<0.001) than women in towns with a gynecologist. The disparity existed in each age group. Among 5,189 adult women living in towns without a gynecologist and having gynecological diseases, 78.5% (number [n]=4,074) visited gynecologists out of town, especially for infertility, benign disorders of the uterus and ovaries, gynecological examinations, and contraceptive problems, and by contrast 23.3% (n=1,209) visited nongynecologists in town, most commonly for menopausal disorders, endometriosis and pelvic pain, menstrual disorders and hormonal dysfunction, and genital dysplasia. Conclusion: Gynecological care of rural women was adversely affected by the shortage of gynecologists. The consequences of accessibility in underserved areas deserve further investigation. 關聯 Patient Preference and Adherence 2015, 1077-1083 資料類型 article DOI http://dx.doi.org/10.2147/PPA.S64731 dc.contributor 財政學系 - dc.creator (作者) Chou, Li-Fang - dc.creator (作者) 周麗芳 - dc.date (日期) 2015 - dc.date.accessioned 23-Oct-2015 17:20:19 (UTC+8) - dc.date.available 23-Oct-2015 17:20:19 (UTC+8) - dc.date.issued (上傳時間) 23-Oct-2015 17:20:19 (UTC+8) - dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/79019 - dc.description.abstract (摘要) Background: A shortage of gynecologists exists in many countries. Even within an affluent country, gynecological clinics might not be evenly distributed. The purpose of the study was to investigate the disparity in gynecological care between adult women living in towns with and without gynecologists in Taiwan. Methods: Data sources were the cohort datasets of the National Health Insurance Research Database, with claims data of 1 million beneficiaries in 2010. A woman`s residency was operationally inferred from the locations where she had most frequently visited physicians` clinics or local community hospitals within the year. Results: In Taiwan, 145 (39.4%) of 368 towns had no practicing gynecologist. Of 382,167 women with health care use in the datasets, 21,794 (5.7%) lived in towns without a gynecologist. The overwhelming majority of these towns lay in sparsely populated, rural areas. During the year, 132,702 women (34.7%) had sought medical help for gynecological diseases and 113,698 (29.8%) had visited gynecologists for gynecological diseases. Women in towns without a gynecologist were less likely to consult for gynecological diseases (23.8% versus 35.4%; P<0.001) and visit gynecologists (18.7% versus 30.4%; P<0.001) than women in towns with a gynecologist. The disparity existed in each age group. Among 5,189 adult women living in towns without a gynecologist and having gynecological diseases, 78.5% (number [n]=4,074) visited gynecologists out of town, especially for infertility, benign disorders of the uterus and ovaries, gynecological examinations, and contraceptive problems, and by contrast 23.3% (n=1,209) visited nongynecologists in town, most commonly for menopausal disorders, endometriosis and pelvic pain, menstrual disorders and hormonal dysfunction, and genital dysplasia. Conclusion: Gynecological care of rural women was adversely affected by the shortage of gynecologists. The consequences of accessibility in underserved areas deserve further investigation. - dc.format.extent 205387 bytes - dc.format.mimetype application/pdf - dc.relation (關聯) Patient Preference and Adherence 2015, 1077-1083 - dc.title (題名) No gynecologist in town: the gynecological care of women in rural Taiwan - dc.type (資料類型) article en dc.identifier.doi (DOI) 10.2147/PPA.S64731 - dc.doi.uri (DOI) http://dx.doi.org/10.2147/PPA.S64731 -
