No gynecologist in town: the gynecological care of women in rural Taiwan

Figures & data

Table 1 Distribution of population and area in towns with and without a gynecologist in Taiwan, 2010

	Towns with a gynecologist, n (%)	Towns without a gynecologist, n (%)	Total, n
Towns, n	223 (60.6%)	145 (39.4%)	368
Aggregate area (km^2)a	14,697.5 (40.6%)	21,493.5 (59.4%)	36,191
Aggregate populationa	20,487,534 (88.6%)	2,636,332 (11.4%)	23,123,866
Female populationa
Sum	10,354,907 (89.0%)	1,279,674 (11.0%)	11,634,581
Mean (SD)	46,434.6 (50,674.5)	8,825.3 (8,139.2)
Minimum	220	16
Maximum	308,683	46,641
Adult women in the study
Sum	360,373 (94.3%)	21,794 (5.7%)	382,167
Mean (SD)	1,616.0 (1,949.3)	150.3 (148.0)
Minimum	4	0
Maximum	11,189	894

Notes:

a Calculated from the basic data of 368 townships published by the Directorate-General of Budget, Accounting and Statistics of the Taiwan government.⁸

Abbreviations: n, number; SD, standard deviation.

Table 2 Gynecologic care access for adult women in 2010 stratified by age group and residency type

	Women living in towns with a gynecologist, n (%)	Women living in towns without a gynecologist, n (%)	P-valuea
Total
Total number of women	360,373	21,794
Visit for gynecological disease	127,513 (35.4%)	5,189 (23.8%)	<0.001
Visits for gynecologic disease with a gynecologist	109,624 (30.4%)	4,074 (18.7%)	<0.001
18–29 years
Total number of women	86,529	2,962
Visit for gynecological disease	37,126 (42.9%)	1,027 (34.7%)	<0.001
Visits for gynecologic disease with a gynecologist	31,152 (36.9%)	820 (27.7%)	<0.001
30–44 years
Total number of women	112,831	4,993
With gynecological disease	50,509 (44.8%)	1,770 (35.4%)	<0.001
With visits to a gynecologist	44,453 (39.4%)	1,497 (30.0%)	<0.001
45–64 years
Total number of women	114,157	7,913
Visit for gynecological disease	34,969 (30.6%)	1,936 (24.5%)	<0.001
Visits for gynecologic disease with a gynecologist	30,076 (26.3%)	1,466 (18.5%)	<0.001
≥65 years
Total number of women	46,856	5,926
Visit for gynecological disease	4,909 (10.5%)	456 (7.7%)	<0.001
Visits for gynecologic disease with a gynecologist	3,943 (8.4%)	291 (4.9%)	<0.001

Notes:

a Pearson’s χ² test.

Abbreviation: n, number.

Table 3 Distribution of gynecological diseases in adult women in 2010, stratified by age group and residency type (living in towns with a gynecologist or without a gynecologist)

Disease group	18–29 years		30–44 years		45–64 years		≥65 years
	G (%) n=86,529	NG (%) n=2,962	G (%) n=112,831	NG (%) n=4,993	G (%) n=114,157	NG (%) n=7,913	G (%) n=46,856	NG (%) n=5,926
Lower genital tract infectionsa,b,c,d	3,902 (4.5)	109 (3.7)	5,558 (4.9)	193 (3.9)	3,013 (2.6)	166 (2.1)	347 (0.7)	29 (0.5)
Infertilityb	961 (1.1)	23 (0.8)	2,033 (1.8)	36 (0.7)	60 (0.1)	4 (0.1)	2 (0.0)	0 (0.0)
Genital dysplasiaa,b,c	4,008 (4.6)	101 (3.4)	7,385 (6.5)	255 (5.1)	4,610 (4.0)	235 (3.0)	447 (1.0)	47 (0.8)
Menopausal disordersc,d	127 (0.1)	3 (0.1)	1,198 (1.1)	53 (1.1)	12,967 (11.4)	688 (8.7)	2,292 (4.9)	182 (3.1)
Menstrual disorders and hormonal dysfunctiona,b,c,d	25,477 (29.4)	660 (22.3)	28,423 (25.2)	882 (17.7)	9,084 (8.0)	408 (5.2)	155 (0.3)	7 (0.1)
Endometriosis and pelvic paina,b,c	6,784 (7.8)	191 (6.4)	7,882 (7.0)	255 (5.1)	2,850 (2.5)	155 (2.0)	379 (0.8)	38 (0.6)
Reproductive tract malignancy	84 (0.1)	5 (0.2)	437 (0.4)	16 (0.3)	1,115 (1.0)	77 (1.0)	459 (1.0)	46 (0.8)
Inflammatory disease of the upper genital tracta,b,c,d	17,943 (20.7)	453 (15.3)	28,802 (25.5)	1,019 (20.4)	18,574 (16.3)	1,002 (12.7)	2,444 (5.2)	227 (3.8)
Benign disorders of the uterus and ovariesa,b,c,d	3,711 (4.3)	84 (2.8)	10,534 (9.3)	366 (7.3)	7,927 (6.9)	365 (4.6)	337 (0.7)	23 (0.4)
Other disorders of female genital organsc,d	446 (0.5)	14 (0.5)	783 (0.7)	25 (0.5)	429 (0.4)	11 (0.1)	75 (0.2)	2 (0.0)
Gynecological examinationb,c,d	749 (0.9)	29 (1.0)	1,395 (1.2)	34 (0.7)	909 (0.8)	42 (0.5)	170 (0.4)	11 (0.2)
Encounter for contraceptive management	130 (0.2)	3 (0.1)	303 (0.3)	11 (0.2)	86 (0.1)	3 (0.0)	1 (0.0)	0 (0.0)

Notes:

a Significant difference between women living in towns with and without a gynecologist in women aged 18–29 years; P<0.05.

b Significant difference between women living in towns with and without a gynecologist in women aged 30–44 years; P<0.05.

c Significant difference between women living in towns with and without a gynecologist in women aged 45–64 years; P<0.05.

d Significant difference between women living in towns with and without a gynecologist in women aged 65 years and over; P<0.05.

Abbreviations: G, gynecologist; NG, no gynecologist; n, number.

Table 4 Number and percentage of women living in towns without a gynecologist and having gynecological diseases in 2010 (n=5,189), stratified by disease group and type of consulted clinic

Disease group	Nongynecologist in town, n (%)	Gynecologist out of town, n (%)	Nongynecologist out of town, n (%)	Total*, n
Lower genital tract infections	35 (7.0)	436 (87.7)	31 (6.2)	497
Infertility	1 (1.6)	62 (98.4)	3 (4.8)	63
Genital dysplasia	115 (18.0)	475 (74.5)	71 (11.1)	638
Menopausal disorders	267 (28.8)	581 (62.7)	157 (17.0)	926
Menstrual disorders and hormonal dysfunction	401 (20.5)	1,546 (79.0)	256 (13.1)	1,957
Endometriosis and pelvic pain	183 (28.6)	351 (54.9)	156 (24.4)	639
Reproductive tract malignancy	8 (5.6)	121 (84.0)	63 (43.8)	144
Inflammatory disease of the upper genital tract	354 (13.1)	2,371 (87.8)	121 (4.5)	2,701
Benign disorders of the uterus and ovaries	21 (2.5)	811 (96.8)	32 (3.8)	838
Other disorders of female genital organs	4 (7.7)	45 (86.5)	4 (7.7)	52
Gynecological examination	0 (0.0)	113 (97.4)	4 (3.4)	116
Encounter for contraceptive management	0 (0.0)	17 (100.0)	0 (0.0)	17
Total*	1,209 (23.3)	4,074 (78.5)	773 (14.9)	5,189

Notes:

* One woman may have more than one diagnosis. The total number of women did not represent the total number of diagnoses.

Abbreviation: n, number.

Directorate-General of Budget, Accounting and Statistics, Executive Yuan, R.O.C. (Taiwan) [webpage on the Internet]Ministry of the Interior in Taiwan: Gross domestic product Available from: http://eng.dgbas.gov.tw/mp.asp?mp=2Accessed February 17, 2015

 Google Scholar