| 摘要: | 本研究之目的，在於探討當代醫院社區化之角色功能，藉由醫院社區化的實務運作而促進社區民眾健康。在資料的收集上，採質性研究之深入訪談法（以衛生行政官員、醫院行政實務工作者、學術界學者專家及一般民眾為研究對象），探討的內容及目的包括：（一）探討受訪者對醫院社區化意義之認知。（二）了解受訪者認為醫院在社區中應扮演的角色。（三）探討醫院社區化應提供之服務項目及可尋求之資源協助。 本研究之結果，就受訪者對醫院社區化意義的認知而言，我們發現可將其歸納為6個觀點，包括「取決服務項目觀點」、「主動關心回饋觀點」、「關係建立觀點」、「社區化功能特性觀點」、「醫療資源缺乏地區補償觀點」及「著重行銷觀點」。支持「取決服務項目觀點」者為最多（約40%）；對於醫院必須積極走入社區之原因，受訪者的看法歸納為5種，包括「基於疾病預防需求」、「攸關醫院生存」、「因應民眾需求」、「基於責任回饋」及「拉近關係，彼此互動」。其中「基於疾病預防需求」為最多受訪者所支持；受訪者對於醫院社區化角色的期待，可歸納為6種類型，包括「教育諮詢型」、「健康管理型」、「運用政策考量型」、「主動彈性運用型」、「資源整合型」及「溝通互動型」。其中對於「教育諮詢型」角色的期待最多；受訪者對醫院社區化服務項目之期待可歸為6種，包括「針對三段五級預防層次來提供服務」、「針對不同對象來設計服務」、「建立民眾健康資料系統」、「舉辦休閒活動」、「加強溝通互動」、「提供醫療優惠福利」。受訪者最期待的醫院社區化服務項目為「針對三段五級預防層次來提供服務」；受訪者對於醫院社區化服務運作方法之期待歸為7種，包括「結合其他團隊共同服務」、「掌握地方需求再提供服務」、「結合適當地點場合」、「利用宣傳媒介」、「結合時節慶典」、「成立專責單位辦理」以及「以贈品吸引民眾參與」。受訪者最為期待醫院能「結合其他團隊共同服務」，結合其他單位機構或團體之資源，使服務提供之力量更為強大；受訪者對醫院走入社區可尋求之機構或資源協助可歸為5種類型，包括「民間團體協助」、「官方單位的協助」、「重要關鍵人物的協助」。有最多受訪者認為醫院可尋求「民間團體協助」。 最後，研究者依據研究發現，建議衛生行政部門及醫院皆應設立一專責單位，作為醫院社區化實務運作之對外窗口；衛生行政部門應針對醫院社區化規劃良好的政策及獎勵措施，在社區醫療資源的劃分上也應遵循不重複浪費的原則來作規劃；學術界則應以教育及解惑的角度，促使民眾了解醫院社區化的內容，藉由民眾的積極參與，而增進自己及社區的健康。 關鍵字：醫院社區化、角色功能; The purpose of this study is to research on the role play of contemporary community-based hospitals. By means of practical operation on community-based hospitals, the health of the people in the community can be promoted. For data collection, it adopts further qualitative research in-depth interview(Objects being interviewed are based on health administrative officers, practical administrative workers in the hospital, scholars in academic field, professionals, and the public people.) The content and purpose of this research include (1) Acknowledgement of interviewees to the meaning of community-based hospitals (2) Realization of role playing of the interviewed object in the community-based hospitals (3) Studying on services provided by community-based hospitals and possible resources assistance. The result of this study, as to acknowledgement aspect to the interviewees on community-based hospitals, we discover that there are classified into six viewpoints, including “Viewpoint on service items”, “Viewpoint of feedback to active concerns” “Viewpoint on relationship establishment”, “Viewpoint on function and features of community”, “Viewpoint of compensation on medical resources shortage area”, and “Viewpoint of marketing under emphasis”. The supporter of “Viewpoint on service items” was the most high one (approx. 40%). However, the reason of hospital have to step into community progressively, according to the viewpoints of the interviewees, it was classified into five categories: including “Based on demand for prevention on disorder”, “Relation to the existence of the hospital”, “To meet the demand of the public”, “”Based on duty feedback”, and “To close tight the relation and interact between each other”. Among them, “Based on demand for prevention on disorder” was supported by most of the supporters. The expectation of interviewees toward the role of community-based hospitals can be classified into 6 categories: including “Education consulting type”, “Health administration type”, “Policy operating type”, “Authority power operation change type”, “Resource integration type”, and “Communication interact type”. Among them, the role on “Education consulting type” was the most expectation. Moreover, the expectation of interviewees on service items of community-based hospitals can be classified into six categories: including “Services provided by 3-Step 5-Grade Prevention” “Services designed according to different objects”, “Establishment of public health data system”, “Holding the activities in the community”, “Stressing on communication and interaction”, “Providing medical preferential welfare”. The most expectation for interviewees on service items was “Services provided by 3-Step 5-Grade Prevention”. The expectation of the interviewees on service operating methods of community-based hospitals was classified into seven categories, inclu |
