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Li-Jung Lai,1 Chia-Lin Chou,2 H Irene Su,3 Tzeng-Ji Chen,1,4 Li-Fang Chou,5 Yueh-Ching Chou,2,6,7 Shinn-Jang Hwang,1,8 Hann-Chin Yu9,10 1Department of Family Medicine, 2Department of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan; 3Department of Reproductive Medicine, University of California, San Diego, CA, USA; 4Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, 5Department of Public Finance, National Chengchi University, 6Department and Institute of Pharmacology, National Yang-Ming University, 7College of Pharmacy, Taipei Medical University, 8Department of Family Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 9Taipei Veterans General Hospital Hsinchu Branch, Hsinchu County, Taiwan; 10Department of Healthcare Management, Yuanpei University, Hsinchu, Taiwan Background: A shortage of gynecologists exists in many countries. Even within an affluent country, gynecological clinics might not be evenly distributed. The purpose of the study was to investigate the disparity in gynecological care between adult women living in towns with and without gynecologists in Taiwan.Methods: Data sources were the cohort datasets of the National Health Insurance Research Database, with claims data of 1 million beneficiaries in 2010. A woman’s residency was operationally inferred from the locations where she had most frequently visited physicians’ clinics or local community hospitals within the year.Results: In Taiwan, 145 (39.4%) of 368 towns had no practicing gynecologist. Of 382,167 women with health care use in the datasets, 21,794 (5.7%) lived in towns without a gynecologist. The overwhelming majority of these towns lay in sparsely populated, rural areas. During the year, 132,702 women (34.7%) had sought medical help for gynecological diseases and 113,698 (29.8%) had visited gynecologists for gynecological diseases. Women in towns without a gynecologist were less likely to consult for gynecological diseases (23.8% versus 35.4%; P |
