利用谷歌地圖呈現各醫院病例組合指標的品質報告卡

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Title:	利用谷歌地圖呈現各醫院病例組合指標的品質報告卡 A quality report card on the Google map to show the performance of case mix index for hospitals in Taiwan
Authors:	魏茹君
Contributors:	醫務管理系吳世望錢才瑋
Keywords:	品質報告卡 quality report card
Date:	2018
Issue Date:	2020-12-09 14:44:05 (UTC+8)
Abstract:	背景：醫療品質報告卡係向民眾公開的醫療品質標準化報告，雖然在國外已行之多年，也儼然成為歐美許多國家衛生管理的趨勢及政策。然而，品質報告卡卻仍停留在靜態的表格或是圖像。隨著科技的進步，尤其是雲端網路的一日千里，品質報告卡也日漸趨向於動態的儀表板方式，以更促進醫療品質的提升。本研究目的係探討谷歌地圖呈現各醫院病例組合指標(CMI)的品質報告卡，希望透過資訊提供讓消費者能做明智的選擇，促使醫療專業品質卡，更符合民眾的期望。方法：擷取健保署網站醫療品質資訊公開之330醫院CMI資料(自2013年第3季至2016年第2季，共計12季)，整理出資料完整的有效樣本 217 家醫院。首先 (1)利用多類量表的信度及效度指標，評估CMI資料的品質。(2)依據谷歌地圖製作醫院CMI儀表板的品質報告卡；另以(3)加權分數評估層級醫院CMI提升的改善成果，評定哪類層級醫院的表現最優。利用Kendall係數(W)評量層級醫院CMI提升的改善成果績效排名評分之一致性。結果：結果顯示，(1) 各醫院CMI資料符合信度及效度的品質；(2)谷歌地圖能夠呈現易讀易懂的儀表板品質報告卡；(3)區域醫院CMI提升的努力表現最優。醫學中心與區域醫院不相上下且優於地區醫院與基層診所。Kendall’s W=1.0，說明評分排名符合其一致性(卡方=6，自由度=2，p= .04)。結論：本研究建置谷歌地圖呈現儀表板的品質報告卡，對於健保署網站醫療品質資訊公開之其他44項指標，提供一具網路科技應用的可行性示範。 Background: Medical quality report card publicly displays the standardized format of the clinical performance in healthcare settings. Although the quality report card has been internationally implemented for many years, it seems to be a trend and policy for national healthcare management in many western countries/areas. However, the quality card still stays with a static tables or image format to display. Along with the computer advance and the cloud websites development in recent years, the report card is gradually moving to the tendency with an animated dashboard-type representation. As such, the medical quality can be upgraded through the improvement in the format and on the internet. The study aimed to demonstrate a quality report card that can be shown on the Google map to investigate the performance of case mix index(CMI) for hospitals in Taiwan. Methods: CMI data(from Q3 2013 to Q2 2016) were obtained from the website of Taiwan National Health Issuance Administration(NHIA). A total of 217 hospitals are eligible based on the data are complete. We used scale quality indicators (1) to assess the quality of the study data; (2) create a dashboard-type quality report card that can be traced on the Google map; (3) select the hospital level that perform better in the trend and competition of CMI. Finally, theKendall coefficient (W) was used to assess the concordance among raters. Results: We found that (1) the CMI data fit the predictable requirement rather well; (2) the dashboard of quality report card shows on the Google map with multidisciplinary functionalities; (3) the level of regional hospitals earns the merit of performance in CMI. Kendall’s W=1.0, indicating all the performance rankings are unanimous( =6, d.f.=2, p= .04). Conclusions: The demonstration of quality report card on CMI using Google maps can inspire other 44 quality indicators of NHIA in use for hospitals in the future.
Relation:	電子全文公開日期：2018-09-04 學年度：107，54頁
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Dissertations and Theses

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