外籍新娘對基層婦產科診所之評價

An Evaluation of the Utilization of OB/GYN Clinic Service by Foreign Spouses

本研究旨在探討台灣東南亞籍配偶對基層婦產科診所就醫之評價及其影響因素。本研究以結構式問卷蒐集所需的資料。問卷主要參考Parasuraman, Zeithmal及Berry的問卷設計而成，並翻譯成併有中文之越文、泰文、印尼文與英文之問卷，分別對東南亞之越南、泰國、印尼與菲律賓籍的台灣外籍配偶做問卷調查。我們以2005年2月仍有執行接生業務的397家診所就醫的東南亞外籍配偶病患為母群體，各健保分區隨機抽出三分之一診所為寄發問卷的對象，共寄出665份問卷，加上各診所自行複印35份，共有700份問卷進行訪問調查。扣除無效問卷後回收329份問卷，有效回收率49%。研究結果發現8.2%的東南亞籍配偶在入境滿4個月仍未享有全民健保的醫療福利。她們選擇診所就醫的考量因素，其優先順序為離家近，其次為親戚朋友或醫師推薦和醫術高明、好口碑。其對診所就醫各面向最滿意之前五項依序為解釋病情、聆聽病情、醫療安全、專業行為、妥善處置。而最不滿意之前五項依序為停車方便、候診時間、逃生指引、醫療設備、整體環境。她們對診所之整體評價，包括整體服務滿意度、再診意願與推薦親朋好友就診之意願，在不同城鄉別的診所，或不同醫師性別看診，皆無統計顯著差異。茲針對本研究結果提出建議如下：(1)建議政府放寬外籍配偶健保資格申請的限制；(2)鑑於外籍配偶就醫常因語言溝通困難與對環境不熟悉，所以建議醫療機構提供更方便的醫療服務，並發揮同理心，尤其對身體較差的外籍配偶給予更貼心的關懷。

The purpose of the research is to understand the evaluation and influential factors of wives of locals from the southeastern Asian countries.The research was composed of collecting and analyzing the constructed questionnaire. The design of questionnaire mainly referred to the concept of Parasuraman, Zeithmal and Berry's questionnaire. The original language was translated into Chinese, Vietnamese, Thai and Indonesian. They were compiled as Chinese-Vietnamese, Chinese-Thai, Chinese-Indonesian and Chinese-English versions in order to be comprehended by the brides or wives of locals from the southern Asian countries. The data were collected from 397 OB/GYN clinics were legally allowed to offer OB/GYN care for those women untill February 2005. The sampling was randomized from one-third of each National Health Insurance district. There were 665 copies of questionnaires sent out plus 35 copies made by recopy themselves. It made a total of 700 copies of questionnaires collected. After the invalid ones deducted, there were totally 329 copies or effective correspondent rate was 49% for the analysis.It was found in the research that 8.2% of such foreign spouses were not allowed to utilize the National Health Insurance (NHI) program after their arrival in Taiwan even more than 4 months. The causes of their priority of choosing OB/GYN clinics were as follows: the distance between home and the clinics, the referral from friends, relatives and the reputation of doctors. The top five satisfied factors were the explanation of the disease, listening to symptom description, health safety, professionalism and the treatment. Also, regard to the overall evaluation of clinics, including overall service satisfaction, re-utilization willingness, referral willingness for the friends and relatives, it was shown no significance by county or gender of doctors. Based on the findings, it is concluded as follows: firstly, it is suggested that the government should partially deregulate the application for the so-called foreign brides for the NHI program; secondly, due to the language reluctance and unfamiliarity to the new living environment for these women, the health care organizations should provide more convenience, empathical and sincere services to those relatively poor-conditioned newly coming fellow citizens.