目標：中央健保局於民國九＋二年起公告實施「家庭醫師整合性照護制度試辦計畫」，整合醫療院所的資源及提升服務品質外希望能吸引被保險人的參與，進而達到預防醫學以及降低整體醫療費用的成效。醫師滿意度是醫病關係及醫療照護過程的重要預測因素，故本研究旨在探討醫師對「家醫整合計畫」的滿意程度及看法，與醫師滿意度之影響因素。方法：以九十二年度，南區二十九個社區醫療群的全部200 家診所之醫師為研究母群，在九十四年七月以郵寄問卷調查法收集資料，總共發出200份問卷，共回收有效問卷105 份，以描述性分析。因素分析、單變項分析、相關分析及逐步複迴歸分析，探討醫師滿意度與看法，及滿意度主要影響因素。結果：發現醫師平均滿意度分數為3.59分，醫師平均認同度分數為3.4分，醫師滿意度經由因素分析後可分為四構面：1)診所與醫院診療、行政管理合作面；2)主管機關對家醫制度管理面；3)醫療群運作情形及診所服務提供；4)病患對家醫制度的接受及參與度。在「診所特性」中開業年資、醫療資訊系統是否與合作醫院連結、是否建立平行轉診及「醫師特性」中是否為社區醫療群執行中心長、參與「家庭醫師整合性照護制度試辦計畫」動機數目、是否贊成「家庭醫師整合性照護制度試辦計畫」實施與醫師對「家醫整合計畫」認同度都會影響醫師對計畫的滿意度。結論：衛生主管機關應加強診所醫師對家醫整合計畫的認同、強化診所與醫院間資訊系統連結的暢通、建立診所平行轉診以提升醫師的滿意，俾利家醫整合計畫之功效。 Objective : As the level of satisfaction of physicians is an import predictive factor for the relationship between the healthcare provide the patient and the healthcare process , this study aims to investigate the level of satisfaction and views of physicians on the " Family Doctor Integrated Health Delivery System , , and the factors influencing the level of satisfaction . Methods ：Taking primary care physicians of the 200 clinics in the29 healthcare communities of the South District in 2004 as subjects, this study adopts questionnaire survey method; a total of200 questionnaires were mailed in July 2005 and 105 valid questionnaires were retrieved. Descriptive analysis, factor analysis, one-way ANOV and stepwise regression analysis were adopted to investigate the level of satisfaction and views of physicians and the major factors influencing the level of satisfaction. Results: The mean score of the level of satisfaction and agreement of physicians are 3.59 and 3.4 respectively. Through factor analysis, the level of satisfaction may be divided into4 constructs : 1 . cooperation between healthcare and the administration management of clinics and hospitals ; 2 . management of competent authorities on the family doctor system ; 3 . operation of healthcare institutes and services provided by clinics ; 4 . level of acceptance and participation of patients on the family doctor system . Factors influencing the level of satisfaction of physician include : 1 . Characteristics of clinic : including the years of operation , if the healthcare information system is connected to cooperative hospitals and if a horizontal referral system is estab1ished ; 2 Characteristics of Physicians : if the physician is the chief of the community healthcare center , the motivation of participating the " Family Doctor Integrated Health Delivery System " , if the physician agrees to the implementation of the " Family Doctor Integrated Health Delivery Pilot System" and the level of agreement to the " Family Doctor Integrated Health Delivery System". Conclusions: The health policy makers should reinforce the level of agreement of physicians to the " Family Doctor Integrated Health Delivery System " , strengthen the connection of information system between clinics and hospitals ; establish horizontal referral system between clinics in order to improve the level of satisfaction of physicians to increase the effects of the " FamilyDoctorIntegratedHea1thDeliverySystem "
