Bridging geographical disparities across 368 townships with healthcare system and socioeconomic factors in Taiwan.

Autor: Hsieh CL; Department of Health Services Administration, China Medical University, No. 100, Sec. 1, Jingmao Road, Beitun District, Taichung, 406, Taiwan., Chung CY; Department of Health Services Administration, China Medical University, No. 100, Sec. 1, Jingmao Road, Beitun District, Taichung, 406, Taiwan., Chen HY; Department of Health Services Administration, China Medical University, No. 100, Sec. 1, Jingmao Road, Beitun District, Taichung, 406, Taiwan., Shieh SH; Department of Health Services Administration, China Medical University, No. 100, Sec. 1, Jingmao Road, Beitun District, Taichung, 406, Taiwan.; Department of Nursing, China Medical University Hospital, Taichung, Taiwan., Hsieh MS; Department of Emergency Medicine, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan., Hsieh VC; Department of Health Services Administration, China Medical University, No. 100, Sec. 1, Jingmao Road, Beitun District, Taichung, 406, Taiwan. hsiehchiarong@gmail.com.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2023 Sep 11; Vol. 13 (1), pp. 15007. Date of Electronic Publication: 2023 Sep 11.
DOI: 10.1038/s41598-023-42124-y
Abstrakt: A universal health insurance program such as the National Health Insurance in Taiwan offers a wide coverage and increased access to healthcare services. Despite its ongoing efforts to enhance healthcare accessibility, differences in health for people living in urban and resource-deprived areas remain substantial. To investigate the longitudinal impact of the healthcare system and other potential structural drivers such as education and economic development on geographical disparities in health, we designed a panel study with longitudinal open secondary data, covering all 368 townships in Taiwan between 2013 and 2017. Our findings indicated higher mortality rates in the mountainous and rural areas near the east and south regions of the island in both years. Multivariate analyses showed an increase in the density of primary care physicians (PCP) was associated with lower all-cause mortality (β = - 0.72, p < 0.0001) and cardiovascular disease mortality (β = - 0.41, p < 0.0001). Effect of PCP is evident, but merely focusing on access to healthcare is still not enough. Additional measures are warranted to address the health disparities existing between urban and underprivileged areas.
(© 2023. Springer Nature Limited.)
Databáze: MEDLINE
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