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Physician Specialty and the Quality of Medical Care Experiences in the Context of the Taiwan National Health Insurance System

Center for General Education (JT), Hungkuang University, Shalu, Taichung County, Taiwan
Department of Health-Business Administration (W-LY), Hungkuang University, Shalu, Taichung County, Taiwan
Department of Hotel and Restaurant Management (L-MH), Hungkuang University, Shalu, Taichung County, Taiwan
Department of Health Policy and Management, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD (LS, LAL)

Correspondence: Corresponding author: Jenna Tsai, EdD, Hungkuang University, Center for General Education, No. 34, Chung-Chie Rd., Shalu, Taichung County, Taiwan 43302 (E-mail: jennatwang{at}gmail.com)

Objectives: Based on a recent patient survey from Taiwan, where there is universal health insurance coverage and unrestricted physician choice, this study examined the relationship between physician specialty and the quality of primary medical care experiences.

Methods: We assessed ambulatory patients’ experiences with medical care using the Primary Care Assessment Tool, representing 7 primary care domains: first contact (ie, accessibility and utilization); longitudinality (ie, ongoing care); coordination (ie, referrals and information systems); comprehensiveness (ie, services available and provided); family centeredness; community orientation; and cultural competence.

Results: Having a primary care physician was significantly associated with patients reporting higher quality of primary care experiences. Specifically, relative to specialty care physicians, primary care physicians enhanced accessibility, achieved better community orientation and cultural competence, and provided more comprehensive services.

Conclusions: In an area with universal health insurance and unrestricted physician choice, ambulatory patients of primary care physicians rated their medical care experiences as superior to those of patients of specialists. In addition to providing health insurance coverage, promoting primary care should be included as a health policy to improve patients’ quality of ambulatory medical care experiences.

Key Words: Primary Health Care • Quality of Health Care • Taiwan • Comparative Health Care Financing

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