Factors Associated with Consumer''s Choice Between Hospital Outpatient Departments and Clinics.

• Main Authors: CHAIN, MEI-FANG, 錢梅芳
• Other Authors: S.H. CHENG
• Format: Others
• Language: zh-TW
• Published: 1997
• Online Access: http://ndltd.ncl.edu.tw/handle/3arxt6

碩士 === 國立臺灣大學 === 公共衛生學系 === 85 === AbstractThe hierarchy of medical services may help patient to obtain complete and continual health cares, improve the health of nation, distribute the medical resources more efficiently, and strengthen medical cost contral. The policy of hierarchical service has been implemented for many years in Taiwan, but the performance is still unsatisfactory . Until now, skipping grades in seeking outpatient service is very common. The skipping grades of outpatient visits increase medical cost and misdistribute medical resources. The implementation of National Health Insurance has reduced the price among the tree level of medial facility(primary, secondary and tertiary), and it might encourage the skipping grades of outpatient, and increase the medical cost. It''s not a preferable result.In order to control the situation of skipping grades, we should first identify the influent factors of consumers'' choice of medical facility, that is one of the purposes of this study. The other purpose of this study is to examine whether NHI changes the market share between the hospital outpatient services and clinic services.Two parts of data were used in this study. In first part, data come from 1994 National Health Interview Survey in Taiwan 1994. The data used in the second part of this study come from 1994 NHIS and a follow-up study of 1994 NHIS in 1996.Persons with higher education, social insurance, worse perceived health status, more often fell sick in two weeks, more seriously disabled in two weeks, with chronic disease, living in an area with regional hospital or hospital-center tend to use the outpatient department of hospital. Comparing the market share before and after the NHI, there is no difference between hospitals and clinics outpatient service. However the patient''s structure has changed both in clinics and hospitals. Persons who is male, workless , with bad health status, with chronic disease, with long traffic and waiting time tend to change from clinic to hospital. On the other hand, person without chronic disease and with shorter waiting time tend to change from hospital to clinic. The government should encourage people using clinics instead of using hospital outpatient departments especially for chronic patients. Although we can hardly find the influence of NHI on patients choice of clinic or hospital outpatient department, but we should keep an eye on what''s going on and to understand the long term effect of NHI on the market share of clinics and hospital outpatient departments.