本研究擬以南區的診所醫師為研究對象，調查其對轉介制度的看法，轉介意願與轉介行為，並探討影響診所醫師轉介行為的相關因素。研究採用郵寄問卷調查法收集資料，共發出404份問卷，第一次回收率27%，經第二次催收後，回收率達45.3%。結果發現診所醫師平均轉介率為1.5%，轉介方式以寫轉介單為居多，診所醫師為病人轉介時，有67.8%的醫師有將病人轉給某些特定機構的傾向，多數醫師會將病人轉至區域醫院與醫學中心，較少醫師會轉至地區醫院與長期照護相關機構。而診所醫師是否為醫院的特約醫師、有無參加家庭醫師試辦計畫、醫師特質與診所特質均不會影響診所醫師的轉介行為。診所醫師之所以願意為病人做轉介主要是以病人病情需要為考量。診所若與受轉機構有良好的合作關係，診所醫師熟悉受轉機構醫師的醫療技術等將有利於醫師做轉介。診所醫師為醫院特約醫師者，有將病人轉至特定機構的傾向。具有醫師專科證書者、專科證書兩張以上者、是醫院特約醫師者、有參加家醫計畫者、診療科別數目兩科以上者具有簽約的轉介機構比較多。診所醫師非醫院的特約醫師、未參加家醫計畫、看診人次1000人次以下者則較多是以口頭告知方式轉介病人。研究結果可做為衛生主管機關推行轉介制度之參考。 The purpose of this research is to investigate clinic physicians’ attitudes toward the referral policy, and their referral intentions and behaviors. Factors affecting referral behaviors are also examined in this research. A questionnaire survey was conducted by mailing to subjects. Who were primary care physicians in the southern Taiwan. Four hundred and four questionnaires were sent out and the final return rate was 45.3%. Results showed that the referral rate of clinic physicians was 1.5%. The most popular referral method for clinic physicians to use is to write referral application form. When the clinic physicians proceed with the patients’ referral, 67.8% of the doctors intend to send the patients to the specific institutions. Most physicians will recommend the patients referral to the regional hospitals or medical centers. It is less likely for them to recommend their referral patients to the local hospitals or nursing homes. Whether physicians are under special engagement or participate in family physicians as a pilot plan or not and the characteristics of the clinics can never influence clinic physicians’ referral behaviors. Clinic physicians only consider the cure needs of the patients. Certainly, the good cooperation between the clinic and the referral medical institution, the good service offered by the referral medical institution, the clinic physicians familiar with the specific skills offered by the referral medical institution, and the good medical equipment known by clinic will help the clinic have confidence in recommending the referral. If the clinic physicians are under special engagement, he intends to shift his patients to the engaged institution. physicians who have specialist certificates, physicians who have more than two specialist certificates, physicians who are under special engagement, physicians who participate in family physicians project, and the clinic having more than two areas of specialization, have more contractual referral medical institutions to work with. Physicians who are not under special engagement, who do not participate in the family physicians project, whose patients are under 1,000 per month, like to verbally tell patients how to do medical referrals. The results of the research can work as a reference for the ROC Department of Health.
