影響台灣地區民眾醫療信任相關因素之探討

Medical Trust and Associated factors from the general public in Taiwan

10.29916/JMPP.201603_10(1).0006

邱政元(Jeng-Yuan Chiou)；陳冠銘(Guan-Ming Chen)；黃子袁(Zih-Yuan Huang)；陳敏郎(Min-Lang Chen)

醫療信任 ； 專業信任 ； 制度信任 ； 台灣社會變遷基本調查 ； medical trust ； professional trust ； institutional trust ； Taiwan Social Change Survey

管理實務與理論研究

10卷1期（2016 / 03 / 01）

113 - 134

繁體中文

目的：現代醫療科技與管理不斷進展的同時，社會大眾對於醫師與醫療照護的信任程度在下降，但是尋求值得信任的醫師與醫療照護的需求不減。本文的目的在探討影響社會大眾對醫師與醫療體系之信任的相關因素。方法：資料來源為「台灣社會變遷基本調查」計畫，「健康與醫療照顧」議題的次級資料庫。以2,199份完訪樣本為對象，進行次數分配、百分比、卡方檢定、皮爾森相關分析、邏輯斯複迴歸等統計分析。結果與結論：回答信任醫師佔72.35%；信任醫療保健系統佔77.26%。信任醫師與信任醫療保健系統的程度，同時會因為教育程度、每月收入、自覺健康、生活品質、生活快樂的不同而有顯著差異。在迴歸分析中，生活快樂同時是「專業信任」(OR=1.41，p＜0.05)與「制度信任」(OR=1.50，p＜0.05)的顯著相關因子。社會大眾對制度信任的比例高於專業信任。專業信任漸漸依賴於制度信任，對醫師執業與醫療保健體系發展的挑戰，是值得關注的重要議題。在制度信任高於專業信任的醫療信任現象中，強化社會大眾對醫療機構的信任，會是改善醫病關係與增進醫師信任的有效途徑。

Objectives: Although trust in the medical field was declining in the progressive process of managed health care, but the patients’ need for trustworthy care is undiminished. The purpose of this article was to investigate the medical trust in Taiwan. Methods: Data were drawn from the 2011 Taiwan Social Change Survey (TSCS, n=2,199), which included a topical module on Health questionnaire revealed the status of health and medical care issue. Case summary, χ^2 test, Pearson correlation and multiple logistic regression analyses were conducted to investigate the relationship among variables. Results and Conclusions: 72.35% respondents reported trust in physicians and 77.26% trust in medical system. Variables filter by educational level, monthly income, health awareness, life quality and happiness showed statistically significant both in the measurement of trust in physician and medical system. In adjusted analyses, both in trusted physician (OR=1.41, 95% CI=1.06-1.90) and medical system (OR=1.50, 95% CI=1.09-2.06) dimensions, respondents with happiness reported had higher odds of reporting than respondents with unhappiness reported. Respondents reported more trust of medical system than physicians. The rise of managed care often is seen as undermining and lessening the trustworthiness of care. But, whether what circumstances, managed health care might make medical process more trustworthy, not less. In our views, that would be a continually challenge for physicians and health care system which can operate in ways that merit patients’ trust.

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