题名
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基層開業醫師對台灣基層醫療制度的評估及滿意度調查
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并列篇名
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Office-Based Physicians' Evaluation of the Primary-Care System
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DOI
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10.7023/TJFM.200809.0137
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作者
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陳郁穎(Yu-Ying Chen);葉端坦(Jui-Yuan Yeh);陳楚杰(Chu-Chieh Chen);林恆慶(Herng-Ching Lin)
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关键词
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office-based physicians ; clinics ; primary care system
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期刊名称
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台灣家庭醫學雜誌
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卷期/出版年月
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18卷3期(2008 / 09 / 01)
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页次
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137
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148
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内容语文
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繁體中文
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中文摘要
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本研究目的旨在探討基層開業醫師對於基層醫療制度和執業上所面臨問題,並瞭解基層醫師對未來基層醫療制度發展之期望。資料來源取自衛生署醫事處,主要抽取2006年衛生署登記執業基層開業醫師名單,採用系統式抽樣法,共得3,407位,以郵寄方式蒐集所需的資料,有效回收樣本總計489份,回收率爲14.4%。資料分析首先以Microsoft Excel 2000建檔,再以SPSS 12.0進行資料分析,除基本描述性統計分析之外,推論性統計則採用羅吉斯複迴歸分析。
研究結果發現,在影響基層開業醫師是否滿意現行基層醫療制度因素方面,「50歲以上」、「基層醫療執業總年資<10年」的基層開業醫師,及對「抽審審查標準不一」和「缺乏完善的家庭醫師人力」愈同意的基層開業醫師,其對現行基層醫療制度愈不滿意;愈同意「缺乏對基層診所的評鑑機制」的基層開業醫師,愈滿意現行基層醫療制度。而影響基層開業醫師是否滿意現行基層醫療工作狀況之因素發現,「聯合執業」和「具專科醫師資格」的基層開業醫師較滿意現行基層醫療工作;愈同意「保險不夠完善而害怕醫療糾紛」、「沒有足夠的時間進修」和「醫療收入減少」,愈不滿意現行基層醫療工作。
醫師之間的良性合作、個人自我充實以及完善的保險制度,可使基層開業醫師更能滿意基層醫療。而在未來,基層醫師希望藉由良好健保政策的影響以及加強基層診所的內部管理,真正做到提升基層醫療品質,給予民眾更佳的醫療服務。
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英文摘要
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Objectives: The objectives of this study were to explore office-based physicians satisfaction with the primary-care system, the difficulties faced by office-based physicians, and the future direction of the primary-care system.
Method: This study used systematic sampling from a list of office-based physicians provided by the Department of Health. We selected 3,407 office-based physicians as the study subjects. Self-administered questionnaires were mailed to the study subjects to collect the required data. In total, 489 questionnaires were returned, for a response rate of 14.35%.
Results: This study found that 13.09% of the respondents felt that the primary-care system had been in recession during the past few years. A total of 49.28% and 32.11% of respondents were not satisfied and very dissatisfied with the present primary-care system, respectively. The three major problems with the primary-care system faced by the office-based physicians were the overlapping of patients with hospitals, lack of an accreditation mechanism, and too many office-based physicians. The three major problems with clinics faced by the office-based physicians were management, blackmail by gangsters, and inadequacy of medical equipment.
Conclusion: Cooperation among physicians, continuing education, and a good insurance system can increase the satisfaction of office-based physicians. In the future, office-based physicians believe that implementation of a good health-insurance policy and enhancement of clinic management will improve the quality of the primary-care system and result in better medical service to the public.
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主题分类
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醫藥衛生 >
社會醫學
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参考文献
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林恆慶、吳傳頌、許佑任、陳楚杰(2005)。台灣基層醫師對家庭醫師制度的認知、態度及認可模式。台灣家醫誌,1,11-24。
連結:
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林恆慶、董鈺琪、李淑雅、陳楚杰(2002)。影響基層醫師不願意參與聯合執業的因素。醫護科技學刊,4,90-103。
連結:
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邵詩媛、蔡良敏(2005)。社區醫院雙向轉診之策略規劃。醫務管理期刊,6,190-199。
連結:
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許佑任、陳家榆、林恆慶、陳楚杰(2004)。台灣民眾對實施家庭醫師制度之意願及相關因素研究-民眾的認知、態度及參加意願。台灣家醫誌,14,159-171。
連結:
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陳楚杰、楊銘欽、林恆慶、黃昱瞳(2002)。參與聯合執業基層醫師之特性及其較認同的聯合執業模式。醫護科技學刊,4,337-348。
連結:
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劉容華、張東亮(2004)。臺灣醫療次區域醫院產業擴張與診所醫師人力消長的關係。台灣衛誌,23,32-36。
連結:
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衛生署衛生統計資訊網:衛生統計指標
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Hodge R(1994).The evolving role of the primary care physician.Physician Executive,20,15-18.
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醫療統計
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呂清元(2003)。碩士論文(碩士論文)。國立陽明大學醫務管理研究所。
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李玉春(2001)。全民健保西醫總額支付制度之推動政策-基層與醫院預算之分力或統合?。台灣醫界,44,43-46。
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林姿伶(2002)。中國醫藥學院醫務管理研究所論文。
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張伊萍(2003)。碩士論文(碩士論文)。台北醫學大學醫務管理學研究所。
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陳錦源(2001)。基層醫療何去何從。台灣醫界,2,48-50。
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劉競明(2002)。基層醫療品質提升知我見。台灣醫界,1,62-63。
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鄭守夏、劉林義、張毓宏(2001)。新設大型醫院對當地基層診所的影響評估-第一部分:供給與利用的變化。台灣公衛誌,20,52-60。
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被引用次数
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龔佩珍、蔡文正、曾盈甄、陳文侯、李亞欣(2011)。基層醫師對實施基層分科總額預算之意願及影響因素。臺灣公共衛生雜誌,30(2),150-164。
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