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Int. J. Environ. Res. Public Health 2014, 11(8), 7669-7677; doi:10.3390/ijerph110807669
Article

The Ecology of Gynecological Care for Women

1
, 2
, 2,3,4
, 5
, 6
, 5,7
, 8
 and 9,10,*
1 Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan 2 Department of Pharmacy, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan 3 Department and Institute of Pharmacology, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei 112, Taiwan 4 College of Pharmacy, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan 5 Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan 6 Department of Reproductive Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA 7 Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Linong Street, Taipei 112, Taiwan 8 Department of Public Finance, National Chengchi University, No. 64, Sec. 2, ZhiNan Rd., Wenshan District, Taipei 116, Taiwan 9 Taipei Veterans General Hospital Hsinchu Branch, No. 81, Sec. 1, Zhongfeng Rd., Zhudong Township, Hsinchu County 310, Taiwan 10 Department of Healthcare Management, Yuanpei University, No.306, Yuanpei street, Hsinchu 300, Taiwan
* Author to whom correspondence should be addressed.
Received: 15 May 2014 / Revised: 17 July 2014 / Accepted: 18 July 2014 / Published: 31 July 2014
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Abstract

Gynecological care is vital to women’s health but utilization of gynecological care has been seldom addressed. We applied the population-based “ecology model” to demonstrate the utilization of gynecological care of women, with examples from Taiwan. We analyzed the claims data from the cohort datasets within the National Health Insurance Research Database in Taiwan. Women’s utilization of gynecological care in 2009 was computed. Of 1000 women, 319 utilized gynecological care at least once, 277 visited Western medicine clinics, 193 visited physician clinics, 118 visited hospital-based outpatient clinics, 73 visited traditional Chinese medicine clinics, eight were hospitalized, four were hospitalized in an academic medical center, and four visited emergency departments. More than 90% of young and middle-aged women who sought gynecological care visited gynecologist clinics. Elderly women were less likely to utilize gynecological care in all settings of medical care, but were more likely to be attended by non-gynecologists. Young women tended to visit emergency departments. The ecology model highlighted age disparities in women’s utilization of gynecological care in various settings of medical care. Since gynecological conditions were common among women, more attention should be paid on the availability of gynecologists and continuing medical education in gynecological care for non-gynecologists to guarantee women’s health.
Keywords: gynecological; ecology; medical care; national health insurance; utilization gynecological; ecology; medical care; national health insurance; utilization
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Chang, C.-P.; Chou, C.-L.; Chou, Y.-C.; Shao, C.-C.; Su, H.I.; Chen, T.-J.; Chou, L.-F.; Yu, H.-C. The Ecology of Gynecological Care for Women. Int. J. Environ. Res. Public Health 2014, 11, 7669-7677.

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