| 摘要: | 在台灣是中西醫醫療體系雙軌並行，中西醫醫療在全民健保制度下皆有給付。由於全民健保將中醫門診納入給付範圍，使得民眾對於中醫醫療利用快速增加，中醫門診的業務量呈現成長的趨勢。市場的開放政策促使中醫醫療機構到處林立，激烈的良性競爭使醫院不惜成本，各顯行銷策略吸引民眾；因此為了達到良好的經營績效，中醫院所積極向自費醫療服務市場發展。 現今民眾對於就醫有更多的選擇及採取主動的成份，就醫時選擇醫院的考慮因素眾多，在選擇求診醫療時，醫師的態度、診斷的準確性與服藥的方便性是考慮的重要因素；民眾對選擇要素，會因個人考量不同而有所差異，因此對於瞭解民眾選擇中醫醫療院所時的考量因素是相當重要的課題。本研究以南部某區域醫院中醫門診民眾為訪查對象，對於民眾選擇中醫的就診背景、選擇使用濃縮中藥或中藥材之用藥知識及行為等方面做深入的探討。本研究以無記名結構式問卷，針對南部某區域醫院中醫門診民眾，並以隨機抽樣方法進行問卷調查發放，瞭解1.民眾之就醫背景、經驗、要因及對濃縮中藥與中藥材的期望。2.找出民眾自費中藥材的原因、期待、可接受醫療費用等之相互關係。3.探討民眾就醫醫療服務的滿意度。研究結果發現，民眾對中醫健保服務的滿意度，以滿意的居多，佔63.3％；在中醫自費醫療，有60.0％的民眾就診中醫時，對於健保不給付的項目有意願自費支付；願意中醫自費範圍以保健養生佔多數。民眾可接受中醫自費藥品比例，以少數健保，多數自費佔64.7％；當藥帖比濃縮中藥粉療效佳的情況下，願意自費佔85.3％，接受中醫看診自費藥材每天費用以101－105元佔多數；對中醫自費藥帖擔心部份，以擔心農藥或重金屬殘留居多。 經樣本的實證研究及結果分析，對醫師開立處方、健保政策面、及病人用藥安全等三方面提出建議，以提供實務運用及後續研究者之參考。
In Taiwan, the Chinese and Western medical system, dual track, Chinese and Western medicine in the health care system, all payments. The object of this study to a regional hospital in Traditional Chinese Medicine outpatient visits for people to use concentrated herbal extracts and chinese medicine Pieces of drug knowledge, attitudes, behavior in-depth discussion. In this study, the structural test questionnaires, interviews with a regional hospital in southern Traditional Chinese Medicine outpatient, and the random method of sample selection and implementation of a questionnaire survey. 1. Traditional Chinese Medicine outpatient medical background, experience, and because expectations of concentrated herbal ectracts and chinese medicine. 2. Identify patients at their own expense crude drugs chinese medicine reasons, expectations, acceptable medical expenses, such as mutual relations. 3.The satisfaction of patients that visited the Traditional Chinese Medicine outpatient survece.The results indicate that 60.0% Traditional Chinese medical outpatients under the National Health Insurance could accept self–payment when health insurance does not cover private clinic expense. The major acceptable item of self-payment is medicine of health care. The National Health Insurance of Chinese medical services were satisified by 63.3% patient. The 64.7% patients agree to the ratio of self-paying Chinese medicine more than paid by the National Health Insurance. However, the better efficiency of Chinese crude drug is compared to extract concentrate medicine, 85.3% patients could accept self-payment. The acceptable daily self-paying range of Chinese medicine is around 101-105 NT dollars. It is worried too much poision such as agricultural chemical and heavy metal residue on Chinese crude drug.Empirical research and results of analysis of the samples, the opening of the physician prescription, health insurance policy side, and patient medication safety recommendations, to provide practical use and future researches. |
