近年來國民生活水準提高，醫療科技進步，國人平均壽命延長，而維持良好的生活品質與健康的生活型態，漸漸成為國人關心的議題。行政院衛生署在民國八十八年提出「社區健康營造」計劃，主要是整合社區資源，鼓勵由下而上的社區民眾參與，共同擔負社區健康維護的責任。醫院對社區健康營造的推動具有重要地位，除了可以提供基層醫療照護需求，更可提高醫院的競爭力。 本研究主要目的是探討醫院參與社區健康營造動機、滿意度及關鍵成功因素。研究方法採用問卷調查方式，研究對象是經衛生署評鑑為地區醫院以上之各層級醫院。總共發出574份問卷，有效樣本數為124份，回收率為22.13%。 本實證研究結果僅有57家醫院設有專職負責社區健康營造工作部門，而專責單位多為社區服務有關之部門，其餘未設置專責部門者，多隸屬護理部。在經費來源部分，大部分醫院自行編列預算。至於參與模式部分，主導式有40家，參與式22家、零星式則有7家。 醫院參與社區健康營造的主要考量包括外部環境因素：健保因素、競爭因素、社區需求因素；內部環境因素包括成本效益、醫院使命、社區導向等。在參與社區健康營造滿意度部分包括：提昇醫院形象與地位、建立社區互動關係、增加社區資源及社區資訊的掌握等。至於關鍵成功因素，在敘述分析發現受訪醫院一致認為最重要的是社區民眾對健康的自覺，參與模式則以完善的志工管理最重要。 本研究結果發現所有受訪醫院均表達參與社區健康營造意願，並建議醫院應審視所面臨的內、外環境因素，主動積極參與社區健康營造，結合地方資源，提供社區醫療照護，並納入醫院管理，為醫院及社區居民謀求最大福利。; Due to enhanced living standard and development of medical care technologies in recent years; the average live expectancy in Taiwan has increased. As a result, maintaining good quality of living and a healthy lifestyle has become an important issue. In 1999 the Department of Health of Executive Yuan implemented a Three-year Project for Community health management center is project aimed to organize community resources, encouraging a bottom-up approach for community residents to take the responsibilities of improving health status. The hospitals that participate in the project would benefit form advancing its competitive advantage in the market and take care of the needs of community residents. The purpose of this research is to examine the participating hospitals′ motives、satisfaction and key successful factor that involved in community health management activities. Questionnaires had been sent to 574 target hospitals, including medical center hospitals, public hospitals, local hospitals based on the accreditation list conducted by the Department of Health.The respond rate is 22.13 percent ( 124 hospitals responded.) The research shows that only 57 of 124 hospitals have set up a special unit to deal with community health management activities, and most of the units are under the supervision of social service department. The rest of the hospitals usually put the community medical service affairs under the supervision of nursing department. Expenditure for the medical service comes mainly from hospital budget, without the support of the government departments and community institutions. Among the hospitals that participate in the project, 40 hospitals have been categorized as active model , 22 as passive model, 7 as sporadic cooperation model. The research also indicates that the hospitals that participate in the community health management generally take external factors and internal factors into consideration. External factors include National Health Insurance、competitive advantage and community needs, and internal factors include costs、hospital mission and community orientation. The degree of satisfaction also shows that participation is helpful in improving hospital image、 establishing relationship with community、increasing its understanding to community resources and community information. In addition, the results of the descriptive analysis shows that the self-conscious of community residents to the health management is emerging as the most important factor for the success of community health management system. Based on the result of participation model analysis, a sound volunteer management system is crucial. The research has shown that all hospitals are willing to participate in the community health management. It also suggests that hospitals should participate in the community health management activities, and integrate community institutions in order to offer a better health resources to the community residents.
