中西醫合診臨床療效評估及成本效益分析之結果研究

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Title:	中西醫合診臨床療效評估及成本效益分析之結果研究
Authors:	馬作鏹
Contributors:	公共衛生學院醫務管理學系
Keywords:	中西醫合診;成本效益;教育訓練;臨床試驗;Traditional Chinese and western medicine combine therapy;cost-effective;education and training;clinical trial
Date:	2006-12-31
Issue Date:	2009-09-01 15:10:31 (UTC+8)
Abstract:	一、目的： 1.監督各計劃之進行及使子計畫順利進行 2.使計畫執行者接受教育訓練更謹慎的執行臨床試驗 3.同時本研究針對中西醫合診的病患，進行療效評估，並進一步評估是否具有成本效果，以作為未來推行計畫及研究者的參考依據。二、實施方法本計畫為一年期之計畫，負責監督底下五個子計畫的進行，分別為小兒腦性麻痺中醫門診照護之療效及生活品質評估之研究、腦中風住院患者中醫會診照護作業流程與療效評估、腦性麻痺患者中醫優質照護門診標準作業流程建立與療效評估、中醫優質門診對氣喘病人療效評估分析、中西醫合診臨床療效評估之成本效益分析及結果研究。為使所有計畫順利進行，總指揮中心底下，設立監督、教育及協調三個組。其執掌及負責事項如下： 1、監督組：負責監督各個子計劃執行進度，以使子計畫能於時間內準時完成。由總指揮中心於計畫開始前一個月內，召開進度會議，與各計畫負責人達成共識，協定預定達成之進度；於計劃開始之後，每三個月進行監督工作，由助理發文通知繳交進度，審查之工作由總指揮中心人員負責。 2、教育組：為了使研究者能清楚研究須注意之事項，成立教育組，負責安排教育訓練。針對各計劃執行人員，由指揮中心排定與計劃相關之教育訓練課程，每兩個月舉行一次，共舉辦六場。舉辦時間及主題如下所示： 3、協調組：執行計畫多少會遇到瓶頸，協調組由指揮中心設立專員負責，透過電話、 e-mail、信函等，收集各計畫之協調意見，並於接案日三週內緊急處理，以使計畫能順利進行。研究對象為北中南共三家醫學中心，針對特定疾病前來就醫的患者，依照就診的類型為區分標準。實驗組為採用中西醫合診的病患，對照組為僅採用西醫的患者。病患於收案後即進行前測評估，評估工具為生活品質量表(Short Form-36,SF-36)；而經過醫師評定，認定該患者已滿足後測所需條件之後，即施行後測評估。　　在成本評估方面，包括醫療機構所需花費之成本(包含直接成本如人力、藥品衛材、醫療設備，及間接成本如作業費用、行政管理等成本)，及病人所花費之私人成本(如病患及家屬的時間成本及生產力損失之成本等)。　　透過本研究，可以了解中西醫合診對患者在臨床上的成效，以及在臨床應用上是否具有成本效果，研究結果可以作為醫師及管理者在選擇中西醫合診與西醫治療上的參考依據。關鍵詞：中西醫合診、成本效益、教育訓練、臨床試驗 Objective: 1.To supervise each plan and make the sub plan go on smoothly 2.To make planning executors accept education and training which have more prudent execution on clinical testing. 3.In the meanwhile, this research also to aim at Chinese and western medicine combine therapy patient, carry the curative effect evaluation out and evaluate the result of cost further. It is to be the reference bases for researcher in the future. Methods: This plan is a one-year plan, the ones that take charge of supervising five following plans to go on,respectively, the study on the assessment of Chinese Medicine therapeutic effect and life quality in cerebral palsy patients with Chinese Medicine out-patient care, cerebrovascular accident patient with traditional chinese medicine consultation care operation procedure and curative effect assessment, the establishment of Chinese Medicine out-patient care standard operating procedure and assessment of Chinese Medicine therapeutic in cerebral palsy patient, clinical evaluation of Chinese treatment in asthma, The cost-benefit analysis and result analysis of the outcome of Chinese western combine therapy. In order to make all plans go on smoothly, under the general command centre , set up supervision , education and coordination three groups. It wields and responsible for the item as follows: 1.Supervision group: Responsible for supervising every sub planning to carry out the progress, in order to enable sub plan to finish on time. Hold the progress meeting one month before the plan begins by the general command centre, reach a common consensus with each plan director and reach an agreement to scheduled the progress to reach; After the plan begins, it will supervise work every three months, sending the documents by the assistant to notice and hand in the progress, the personnel of command centre will responsible for censorship work. 2.Educational group: In order to enable researcher clearly to know what a research must be paid attention to, the educational group is established, take charge of arranging education and training class. To be aimed at the operational staff, the command centre will arrange related education training program. 3.Coordination group: Carry out plan may run into bottleneck more or less , coordination group set up by command centre commissioner responsible for, by telephone, E-mail, letter ,etc., collects the coordination suggestion of each plan, and deal with promptly at once when taking over case in three weeks, In order to enable plan to go on smoothly. The object of research is north, middle and southern three medical centers altogether, to the specific of disease patient coming to seek medical advice, according to the type of going to a doctor in order to distinguish the standard. The patient of experiment group was adopt traditional Chinese and western medicine combine therapy, contrast group was the patient only adopt Western medicine. After collecting the case, then promptly carry front test out. The assess tools as Short Form-36, And evaluate through the doctor, after asserting that this patient examines the necessary condition after already meeting, namely examine assessing after implementing . Assess the respect in the cost, including the cost of necessary cost of medical organization (include the direct cost such as manpower and medicines, expendable material, medical equipment, and the indirect cost such as operations expenses, and administration cost, etc.), and the private cost of patient(such as the time and productivity cost of the patient and relative) Keyword: Traditional Chinese and western medicine combine therapy, cost-effective , education and training , clinical trial
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