醫療可近性之概念分析

Concept Analysis of Medical Accessibility

醫療可近性為一個整合性的概念，說明病患與健康照護系統之間緊密連結的程度，亦即病患能夠即時，獲得足夠質量且適當的醫療保健服務，使其健康能夠達到最佳的結果。目前國內外對於醫療可近性雖然有相關的研究與文獻回顧，但無針對醫療可近性進行有系統的概念分析，故本文依據Walker和Avant（2019）的概念分析步驟，進行醫療可近性的概念分析，歸納出醫療可近性的定義性特徵，包含：一、所居住的區域設有健康照護系統；二、健康照護系統提供充分且適當的醫療照護服務；三、個人能夠及時取得所需要的醫療資源。列舉典型、邊緣、相反及相關案例，並確認概念發生的前因（如：人口組成、城鄉差異）與後果（如：醫療滿意度、健康結果），最後提供實證性的資料。期望藉由多面向詮釋此概念分析之結果，增進醫療相關人員對醫療可近性之了解，藉此提升醫療服務量能，並提供醫療相關政策發展與推動之參考。

As an integrative concept, medical accessibility describes the degree of closeness in the relationship between patients and the healthcare system. This closeness is essential for achieving optimal health outcomes, as it ensures patients receive timely access to comprehensive, relevant, and high-quality medical care. While a substantial body of literature—both in Taiwan and internationally—has explored medical accessibility, these studies often lack a systematic conceptual analysis. To address this gap, this article applies Walker and Avant’s (2019) method for conducting a conceptual analysis of medical accessibility. The analysis includes the following key components: (1) the presence of a healthcare system within the area where people live, (2) the provision of adequate and appropriate healthcare services by that system, and (3) timely access to health resources by the population. This article identifies and summarizes the defining attributes of medical accessibility, its antecedents (e.g., population demographics, urban-rural disparities), and its consequences (e.g., patient satisfaction, health outcomes). It also includes examples of how the concept is used in various contexts and presents supporting empirical data. By analyzing medical accessibility from multiple perspectives, this article aims to enhance healthcare professionals' understanding of the concept. Ultimately, the goal is to strengthen healthcare service capacity and inform the development and promotion of more effective health policies.