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http://ir.cmu.edu.tw/ir/handle/310903500/11233
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| 題名: | 實施西醫基層品質報告卡可行性研究 |
| 其他題名: | Feasibility of Implementation of Quality Report Cards for Primary Care Clinics |
| 作者: | 蔡文正(Tsai, Wen-Chen);吳守寶;楊志良;龔佩珍(Kung, Pei-Tseng) |
| 貢獻者: | 公共衛生學院醫務管理學系 |
| 關鍵詞: | 西醫基層;品質報告卡;醫療品質;Quality report card;Primary care;Health care quality |
| 日期: | 2005-06-30 |
| 上傳時間: | 2009-09-01 15:08:30 (UTC+8) |
| 摘要: | 政府於民國87年開辦了牙醫總額支付制度，以抑制醫療費用的高漲，並陸續於89年、90年與91年實施中醫、西醫基層與醫院總額，除了醫療費用的控制之外，各界最擔憂的仍然是醫療品質是否受到影響。而在醫療市場中，因就醫的財務障礙降低，民眾擁有高度的就醫選擇，因此，所得到的就醫相關資訊是否足夠就更顯得重要。然而，民眾實際在就醫選擇時，因為沒有足夠的資訊，作為選擇院所的依據，促使民眾嘗試地以重複就醫尋求最佳的醫療，不但浪費醫療資源，醫療費用逐年高漲，病患也不見得獲得最適當的醫療照護。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，提供民眾作為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。有鑑於此，本研究將先探討目前國內外醫療品質報告卡之現況，參考過去相關研究對醫療品質報告卡實施上之影響因素及優缺點，並集合產官學及消費者代表對於醫療品質報告卡之推行機制等議題進行討論。且分別利用問卷收集西醫基層診所醫師對於醫療品質報告卡實施的意見及民眾對於醫療品質報告卡內容重要性與適當性之評估結果，之後將採用統計分析方法Ploytomous Logistic Regression Model分析出影響西醫基層診所醫師贊成實施醫療品質報告卡意願之因素，並使用描述性分析來探討民眾對於醫療品質報告卡內容及項目適當性之看法與意見等概況。最後將再度召開專家座談會，針對前述專家座談及統計分析之結果來確立出適合國內推行西醫基層診所醫療品質報告卡之可行方案與相關配套措施。
To curb the inflation of healthcare expenditure, the Bureau of National Health Insurance (BNHI) has implemented the payment system known as ？HH？HHglobal budget systems？HH？HH in the dental care since July of 1998, and extended to Chinese medicine in July 2000, Western medicine in July 2001 and the hospital care in July 2002. Beside the fears of facing limited budget, the impact on healthcare quality has also been concerned. In Taiwan, since the NHI has reduced the financial barrier of the insured people, patients now have extreme freedom of choosing physicians and hospitals. That patients acquire sufficient information to make choices is obviously important. When insured people, however, with inadequate information look for ideal healthcare services form one to another, the payment of BNHI is enormous.The quality report card is the tool of information of health care quality to make public for the health care providers. The major function of quality report cards is a reference for patients to choose health care providers. The quality guarantee program of primary care medicine in global budget system indicated that issuing the quality report cards for insured people was able to ensure patients to have better healthcare quality. The quality report card not only discloses the health care quality information but also is an effective measurement of health care quality among the providers.Firstly, this study will explore the situation of implementation of quality report cards in Taiwan and other countries, and also review the relative literatures and analyze their advantages and disadvantages. The expert panel meeting, in which the representatives of government, consumer, health care providers, scholars and the BNHI will be invited, will be held to discuss the relative topics for implementing quality report cards. Secondly, the questionnaire will be used to survey the opinions of clinic physicians on implementing the quality report cards and of the public on the importance and adequacy of the contents of the quality report cards. Then the Polytomous Logistic Regression Model will be conducted to explore the significant factors that influence clinic physicians？HH？HH willingness to adopt the quality report cards. By using descriptive statistic analysis method, this study will discuss the inclinations and attitudes of the public about the contents of quality report cards. Finally, based on the survey results, the expert panel will be held again to establish 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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| 93-NH-1011.pdf | | 4155Kb | Adobe PDF | 748 | 檢視/開啟 |
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