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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: 2017-08-31 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 連結: http://dx.doi.org/10.1016/j.pedneo.2016.07.008
    DOI: 10.1016/j.pedneo.2016.07.008
    顯示於類別:[財政學系] 期刊論文

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