Tsai Meng-Che, Lin Sheng-Hsiang, Chou Yen-Yin, Lin Shio-Jean
Eur J Pediatr. 2014 Feb;173(2):187-96. doi: 10.1007/s00431-013-2117-1.
There have been few reports about adolescent experiences with and expectations of health service utilization in an Asian societal setting. The aim of this study is to analyze the use of healthcare services in relation to health status and explore adolescents' preferences for youth-friendly service among Taiwanese high school students. A cross-sectional questionnaire-based survey was conducted on Taiwanese adolescents aged 12–18 years in 2010.We invited participants to rate their health status, report their previous healthcare service use, and rank their health service preferences.We used logistic regression analysis to investigate the association between self-rated health status and healthcare utilization and used nonparametric analysis to compare health service preferences among sociodemographic subgroups. A total of 4,907 students (97.2 % response rate) returned valid questionnaires for analysis. Poor health status and chronic illness were most salient factors independently associated with frequent healthcare service use. Only 40 % of respondents reported having a regular doctor, and pediatrics (57.7 %) was the most commonly identified professional source of medical care. A great majority (86.2 %) of respondents made clinical visits with parents. For characteristics of youth-friendly clinician, the top-ranked items included competency and patience, while having helpful and friendly personnel was highlighted for clinical setting.
Family participation is critical in healthcare for adolescents in Asian cultures. Health service use is significantly influenced by health status and chronic illness in the general health insurance system. Understanding these background influences on expectations for healthcare may help to create youth-friendly health services that are more culturally appropriate.
在亚洲社会背景下，关于青少年使用医疗服务的经历和期望的报道很少。本研究的目的是分析与健康状况相关的医疗服务使用情况，并探讨台湾高中生对青少年友好型服务的偏好。2010年，我们对12至18岁的台湾青少年进行了一项基于问卷调查的横断面研究。我们邀请参与者对他们的健康状况进行评分，报告他们以前使用医疗服务的情况，并对他们的医疗服务偏好进行排序。我们使用逻辑回归分析来研究自我评估的健康状况与医疗服务利用之间的关联，并使用非参数分析来比较社会人口亚组之间的医疗服务偏好。共有4907名学生（回复率为97.2%）返回了有效问卷以供分析。健康状况不佳和慢性病是与频繁使用医疗服务独立相关的最显著因素。只有40%的受访者报告有固定的医生，儿科（57.7%）是最常被提及的医疗专业来源。绝大多数（86.2%）的受访者与父母一起进行临床就诊。对于青少年友好型临床医生的特点，排名靠前的项目包括能力和耐心，而临床环境方面则强调要有乐于助人且友好的工作人员。
在亚洲文化中，家庭参与对青少年的医疗保健至关重要。在全民健康保险体系中，健康状况和慢性病对医疗服务的使用有显著影响。了解这些背景因素对医疗保健期望的影响，可能有助于创建更符合文化背景、对青少年友好的医疗服务。
