title: The ecology of gynecological care for women.
abstract: Gynecological care is vital to women's health but utilization of gynecological care has been seldom addressed. We applied the population-based "ecology model" to demonstrate the utilization of gynecological care of women, with examples from Taiwan. We analyzed the claims data from the cohort datasets within the National Health Insurance Research Database in Taiwan. Women's utilization of gynecological care in 2009 was computed. Of 1000 women, 319 utilized gynecological care at least once, 277 visited Western medicine clinics, 193 visited physician clinics, 118 visited hospital-based outpatient clinics, 73 visited traditional Chinese medicine clinics, eight were hospitalized, four were hospitalized in an academic medical center, and four visited emergency departments. More than 90% of young and middle-aged women who sought gynecological care visited gynecologist clinics. Elderly women were less likely to utilize gynecological care in all settings of medical care, but were more likely to be attended by non-gynecologists. Young women tended to visit emergency departments. The ecology model highlighted age disparities in women's utilization of gynecological care in various settings of medical care. Since gynecological conditions were common among women, more attention should be paid on the availability of gynecologists and continuing medical education in gynecological care for non-gynecologists to guarantee women's health.
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan. jpchang2@vghtpe.gov.tw.
authors.forename: Chia-Pei
authors.initials: CP
authors.lastname: Chang
authors.affiliation: Department of Pharmacy, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan. clchou6@vghtpe.gov.tw.
authors.forename: Chia-Lin
authors.initials: CL
authors.lastname: Chou
authors.affiliation: Department of Pharmacy, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan. ycchou@vghtpe.gov.tw.
authors.forename: Yueh-Ching
authors.initials: YC
authors.lastname: Chou
authors.affiliation: Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan. jnshao@gmail.com.
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Shao
authors.affiliation: Department of Reproductive Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA. hisu@ucsd.edu.
authors.forename: H Irene
authors.initials: HI
authors.lastname: Su
authors.affiliation: Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan. tjchen@vghtpe.gov.tw.
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.affiliation: Department of Public Finance, National Chengchi University, No. 64, Sec. 2, ZhiNan Rd., Wenshan District, Taipei 116, Taiwan. lifang@nccu.edu.tw.
authors.forename: Li-Fang
authors.initials: LF
authors.lastname: Chou
authors.affiliation: Taipei Veterans General Hospital Hsinchu Branch, No. 81, Sec. 1, Zhongfeng Rd., Zhudong Township, Hsinchu County 310, Taiwan. yhc@vhct.gov.tw.
authors.forename: Hann-Chin
authors.initials: HC
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006176:Gynecology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D008516:Medicine, Chinese Traditional / Q000706:statistics & numerical data*; D008875:Middle Aged; D013624:Taiwan; D014932:Women's Health Services / Q000706:statistics & numerical data*; D055815:Young Adult
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