Family Physician Division, Taipei Veterans General Hospital Yuli Branch, Hualien, Taiwan, ROC.
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2018 Nov;81(11):964-969. doi: 10.1016/j.jcma.2017.12.010. Epub 2018 Sep 1.
General medicine practices in England are required to provide services from 8am to 8pm on weekdays and to also open on Saturdays and Sundays. Internationally, however, the literature regarding the temporal availability of primary health care on national levels is scarce.
To provide such information regarding Taiwan, in this study, all family medicine clinics within Taiwan's National Health Insurance system were stratified by urbanization level, and the opening hours of the clinics were then analyzed. The opening hours of the clinics were downloaded and the data were extracted cross-sectionally in July 2015. For each clinic, the number of open sessions (in terms of morning, afternoon, and evening sessions) per week was calculated. For each urbanization level, the opening ratios for out-of-hours services and for seven-day services were also analyzed.
Among 1621 family medicine clinics, 835 were located in urban areas, 563 were suburban, and 223 were rural. The average numbers of open sessions per week among urban and suburban clinics were higher than among rural clinic (15.7 ± 3.7 and 15.8 ± 3.7 vs. 14.4 ± 4.0). Urban and suburban clinics also had higher opening ratios on weekday evenings and on weekends than rural clinics. Only 53 (3.3%) of all the clinics (29 urban clinics, 18 suburban clinics, and 7 rural clinics) remained open for all 21 sessions of a week.
The great majority of family medicine clinics in Taiwan voluntarily offered out-of-hours services, but only a small minority remained open in all 21 sessions of a week.
英国的全科医学实践要求在工作日上午 8 点至晚上 8 点提供服务,并在周六和周日也开放。然而,国际上关于国家一级初级卫生保健的时间可用性的文献很少。
为了提供有关台湾的信息,在这项研究中,台湾全民健康保险系统内的所有家庭医学诊所按城市化水平分层,然后分析诊所的开放时间。下载诊所的开放时间,并于 2015 年 7 月进行横断面数据提取。对于每个诊所,每周的开放次数(上午、下午和晚上)进行计算。对于每个城市化水平,还分析了非工作时间服务和七天服务的开放比例。
在 1621 家家庭医学诊所中,835 家位于城市地区,563 家位于郊区,223 家位于农村。城市和郊区诊所每周的开放次数平均高于农村诊所(15.7±3.7 和 15.8±3.7 比 14.4±4.0)。城市和郊区诊所的工作日晚上和周末的开放比例也高于农村诊所。只有 53 家(3.3%)的所有诊所(29 家城市诊所、18 家郊区诊所和 7 家农村诊所)在一周的 21 次就诊中都保持开放。
台湾绝大多数家庭医学诊所自愿提供非工作时间服务,但只有一小部分在一周的 21 次就诊中都保持开放。