西醫基層總額六分區品質報告卡實施計畫之評估

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 公共衛生學院 > 醫務管理學系暨碩士班 > 研究計畫 > Item 310903500/11197

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題名:	西醫基層總額六分區品質報告卡實施計畫之評估
其他題名:	Evaluation of Implementation of Quality Report Cards for Primary Care Clinics under Global Budgets System
作者:	蔡文正(Tsai,Wen-Chen);楊志良;吳守寶;龔佩珍(Kung, Pei-Tseng)
貢獻者:	公共衛生學院醫務管理學系
關鍵詞:	品質報告卡;西醫基層;醫療品質;Quality Report Cards;Primary Care Clinics;medical quality
日期:	2006-06-30
上傳時間:	2009-09-01 15:07:19 (UTC+8)
摘要:	中文摘要醫療品質報告卡為醫療機構對民眾公佈其醫療品質資訊之工具。而品質報告卡最大的功能就是藉由公佈醫療機構的品質概況，提供民眾選擇就醫場所之參考。在西醫基層實施總額之後所訂定的西醫基層總額品質確保方案中，亦明確指出，出版品質報告卡係以提供西醫基層診所以及保險對象參考，期望能使保險對象的醫療服務品質更有保障。醫療品質報告卡可滿足醫療服務資訊的公開性，亦可藉由醫療服務資訊的透明化來督促醫療機構提高其醫療品質，同時，亦不失為評估醫療機構品質的有效工具。而健保局高屏分局亦於91年起於其網站上公佈相關醫療院所之基本資料與民眾就醫滿意度調查結果，以供民眾就醫選擇醫療院所之參考。中央健康保險局已於93年度委託本研究團隊執行「實施西醫基層品質報告卡可行性之研究」，並將於94年6月有具體初步之成果，本研究之目的乃依據其結果評估實施品質報告卡後，對於醫師執業行為與民眾就醫行為之影響與滿意度，並且依此再次修訂品質報告卡項目內容與公開機制及流程。此外，建立品質報告卡實施計畫，以作為健保局實施該方案時的參考。本研究針對基層診所醫師與一般民眾進行問卷調查，以瞭解實施品質報告卡對院所經營及民眾就醫行為可能之影響。在西醫基層診所方面：本研究以高屏分局轄區內之西醫基層醫師為研究對象，透過郵寄問卷的方式，預計回收有效樣本250份。在民眾方面：本研究以高屏分局轄區內之20歲以上之民眾為研究對象，透過電訪的方式，預計回收有效樣本800份。並且利用複迴歸分析影響民眾與醫師對於實施品質報告卡滿意度之相關因素。此外，運用羅吉斯迴歸分析探討品質報告卡是否影響民眾就醫選擇之因素，以及瞭解影響基層醫師是否贊成實施品質報告卡的因素。根據本研究調查結果與93年度研究成果報告，本研究將採用專家座談方式針對已建立之品質報告卡項目與內容的合適性與適當性進行再評估，將邀請產官學界專家學者對於公開流程與實施方式進行討論，以確立出適合國內推行西醫基層診所品質報告卡之可行方案與相關配套措施。 Abstract The quality report card is the tool to make the healthcare quality public for the health care providers. The major function of quality report cards is as a reference for patients to choose health care providers. The quality assurance program for primary care medicine under the global budget system indicates that issuing the quality report cards is able to ensure patients to have better healthcare quality. The quality report card not only discloses the healthcare quality information but also is an effective tool to measure healthcare quality to the providers. The Kao-Pin branch bureau of National Health Insurance (NHI) has implemented the demonstration program of quality report cards for hospitals and clinics since 2002, and published the hospitals' and clinics' basic information and patients' satisfaction in the internet as the reference for general population. This research team is conducting the project-"Feasibility of Implementation of Quality Report Cards for Primary Care Clinics", which was financially supported by Bureau of NHI in 2004, and will have the study results and conclusion in June 2005. The objectives of this study will evaluate the impact of implementation of quality report cards for primary care clinics on physicians' practice patterns and on patients' choices for medical care as well as physicians' opinions and patients' satisfaction for quality report cards. Then this study will improve the contents of quality report cards and the mechanism of publishing and dissemination based on the survey. Finally, this study will like to propose the plan of implementation of quality report cards for primary care clinics for the Bureau of NHI. In order to understand the impact of quality report cards on clinic physicians' practice and patients' behaviors when they seeking medical treatment, questionnaires will be used to interview primary care physicians and general population. For primary care clinic, the study population will be primary care physicians whose clinic is located at the areas managed by Kao-Pin branch bureau of NHI. Questionnaires will be sent to these physicians and the returned questionnaires will be expected to be 250. People aged more than 20 years old and living in the areas managed by Kao-Pin branches of BNHI will be interviewed by phone and a total of 800 samples will be collected. Multiple regression analysis will be applied to analyze the affecting factors of primary care physicians' satisfaction as well as on patients' satisfaction with the implementation of quality report cards. In addition, logistic regression analysis will be used to explore the factors which will influence patients' behavior when they seek medical treatment, and also to examine the factors influencing primary care physicians to support quality report cards. Moreover, this research will like to understand the opinions of primary care physicians about the implementation of quality report cards. According to the investigation and the first-year study results conducted by this research team, the expert panel will be hold to discuss the appropriation of the contents of quality report cards. Finally, this research will propose the suitable plan and feasible alternatives of implementing the quality report cards for clinics in Taiwan.
顯示於類別:	[醫務管理學系暨碩士班] 研究計畫

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