| Summary: | 碩士 === 國立臺北護理健康大學 === 健康事業管理研究所 === 104 === Objectives:
Taiwan conducted a National Health Insurance since 1995. Due to the increase in the number of dialysis patients and health care costs, National Health Insurance Administration, Ministry of Health and Welfare has begun to implement outpatient dialysis global budget cap since 2003. The gap between the patients' needs and outpatient dialysis offers is worth to be explored.As more and more accumulative health data have been established and released, researchers can evaluate the patients' expectation, experience, and self-perceptions of health care institutes through this data analysis. Among them, intimation regarding to dialysis-related self-perceptions of medical utilization and geographical difference from the patients' points of view are lacking. This study aims to explore the self-perceptions of medical utilization and geographical difference under the global budget among outpatient dialysis.
Methods:
This study utilizes the 2015 Outpatient Dialysis Survey Data to investigate the treatment experiences and process of medical care differences in the geographical area of outpatient dialysis.
Results:
The result showed that the enabling factor "perception of traffic time", the need factor "health status in the past year", and the use of personal health services factor "current mode of dialysis" and "explanation of choice dialysis method from physician" are predictors of patient satisfaction which are statistically significant after adjusting with related risk factors.Moreover, the predisposing factor "patients' age", and the use of personal health services factor "current dialysis mode" are predictors of the process of medical care which are statistically significant after adjusting with related risk factors.Finally, we explored regional differences in the geographical outpatient dialysis satisfaction and process of medical care. The results showed that residents in the sixth area are less satisfied with the quality satisfaction than residents in other areas. In the process of medical care, residents in the seventh area used self-paid medical service more than residents in other areas. In terms of wills to accept kidney transplant, residents of the sixth area transplant had lowest incline to kidney transplant willingness.
Conclusions:
To conclude, after twenty-year practice National Health Insurance in Taiwan, patients showed high satisfaction about the quality of medical service. How to maintain satisfaction and meet patients' expectations is a great challenge. In this research concept maps with satisfaction and process of medical care experience, we can see that outpatient dialysis had a high opinion of health care. Self-evaluated health conditions, dialysis modes, age, location and medical communication are key factors of impact on medical satisfaction and process of medical care. These findings can provide some directions for future policy making of our government.
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