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Factors Associated with Healthcare Services Utilization and Satisfaction with Healthcare Services Quality among Indonesian Migrant Workers in Taiwan
Other Title
Factors Associated with Healthcare Services Utilization and Satisfaction with Healthcare Services Quality among Indonesian Migrant Workers in Taiwan
Type
thesis
Date Issued
2025-05-21
Author(s)
Ari Sety Awan
Advisor
Subjects
系所名稱：公共衛生學系博士班
Publisher
公共衛生學系博士班
Description
學位別：博士
口試委員：莊坤洋; 莊媖智; 邱尚志; 吳文琪; 徐慧娟
關鍵字：Health services utilization、Healthcare access、Unmet medical needs、Healthcare quality、Patient satisfaction、Migrant worker
口試委員：莊坤洋; 莊媖智; 邱尚志; 吳文琪; 徐慧娟
關鍵字：Health services utilization、Healthcare access、Unmet medical needs、Healthcare quality、Patient satisfaction、Migrant worker
Abstract
Background and purpose: Equal access to healthcare is crucial for guaranteeing accurate and effective care. However, migrant workers face several challenges in exploring how to use healthcare services, as the health-seeking behaviors of migrants may differ from those of natives. This study aimed to identify the factors influencing healthcare service utilization and unmet medical needs among Indonesian migrant workers in Taiwan and to identify the factors related to the satisfaction of Indonesian migrant workers with healthcare services in Taiwan and compare their level of satisfaction with healthcare services between Taiwan and Indonesia.
Methods: “This cross-sectional study collected data using self-reported questionnaires (n=352) for Study 1 and only those who had utilized healthcare services for inpatient, outpatient, or emergency care were included in the analysis of Study 2 (n=241). The analysis methods include descriptive analysis, bi-variate analysis, multivariate linear regression, logistic regression and multinominal logistic regression applied to examine the factors related between individual and health care system characteristics with healthcare utilization and satisfaction of healthcare service.
Results: In the first study, among Indonesian migrant workers in Taiwan, 9.4% had been used inpatient care, 67.6% had visited outpatient care, 7.7% had experience in the emergency department, and 20.2% reported unmet medical needs. Participants having a spouse (OR=0.322 for those without a spouse) and healthcare staff with better language skills (OR=4.499) increased the use of hospital admission. Participants who had been in Taiwan for more than 2 years (OR=2.181) or who did not need a translator (OR=0.396 for those needing a translator) were more likely to have used outpatient care services. Participants with a higher educational level (OR=3.683), who had poorer mental health (OR=0.234 for those having good mental health), who were rarely provided a translator in hospitals (OR=0.189 for those often provided), or who obtained more assistance from volunteers (OR=5.398), were more likely to use emergency treatment. Those who were a crewman (OR=3.576) or had a shorter transportation time (OR=3.192) had a higher possibility of having unmet medical needs. In the second study, overall satisfaction with Taiwan's healthcare was generally high (mean=4.23/5). Longer wait times were associated with decreased empathic dimension (B=-0.272), while receiving more assistance from volunteers (B=0.067) and the friendliness of the staff (B=0.112) were linked to higher tangible dimension. In comparison to healthcare service in Indonesia, longer waiting times were associated with higher satisfaction of Indonesia's healthcare in terms of tangibility and responsiveness dimension. Expensive healthcare payments were linked to lower satisfaction with Taiwan's healthcare (OR=0.432 for tangibility) and higher satisfaction with Indonesia's healthcare (OR=5.079 for reliability). Additionally, language proficiency was associated with higher satisfaction with Indonesia's healthcare (OR=5.277 for tangibility and OR=10.443 for reliability). Meanwhile, easy explanations were associated with lower satisfaction with Indonesia's healthcare (OR=0.445 for assurance) and receiving assistance from volunteers (OR=0.326 for tangibility and OR=0.272 for reliability) and staff friendliness (OR=0.085 for reliability and OR=0.216 for empathy) were linked to lower satisfaction with Indonesia’s healthcare. Education and other demographic factors also played a role in shaping healthcare satisfaction
Conclusion: Individual and healthcare system factors influenced the utilization of healthcare services and unmet medical needs among Indonesian migrant workers in Taiwan. These factors also affected their satisfaction. To enhance service quality and address healthcare utilization services, healthcare providers should consider these factors and provide better assistance for migrant workers.
Methods: “This cross-sectional study collected data using self-reported questionnaires (n=352) for Study 1 and only those who had utilized healthcare services for inpatient, outpatient, or emergency care were included in the analysis of Study 2 (n=241). The analysis methods include descriptive analysis, bi-variate analysis, multivariate linear regression, logistic regression and multinominal logistic regression applied to examine the factors related between individual and health care system characteristics with healthcare utilization and satisfaction of healthcare service.
Results: In the first study, among Indonesian migrant workers in Taiwan, 9.4% had been used inpatient care, 67.6% had visited outpatient care, 7.7% had experience in the emergency department, and 20.2% reported unmet medical needs. Participants having a spouse (OR=0.322 for those without a spouse) and healthcare staff with better language skills (OR=4.499) increased the use of hospital admission. Participants who had been in Taiwan for more than 2 years (OR=2.181) or who did not need a translator (OR=0.396 for those needing a translator) were more likely to have used outpatient care services. Participants with a higher educational level (OR=3.683), who had poorer mental health (OR=0.234 for those having good mental health), who were rarely provided a translator in hospitals (OR=0.189 for those often provided), or who obtained more assistance from volunteers (OR=5.398), were more likely to use emergency treatment. Those who were a crewman (OR=3.576) or had a shorter transportation time (OR=3.192) had a higher possibility of having unmet medical needs. In the second study, overall satisfaction with Taiwan's healthcare was generally high (mean=4.23/5). Longer wait times were associated with decreased empathic dimension (B=-0.272), while receiving more assistance from volunteers (B=0.067) and the friendliness of the staff (B=0.112) were linked to higher tangible dimension. In comparison to healthcare service in Indonesia, longer waiting times were associated with higher satisfaction of Indonesia's healthcare in terms of tangibility and responsiveness dimension. Expensive healthcare payments were linked to lower satisfaction with Taiwan's healthcare (OR=0.432 for tangibility) and higher satisfaction with Indonesia's healthcare (OR=5.079 for reliability). Additionally, language proficiency was associated with higher satisfaction with Indonesia's healthcare (OR=5.277 for tangibility and OR=10.443 for reliability). Meanwhile, easy explanations were associated with lower satisfaction with Indonesia's healthcare (OR=0.445 for assurance) and receiving assistance from volunteers (OR=0.326 for tangibility and OR=0.272 for reliability) and staff friendliness (OR=0.085 for reliability and OR=0.216 for empathy) were linked to lower satisfaction with Indonesia’s healthcare. Education and other demographic factors also played a role in shaping healthcare satisfaction
Conclusion: Individual and healthcare system factors influenced the utilization of healthcare services and unmet medical needs among Indonesian migrant workers in Taiwan. These factors also affected their satisfaction. To enhance service quality and address healthcare utilization services, healthcare providers should consider these factors and provide better assistance for migrant workers.