Dai Ying-Xiu, Chen Tzeng-Ji, Chang Yun-Ting
Department of Family Medicine and Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; and School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; and School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
Rural Remote Health. 2018 Aug;18(3):4730. doi: 10.22605/RRH4730. Epub 2018 Aug 31.
Shortages and maldistribution of dermatology services have negative impacts on the quality of care for patients with skin problems. Only a limited amount of literature is available regarding the current state of dermatologic services in Taiwan. The aim of this study was to examine the urban-rural distribution of dermatologists and office-based dermatology services in Taiwan.
Data regarding dermatology workforce and their geographic distribution were collected from the Taiwan Medical Association, Taiwan Dermatological Association, and Department of Household Registration, Ministry of the Interior, while data on the locations and opening hours of dermatologic clinics were sourced from the National Health Insurance Administration. The locations and opening times of dermatologic clinics were stratified by urbanisation levels.
There were 4.27 dermatologists per 100 000 persons in Taiwan. Taipei City was the most dermatologist-dense area (9.61 dermatologists per 100 000 people), while Lienchiang County had no dermatologists at all. Among the 444 office-based dermatologic clinics in Taiwan, the overwhelming majority were located in urban (77.5%) and suburban (20.9%) areas, with two-thirds of towns in Taiwan (67.1%, n=247) having no dermatologic clinics at all. On average, the clinics provided 14.9 service sessions per week (standard deviation 3.04). Altogether, only 57.1% of the rural clinics were open during any of Saturday evening, Sunday daytime and Sunday evening, while the corresponding percentage was 75.9% for urban areas. Statistical analysis shows that the open ratios in suburban areas were significantly lower than those in urban areas on Saturday evening, Sunday daytime and Sunday evening (p<0.001), while urban and rural areas had no significant difference in open ratios on these three sections.
In Taiwan, dermatologists are unevenly geographically distributed, with most practising in urban areas. Also, there are remarkable urban-rural disparities in the availability of services on Saturday evening, Sunday daytime and Sunday evening.
皮肤科服务的短缺和分布不均对皮肤问题患者的护理质量产生负面影响。关于台湾皮肤科服务现状的文献数量有限。本研究的目的是调查台湾皮肤科医生的城乡分布以及门诊皮肤科服务情况。
从台湾医学会、台湾皮肤科医学会和内政部户籍司收集皮肤科劳动力及其地理分布的数据，而皮肤科诊所的位置和营业时间数据则来自国民健康保险局。皮肤科诊所的位置和营业时间按城市化水平分层。
台湾每10万人中有4.27名皮肤科医生。台北市是皮肤科医生密度最高的地区（每10万人中有9.61名皮肤科医生），而连江县根本没有皮肤科医生。在台湾的444家门诊皮肤科诊所中，绝大多数位于城市（77.5%）和郊区（20.9%），台湾三分之二的乡镇（67.1%，n = 247）根本没有皮肤科诊所。这些诊所平均每周提供14.9次服务（标准差3.04）。总体而言，只有57.1%的农村诊所在周六晚上、周日白天或周日晚上的任何时间营业，而城市地区的相应比例为75.9%。统计分析表明，郊区诊所在周六晚上、周日白天和周日晚上的开业率显著低于城市地区（p<0.001），而城市和农村地区在这三个时间段的开业率没有显著差异。
在台湾，皮肤科医生的地理分布不均衡，大多数在城市地区执业。此外，在周六晚上、周日白天和周日晚上的服务可及性方面，城乡差距显著。
