Utilization of well-baby care visits provided by Taiwan's National Health Insurance Program
Utilization of well-baby care visits provided by Taiwan's National Health Insurance Program
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DOI：
10.1016/j.socscimed.2004.02.008
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发表时间：
2004-10-01
影响因子：
5.4
通讯作者：
Yeh, CL
中科院分区：
文献类型：
--
作者：
Chen, LW;Yang, WS;Yeh, CL
1995年4月，台湾的国民健康保险计划开始为每个符合条件的儿童提供总共六次健康婴儿护理。前四个是婴儿期，第五个是第二和第三岁，第六个是第四年。这些服务是在新生儿筛查和一系列初级免疫之外提供的，这些服务多年来一直由公共资助并按常规使用。本研究的目的是调查这些健康护理访视的利用程度，并探讨相关因素。结果显示，在20世纪90年代末，36%符合条件的儿童没有使用前四次访问中的任何一次，58%没有使用第五次访问，82%没有使用第六次访问。看来对这些服务的接受程度远不能令人满意。产妇对这些服务的认识和态度似乎是影响利用的最重要因素。这两个因素不仅影响最大，而且在很大程度上导致了不同地区和不同类型住宅区之间的利用差异。因此，它们应该成为促进婴儿保健的干预措施的重点。虽然这两个因素是在个人层面，但它们并不是独立于医疗保健系统的，因为医疗保健系统对个人因素有影响。鉴于医师可作为教育家长相关资讯及正确态度的良好工具，且台湾医师大多对收费机制有不满，因此强化医师推广此类服务的诱因，可能有助于提高婴儿健康照护的利用率。(C) 2004 Elsevier Ltd.版权所有。
In April of 1995, Taiwan's National Health Insurance Program started providing each eligible child a total of six well-baby care visits. The first four are for infancy, the fifth is for the second and the third years of life, and the sixth is for the fourth year. These services are in addition to neonatal screening and a series of primary immunizations that have been publicly financed and utilized conventionally for years. The purposes of this study were to investigate the utilization level of these well-baby care visits, and explore relevant factors. The results reveal that 36% of eligible children did not use any of the first four visits, 58% did not utilize the fifth, and 82% did not use the sixth in the late 1990s. It appears that the take-up of these services is much less than satisfactory. Maternal awareness of and attitudes toward the services appeared to be the most important factors influencing utilization. These two factors not only were most influential, but also significantly contributed to disparities in utilization among different regions and types of residential districts. As a result, they should be the focus of interventions for advancing well-baby care. While these two factors are at the individual level, they are not independent from the health care system because the health care system has impacts on individual factors. Since physicians can serve as a good vehicle for teaching parents about relevant information and correct attitudes, and most physicians in Taiwan complained about the payment scheme, offering stronger incentives for physicians to promote such services might be helpful for achieving a high utilization level of well-baby care. (C) 2004 Elsevier Ltd. All rights reserved.