The Impact of Different Healthcare Provision on the Prison' Healthcare service

• Main Authors: CHEN.HSIU-LI, 陳秀麗
• Other Authors: 龔佩珍
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/78905329623343163937

碩士 === 臺中健康暨管理學院 === 健康管理研究所 === 93 === Abstract The purpose of this study was to investigate (1) prisoners’ satisfaction of health care quality provided by different correctional institutes and (2) the influenced factors associated with their satisfaction. Importance-Performance Analysis (IPA) was employed to investigate the health care services which needed to be improved urgently by correctional institutes. The study populations were the prisoners in nationwide correctional institutions in Taiwan. Correctional institutions were separated into five levels according to the types of health care services, scopes and regional distributions. Nine correctional institutions were selected using stratified random sampling method. A total of 1893 prisoners were included as the studied samples in this study. Among the six characteristics of health care services, “accessibility,” “comprehensiveness,” “appropriateness,” and “continuity” serviced were treated as the dimensions to evaluate health care quality. The descriptive statistics showed the prisoners’ characteristics; bivariate analysis explored the differences between prisoners’ satisfaction of different health care services and the percepts of their importance; linear multiple regression analysis was used to investigate the factors associated with the prisoners’ satisfaction of different types of health care services; finally, IPA was employed to find out the health care services which needed to be improved urgently. The results showed that the prisoners from different scopes of correctional institutions were significantly different in terms of the health care satisfaction and the percepts of their importance. Regression analysis indicated that the following factors had great impacts on prisoners’ satisfaction, such as (1) prisoners’ personal characteristics (age and education level), (2) health status (major/injured illness and chronics disease), (3) experiences of health care services (monthly expenditures of medication and monthly out-of-pocket fees for health care services), and (4) different health care services. In the light of difference types of health care services, the affiliation of hospitals had the greatest impact and followed by the percentage of out-of-pocket fees for health care services. In addition, the results of IPA analysis indicated that the top three health care services that the prisoners most satisfied with were “environmental hygiene,” “attitude/courtesy of hospital staffs,” and “attitude of physician’ consolations.” With respect to the percept of the importance of health care services, “the effect of medication,” “disease explanation,” and “the continuous trace of health care services provided by the correctional institutions” were prisoners’ primary concerns. Subjects also reported that the health care services which needed to be improved urgently were “the subsequent consultation provided by the correctional institutions after hospitalization” and “continuity.” Based on the result, this study provided the followings suggestions to the administration and fieldwork practice. The suggestions were (1) to establish the specific health care policy and responsibility for the provision of comprehensive health care service network, (2) to integrate health care resources for supporting the health care services between society and correctional institutions, and (3) to promote of the health care services model of Taichung prison Pei-te hospital. For the fieldwork application, the suggestions were (1) to build up prisoners’ medical history referred to the disease categories of Bureau of National Health Insurance (BNHI) dataset, (2) to establish the standard of medical expenditures specifically for out-of-pocket fees for medical services and medication, and (3) to reinforce of the continuity of prisoners’ health care services and to reach the goal of patient-focused health care services. Keyword : Correctional institution, Prisoner, Types of health care services, Quality of health care services, Satisfaction of health care, Importance - Performance Analysis