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

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Title:	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
Authors:	陳惠芳
Contributors:	醫務管理系
Keywords:	家庭醫師醫師意見衛生政策 Family Physicians Physicians’Views
Date:	2004
Issue Date:	2008-06-24 11:52:30 (UTC+8)
Publisher:	台南縣：嘉南藥理科技大學醫務管理系
Abstract:	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”.
Relation:	計畫編號：CNHA9303_4
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Chna Project

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