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    標題: 社區民眾健康行為與醫療利用行為調查分析─子計劃4:社區整合家庭醫師計劃成效之探討-以南區某體系為例
    作者: 陳惠芳
    貢獻者: 醫務管理系
    關鍵字: 家庭醫師
    醫師意見
    衛生政策
    Family Physicians
    Physicians’Views
    日期: 2004
    上傳時間: 2008-06-24 11:52:30 (UTC+8)
    出版者: 台南縣:嘉南藥理科技大學醫務管理系
    摘要: 台灣自從於民國八十四年三月實施全
    民健康保險後,在每年支出醫療費用總額、平
    均每人每年醫療保健支出及醫療保健支出佔
    GNP的比率,皆呈現正向成長趨勢。成本、
    品質、可近性是民眾選擇就醫之三大要素,為
    降低醫療費用、提昇民眾就醫品質,近年來衛
    生主管機關陸續推出相關策略,策略之一為於
    民國九十二年三月實施的「家庭醫師整合試辦
    計畫」,衛生計畫實施成功與否需考慮實施對
    象對制度的接受性,並了解各項可能影響因
    素,然而「家庭醫師整合試辦計畫」實施迄今
    其管理成效如何?實施對象對制度的接受性
    又如何?參與計畫機構服務情形文獻上少有
    著墨。故本計畫以南區有參與家庭醫師整合性
    照護試辦計畫的全部診所38 家之基層醫師團
    隊38 位醫師為研究母群,採用郵寄問卷調查
    法收集資料,回收率為82%。以探討有關診
    所預期達成的指標、醫師贊同度、目標達成度
    與醫師同意度之影響因素,結果顯示醫師對家
    醫政策的平均贊同度為3.834 分,診所特性及
    醫師特性會影響贊同度;雙向轉診率為77%,
    會受診所特性及醫師因素影響其高低。該結果
    可作為衛生主管機關、醫院、診所及學術研究
    對「家庭醫師整合試辦計畫」規劃、執行、評
    估及提高機構競管理之參考。
    Ever since the implementation of
    National Health Insurance on March of 1995 in
    Taiwan, the annual total medical expenditure,
    healthcare cost per capita and percentage of
    GNP for healthcare cost have increased
    proportionally. Cost, quality and accessibility
    were the main factors for the population
    choosing healthcare facilities. In order to
    decrease medical expenditures and increase the
    quality of healthcare, the health authority
    launched related strategies. One of them was the
    “National Health Insurance Pilot Project of
    Family Physicians’ Integrated Health Care
    System” launched on March of 2003. The
    success of the health project depended on the
    acceptance of subjects on the system
    implemented and understanding of all potential
    factors. Nevertheless, how effective was the
    management of “National Health Insurance Pilot
    Project of Family Physicians’ Integrated Health
    Care System” since its launch? How well was it
    accepted by the subjects? Few literature
    described the state of the facilities that
    participated in this project. Thus, this study
    planned to use 38 primary care physicians from
    the 38 clinics in southern area of Taiwan which
    joined National Health Insurance Pilot Project of
    Family Physicians’ Integrated Health Care
    System as subject; whereas the data were
    collected through mailed questionnaire and
    investigation would focus on issues relating to
    the achievement index projected by the clinic,
    physician approval score, achievement rate and
    factors of the physician agreement score,
    completed by 31/38(82﹪). The physicians’
    average agreement score was 3.834, and it was
    correlated with Clinics’ characteristics and
    physicians’ characteristics. The average transfer
    rate was 77 %, and it was correlated with
    Clinics’ characteristics and physicians’
    characteristics. The result can be applied as a
    reference for the health authority, hospitals,
    clinics and academic research when planning,
    executing, evaluating and improving the
    management of facilities for the “National
    Health Insurance Pilot Project of Family
    Physicians’ Integrated Health Care System”.
    關聯: 計畫編號:CNHA9303_4
    Appears in Collections:[醫務管理系(所)] 校內計畫

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