The rural - urban divide in ambulatory care of gastrointestinal diseases in Taiwan
1 Department of Family Medicine, Kaohsiung Veterans General Hospital Pingtung Branch, Pingtung, No. 1. Anping Lane 1, Jausheng Rd., Pingtung, Neipu Shiang, 91245, Taiwan
2 Respiratory Therapy Department, Taipei Veterans General Hospital, Taipei, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan
3 Department of Family Medicine, Taitung Veterans Hospital, Taitung, No. 1000, Gengsheng Rd., Taitung City, Taitung County, 95050, Taiwan
4 Department of Family Medicine, Taipei Veterans General Hospital, Taipei, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City 11217, Taiwan
5 School of Medicine, National Yang-Ming University, Taipei, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan
6 Department of Public Finance, National Chengchi University, Taipei, No. 64, Sec. 2, ZhiNan Rd., Wenshan District, Taipei City, 11605, Taiwan
BMC International Health and Human Rights 2013, 13:15 doi:10.1186/1472-698X-13-15Published: 8 March 2013
The utilization of medical care for gastrointestinal diseases increased over the past decade worldwide. The aim of the study was to investigate the difference between rural and urban patients in seeking medical service for gastrointestinal diseases at ambulatory sector in Taiwan.
From the one-million-people cohort datasets of the National Health Insurance Research Database, the utilization of ambulatory visits for gastrointestinal diseases in 2009 was analyzed. Rural patients were compared with urban and suburban patients as to diagnosis, locality of visits and choice of specialists.
Among 295,056 patients who had ambulatory visits for gastrointestinal diseases in 2009, rural patients sought medical care for gastrointestinal diseases more frequently than urban and suburban patients (1.60 ± 3.90 vs. 1.17 ± 3.02 and 1.39 ± 3.47). 83.4% of rural patients with gastrointestinal diseases were treated by non-gastroenterologists in rural areas. Rural people had lower accessibility of specialist care, especially for hepatitis, esophageal disorders and gastroduodenal ulcer.
The rural–urban disparity of medical care for gastrointestinal diseases in Taiwan highlighted the importance of the well communication between rural physicians and gastroenterologists. Besides the establishment of the referral system, the medical teleconsultation system and the arrangement of specialist outreach clinics in rural areas might be helpful.