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The Utilization of Pap Test Services of Women: A Nationwide Study in Taiwan

Lee, Fang H. MSN, RN; Wang, Hsiu H. PhD, RN, FAAN

doi: 10.1097/NCC.0b013e31820b7866
Articles

Background: Papanicolaou test (Pap test) is the most effective screening tool to prevent cervical cancer. In Taiwan, the National Health Insurance offers women older than 30 years free Pap test; however, the screening rate is merely 52.6%.

Objective: The purposes of this study were to understand the status quo of Taiwanese women undertaking Pap test and to investigate relevant factors affecting women having Pap tests by applying Andersen's health-service utilization model.

Methods: This study adopted data from the Taiwan's National Health Insurance Research Database from 2004 to 2008, in which 241 843 women having Pap tests were analyzed.

Results: The following groups have a higher odds ratio of participating in Pap tests: indigenous women, low-income women, elderly women, women who visit obstetrics and gynecology departments more frequently, less urbanized women, women with less access to medical resources, women with severe diseases, disabled women, women with chronic illnesses, women with cancer, women with gynecological diseases, women with acute diseases who have longer length of hospital stay, and women with chronic diseases who have shorter length of hospital stay.

Conclusion: This study provides the status quo and influential factors of women undergoing Pap tests.

Implications for Practice: The results can assist medical personnel to offer appropriate information and intervention and can be a reference for making relevant health policies to raise the screening rates of Pap tests.

Author Affiliations: Department of Nursing, Chung Hwa University of Medical Technology, Tainan (Ms Lee); and College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan (Dr Wang).

This study is based, in part, on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by National Health Research Institutes, Taiwan.

The interpretation and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or National Health Research Institutes, Taiwan.

Financial support was provided by the Chung Hwa University of Medical Technology in Taiwan.

The authors have no conflicts of interest to disclose.

Correspondence: Hsiu H. Wang, PhD, RN, FAAN, College of Nursing, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd, Kaohsiung 807, Taiwan (hhwang@kmu.edu.tw).

Accepted for publication December 13, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.