Physicians’ Evaluation of Adult Health Examination Provided by National Health Insurance

• Main Authors: Fang-Mien Tsai, 蔡芳綿
• Other Authors: Wen-Chen Tsai
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/70507883865963366658

碩士 === 中國醫藥大學 === 醫務管理學研究所 === 96 === Objectives: Adult health examination provides free physical examinations to people over 40 years old. The service can identify popular diseases and help its treatment earlier to prevent further aggravation. Adult health examination has been operating for over ten years, however, no research has evaluated its content of service yet. The purpose of this study is to examine the adequacy of adult health services and analyze the factors that may affect physician’s attitude towards service benefits to the public, through physician’s opinions. Methods: This cross-sectional research used a structured questionnaire as research instrument. The studied subjects included clinic physicians (4630) and hospital physicians in department of family medicine (615). Questionnaires were mailed to all clinics and hospitals which provided adult health examination service. A total of 168 effective questionnaires has received from hospital physicians and 955 from clinic physicians. Descriptive analysis and Chi-square test were used to investigate the differences between clinic physicians and hospital physicians in their opinions for adult health examination. Multiple regression analysis was conducted to explore the relative factors that influenced physicians’ perception for benefits of adult health examination to the public. Results：Overall, most physicians thought that the content of adult health examination was appropriate and that the report needs to be modified. For instance, the physicians suggested adding the examinations for waist, HDL, HBs Ag, Anti-HBsAb, Anti-HCV and removing the consultation for driving or riding. About 25% of hospital physicians and 40% of clinic physicians suggested reducing the age of starting to receive the examination. 50% of hospital physicians and 70% of clinic physicians suggested increasing examination frequency. About 40% of physicians were not satisfied with the first-stage reimbursement which was 300 NTD and about 50% of physicians were not satisfied with the second-stage reimbursement, 220 NTD. Over 80% of physicians thought that the quality of adult health examination was good whereas clinical breast examination (CBE) and rectal digital examination were not good. Over 90% of physicians thought adult health examination was beneficial to the public. The factors affecting physicians’ perception of adult health examination for its benefits to people were compliance with physician''s order, hospital’ support for adult health examination, physician’ evaluation about quality of adult health examination, and accuracy of examination. Conclusion and suggestions：Most physicians thought adult health examination was helpful for people and its quality was good, however, some examinations were not practicing well. The content of adult health examination should be amended slightly. The present study suggested: (1)reappraising the age of examination and examination frequency; (2)amending the content of adult health examination; (3)reevaluating the reimbursement to understand the cost-effectiveness of adult health examination; (4)enhancing the practices of CBE and rectal digital examination; and (5)strengthening to educate the public, physicians, and health care organizations the significance of adult health examination.