Accessibility Assessment of the Health Care Improvement Program in Rural Taiwan

Autor/inn/en	Tan, Hsiu-Fen; Tseng, Hung-Fu; Chang, Chen-Kang; Lin, Wender; Hsiao, Shih-Huai
Titel	Accessibility Assessment of the Health Care Improvement Program in Rural Taiwan
Quelle	In: Journal of Rural Health, 21 (2005) 4, S.372-377 (6 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2005.tb00110.x
Schlagwörter	Foreign Countries; Access to Health Care; Improvement Programs; Longitudinal Studies; Medical Care Evaluation; Program Effectiveness; Satisfaction; Interviews; Medical Services; Rural Areas; Patients; Taiwan + Suchen Sie Ihr Suchwort? Ausland; Effizienzsteigerung; Longitudinal study; Longitudinal method; Longitudinal methods; Längsschnittuntersuchung; Zufriedenheit; Interviewing; Interviewtechnik; Arzt; Rural area; Ländlicher Raum; Patient
Abstract	Context: An experimental Health Care Improvement Program (HCIP) was initiated by the Bureau of National Health Insurance in 1997 to improve the accessibility of health care in several rural, mountainous districts. Purpose: This longitudinal study evaluated service availability, utilization patterns, and effectiveness of services under the HCIP in the A-Li Mountain District. Methods: Outpatient claims made by residents in the A-Li Mountain District were extracted from the database of the National Health Insurance program. Changes in utilization pattern and volume were analyzed. Satisfaction levels were assessed by 2-stage face-to-face interviews with local residents. Findings: After the HCIP, the average population served by each doctor decreased 75%, and total outpatient visits increased 15.4%. The total number of in-district outpatient visits increased 83.6%. The proportion of in-district outpatient visits to all visits increased from 22.1% to 35.1%. The total in-district outpatient visit fee claimed increased 100.2%, and the total out-of-district outpatient visit fee claimed increased only 7.2%. About 60.4% of the residents were not satisfied with overall health care services before the HCIP. The proportion decreased to 32.4% after the HCIP. Conclusions: The HCIP improved accessibility, enriched local medical care resources, changed the utilization pattern of some residents, and increased residents' satisfaction level. A well-managed program with stabilized financial resources is more likely to succeed if it also respects cultural differences and responds to community needs. (Author).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10