| Summary: | 碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 100 === The research subjects of this study are women in Taiwan who suffer from dysmenorrhea. The purposes of this study are as follows:
1. Based on their different basic attributes, to compare the difference between Chinese and Western medical utilities, such as outpatient visits and medical payments.
2. To explore what influences their different basic attributes have on seeking for Chinese or Western treatment patterns.
3. Based on their different medical attributes, to compare the difference between Chinese and Western medical utilities, such as outpatient visits and medical payments.
4. To explore what influences their different medical attributes have on seeking for Chinese or Western treatment patterns.
5. In the light of their basic information and medical attributes, try to predict the circumstances of their medical utilization and medical treatment patterns.
Research Methods
The research subjects are the women with dysmenorrhea(ICD-9-CM: 625.3), aged from 13 to 55 years old. Samples were taken from the Taiwan Longitudinal Health Insurance Database 2000(a total of 20 thousand people). We exclude the information of emergency and inpatient treatment cases at the beginning, and then focus on their different basic and medical attributes for proceeding statistical analysis.
Research results
The limited samples of this study are 4855 cases. First, according to the 2008 medical records, woman aged from 13-19 years old and 19-45 years old will seek for Chinese medicine treatment when suffering from dysmenorrhea(the ratio is respectively 75.2% and 63.3%). However, women aged from 45-55 years old will mostly seek for Western medicine treatment (51.6%).
Secondly, when it comes to the treatment choices at different age levels, results show that most of the women aged from 13-19 years old will simply seek for Chinese medicine treatments (59.1%). As for women aged from 19-45 years old, the proportion between simply seeking for Chinese or Western medicine treatment is about half and half(45.8% and 49.4%); women aged from 19-45 years old will seek for Western medicine treatment mostly(61.3%).
Thirdly, when talking about medical payment, except the payment for medical centers, we find that in NHI-contracted clinics, whether it is Chinese or Western medicine clinic, women aged from 45-55 years old pay the most, and the data shows statistically significant difference between this age group and others. Furthermore, comparing to other region branches of Bureau of National Health Insurance, the proportions of the central branch about patients seeking for Chinese medicine treatments and simply seeking for Chinese medicine treatments are the highest(72.6% and 56.8%).
Fourth, if we use population density for analysis index, we can find that in the areas of low population density, most women who suffer from dysmenorrhea will seek for western medicine treatments; in the areas of mid and high population density, most women will seek for Chinese medicine treatments. Besides, about the difference between hospitals and clinics, we find that when they go the hospital, they are mainly for Western medical advices (56.23%); on the contrary, when they go to the clinic, it means they want to seek for Chinese medicine treatments (69.38%).
Finally, as for the gender of the physician, whether it is Chinese or Western medicine treatments, most women will choose male physicians than female physicians (59.4% and 76.9%). However, by all accounts, female physicians’ medical expenses are more than male physicians’ and show statistically significant differences.
Conclusion and Suggestions
Research results show that as age changes, the ratio of seeking for Chinese or Western medicine treatment is positively correlated with medical payments. The reasons may be as follows: on the one hand, the young women tend to suffer from primary dysmenorrhea; on the other hand, the elder women tend to suffer from secondary dysmenorrhea.
According to the medical record of the NHI Central Branch, we find that the ratio of women who seek for Chinese medicine treatment is higher; maybe it is because that there are lots of Chinese medicine resources in central Taiwan.
Although most women choose male physicians than female physicians, female physicians consume more medical resources, resulted from the closer trust relationship between female physicians and women patients. Because of this kind of relationship, women patients are more willing to do further physical examinations. Derived from the research results, we consider that the medical payment is not the main element of seeking for Chinese or Western medicine treatments. Furthermore, comparing to other countries, the results also explain why women in Taiwan tend to seek for Chinese medicine treatment than Western medicine treatment.
Suggestions
1. Since most women use more medical resources for alleviating dysmenorrhea as they get older, the issues of women''s emotion and healthy problems should be taken more seriously.
2. Comparing to other NHI branches, the medical records of the NHI Central Branch show the number of people seeking for Chinese medicine treatment and the ratio of patients who simply seek for Chinese medicine treatment are the highest. It seems that the manpower distribution of Chinese medicine resources should be planned more carefully to resolve the situation of high density of Chinese medicine physicians in Central Taiwan.
3. We find that female physicians consume more medical resources than male physicians on curing dysmenorrhea, and results also show the statistically significant difference. As a result, we can also further discuss the differences of their medical resource expensing on other diseases and symptoms.
4. We may collect the Quality of Life questionnaire to reflect the changes between before and after the medical use in dysmenorrhea.
5. We can further collect Menstrual attitude questionnaire to understand the menstrual attitude of women in Taiwan and investigate physical and psychological impact
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