| Summary: | 碩士 === 國立臺灣大學 === 高階公共管理組 === 96 === Public health center (PHC) was ever an important health care and disease prevention primary institue in Taiwan. However as the social-economic developed and medical resources growth, PHC faced many different challenges. In comparison with the urban area, the function, role and competition of PHC in rural area became more and more important.
We selected six public health centers in mid-Taiwan county to evaluate their function, utilization and positioning. Furthermore we compared PHCs with other primary health care institues to examine the competition analysis. After purposive sampling, we enrolled the first 10 subjects who received services in each PHC (total 6 PHCs), on the first 2 weeks of May, 2008. Self-reported structure questionnaire included general characteristics, utilization, and satisfactions of PHC services were recoded. Competitive situation analysis was conducted to evaluate the performance on different health care institutes.
Totally 720 subjects (278 male, 38.6%, 442 female, 61.4%) were included, 321 utilized the PHC less than≦1 per month (55.2%). For the purpose of visiting PHC, about 55.1% subjects were seeking for general outpatient services. More than 80% subjects considered service attitude, medical expense, time consumption, location convenience, service content and safety were important or very important criteria for PHC services. Among these criteria, the most important factor for the primary health care institute is safety (93.5%).
In competitive situation and perception of positioning analyses, the advantages of PHC were low expense and location convenience. The related disadvantages for PHC were time consumption, service in complete, attitude unfriendly and unsafety. But the PHC still had the nearest distance to the ideal point among these health care institutes. Chinese medicine clinic, western medicine clinic and pharmacy were with the same competitive group in the perception map; however, the hospital was in the separate group. Similar results were found in different gender, age, average income or education level subjects.
The advantages for each PHC were varying, for example, Shalu and Da-an Township PHC, both had better service criteria scores than other medical care institutes, but only with the advantage of low expense. In Waipu Township PHC, low expenses, less time consumption and location convenience were advantages. In addition, location convenience was not only the advantage for public health center, but also for medical clinic and pharmacy. In comparison of these PHCs, Wuci Township PHC had better performances in all service criteria, the following was Cingshuei Township PHC. Da-an, Shalu and Da-jia Township PHCs had similar service criteria scores, but the Waipu Township PHC had the characteristics of service incomplete and unsafety.
Our study used competitive situation analysis and perception of positioning analysis to evaluate the health care satisfiction, performance and competition among different medical care institutes (including PHC) in Taiwan. These results may help us to make better decision, about improving service content, role positioning and primere goal of public health center on primary medical care in the future.
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