| 摘要: | 動機與目的：依據國際經驗，政府為了提升台灣醫療產業之國際競爭力，自2012年起以「自由經濟示範區」形式推動「國際醫療」。由於此政策與「兩岸服務業貿易協議」皆為國際醫療政策中的一環，同時包含對醫療產業的開放，社會大眾易混淆，近年來引起許多輿論，對醫管領域人士而言，如何判斷兩岸開放國際醫療的利弊得失仍缺乏實證討論，因此，本研究欲探討醫管領域人士對於「自由經濟示範區」發展國際醫療之判斷分析。研究方法：本研究經文獻探討及專家訪談內容整理出3個決策參考變數，包括「經濟利益」、「醫療風險」及「政治風險」；依據決策參考變數，進一步以社會判斷理論（SJT）發展出十五個情境，以問卷調查法分析醫管領域人士的社會判斷研究採立意取樣，共計發放149份，有效樣本為125人，經Policy PC軟體計算個案十五個情境之迴歸解釋力達0.7以上者納入分析，有效分析樣本共為72人。研究結果：醫管領域人士對台灣在自由經濟示範區發展國際醫療之判斷，其判斷變數之重要性依序分別為經濟利益(40.5%)>政治風險(36.2%)>醫療風險(23.3%)；經圖形分析發現經濟利益發展程度與接受度之關係呈現線性正相關，醫療風險發展程度與接受度之關係分別包含線性負相關與開口朝上曲線（亦即適中最不好，政治風險發展程度與接受度之關係分別包含線性負相關與開口朝下曲線（亦即適中最好）。結論：整體而言，當經濟利益明確可圖時，醫管領域人士有較高的接受度，兩岸政治風險對其而言並不至構成威脅，但可能導致醫療風險大幅攀升。本研究建議後續為了確保未來可能產生的合作機會並因應投資風險，以及避免因逐利而侵蝕產業結構的道德良知，政策制訂者積極加強並鼓勵醫管領域人士投入創新服務模式之研發與設計；保持關注兩岸議題，並強化公民素養與教育；政府可提供誘因，鼓勵醫療機構投入國際醫療服務之創新設計，協助醫療健康產業優勢之產品或研發技術推廣至國外，促進台灣國際醫療之發展，積極規劃管制配套措施與制定相關法規，確保我國醫療產業結構不致產生扭曲之風險，並培養兩岸關係之中間人角色，保護台資醫療機構之運作、相關醫療健康產業之發展與兩岸之互動關係。
Motivation and purpose: Based on international experiences to enhance the worldwide competitivity of Taiwan medical care industry, the promotion of the specific area of international medical care has become the most prompted public policy in Taiwan by means of “ free economic demonstration zone " since 2012. However, this public policy has also caused controversy because of its confusing understanding of the issue on the open to the medical care industry as well as the"cross-strait trade agreements in services ". That is, it still needs more empirical evidences and discussions upon how to judge the pros and cons of the perspectives from the industrial-wide and national-wide, especially from the perspectives of the healthcare pfofessionals. This study is to investigate the healthcare professionals’ social judgment on the public policy of international medical development from the "free economic demonstration zone." Methods: With literatures review and qualitative interviews of the healthcare professionals, this study concluded three decision-making reference variables, including "economical interests", "risks on medical industry" and "risks on international politics". Furthermore, A purposive sampling survey was made by the questionnaire of a fifteen vignetteswhich were developed by the focus groups . With the basis of decision-making reference variables and the social judgment theory (SJT) , this survey analysed the healthcare professionals’ social judgment. Of atotal of 149 participants, 129 validated cases were enrolled in the analysis. We used the Policy PC software to made the analysis of social judgment. Of the 129 validated cases, an consistency analysis of the fifteen vignettes by case was made by the cutpoint of R2 value above 0.7 . As a result, the validated sample was of 72 participants.Research results: the relative importance of decision-making reference variables was weighed sequentially by "economical interests"(40.5%), "risks on medical industry" (36.2%), and "risks on international politics" (23.3%) . With the graphical analysis, the relationship between "economical interests" and the acceptance of the emphasized policy is presented as a positive linearity. Meanwhile, "risks on medical industry" comprises the relationships including a negative or an upward parabola curve. Finally, the "risks on international politics" contains the relayionships including a negative or a downward parabola curve.Conclusion:In general, we concluded that the higher the economical interes are perceived, the more they will judge by accepetance on the policy object.Meanwhile, though the risks on international politics will not threaten them, it can lead to a significant rise of risks on medical industry. This study finally proposed severaly suggestions based on the research analysis.. |
