公費醫師執業科別、地點、執業機構型態之趨勢研究

Trends of Location and Specialty Selection of Government Sponsored Physicians (GSPs)

10.6288/CJPH1994-13-05-05

楊慧芬(Hui-Fen Yang)；季瑋珠(Wei-Chu Chie)

公費醫師 ； Government Sponsored Physicians GSPs

中華公共衛生雜誌

13卷5期（1994 / 10 / 01）

405 - 418

繁體中文

本研究之目的在瞭解自民國71年至80年分發至行政院衛生署系統之公費醫師服務地點、執業科別、執業機構型態之變化情形。研究對象以衛生署公費醫師電腦檔之資料為依據，並以醫學院學生檔案及衛生署醫事人員資訊系統為輔助資料來源，研究結果如下：分發組別方面：公費醫師選擇特殊科之比例逐年增加，而基層醫療組內外婦兒科逐年漸減。執業機構型態方面：因階段別不同而異。此外隨年代在合立醫院服務之比例漸減，在和立醫療院所的比例漸增；在衛生所服務之比例，第二階段逐年減少，第三階段逐年增加。執業地點方面：第一階段即住院醫師訓練階段主要集中在直轄市及其他地區，第二階段則集中在優先獎勵區及其他地區，隨著年代終優先獎勵區執業之比例增加。基層醫療組公費醫師的特色為第二階段主要在衛生所及優先獎勵區與其他地區服務。基於前述研究的發現與結論，吾人建議衛生及教育主管機關對公費醫師政策應進一步探討，且應對於台灣地區醫師人力專科別分布情形及變遷趨勢，進行深入研究。以符合醫療環境之需，並作為未來政策之參考。

The objective of this study is to understand the charcteristics of medical institution, specialty and location selection of government sponsored physicians (GSPs) from 1982 to 1991. Subjects of the study are GSPs dispatched from 1982 to 1991. Data are collected from the GSPs file and the medical manpower file in the Department of Health, as well as the student file of each medical school. Important findings are as follows: Specialties such as anesthesia, psychiatry, etc, tend to increase, while primary health care specialties decrease annually. Medical Institutions selected by GSPs changed by time and stage of service. The proportion of public hospitals decreased but that of private hospitals increased. The proportion of health station choice decreased annually in the second stage but increased annually in the third stage of service. National Cities are the favorite locations selected in the first stage of service. But medically under-served areas become the major choice in the second stage and its proportion increased annually. The most remarkable characteristics for the GSPs of the primary health care specialty are that health stations and medically under-served areas are the major choice in the second stage. According to the findings above, we suggested that the trends of medical manpower distribution and specialty choice for GSPs should be more thoroughly evaluated. Policies and regulations related to GSPs dispensation also need to be modified.