台灣基層醫師對家庭醫師制度的認知、態度及認可之模式

Primary Care Physicians' Knowledge, Attitudes, and Applicable Model toward the Implementation of Family Physician System in Taiwan

10.7023/TJFM.200503.0011

林恒慶(Herng-Ching Lin)；吳傳頌(Chuan-Song Wu)；許佑任(Yu-Jen Hsu)；陳楚杰(Chiu-Chieh Chen)

family physician ； primary care physician ； logistic regression

台灣家庭醫學雜誌

15卷1期（2005 / 03 / 01）

11 - 24

繁體中文

本研究旨在探討台灣地區基層開業醫師對家庭醫師制度的認知、態度及認可的模式。 本研究採用調查研究法，以郵寄結構式問卷的方式蒐集所需的資料，以於2003年4月在行政院衛生署醫政處登記執業的10,949位基層開業醫師為母群體，以系統抽樣(systematic sampling)抽取l,095位基層開業醫師為研究對象，回收241份，回收率為22%，適合度檢定發現樣本與母群體在年齡(p=0.220)及性別(p=0.157)上並無統計上的顯著差異，扣除有遺漏值的問卷，最後有效問卷共有229份。首先以卡方檢定及t-test來探討醫師特質與參與家庭醫師制度意願之相關性，其次再以羅吉斯迴歸分析影響基層醫師參與家庭醫師制度意願之相關因素。 研究結果發現受訪基層醫師中有20.5%“很願意”參與家庭醫師制度，41.5%“願意”參與家庭醫師制度。且大多數受訪者認為(l)家庭醫師除提供一般醫療服務外，還應該提供心理諮商(72.9%)、藥物諮詢(86.0%)及預防保健服務(91.3%)；(2)最適合擔任家庭醫師的專科醫師為家醫科(93.4%)、一般內科(77.7%)及小兒科醫師(53.7%)；(3)民眾一年可以選擇更換一次家庭醫師(41.1%)。 玆針對本研究結果提出建議如下：(l)家庭醫師除提供一般醫療服務外，還可提供預防保健服務、心理諮商、減重諮詢及一般外科手術；(2)除家醫科外，將未來家庭醫師的認證資格放寬給目前已在執業的一般內科及小兒科醫師； (3)民眾一年可以選擇更換一次家庭醫師。

The purpose of this study was to explore primary care physicians' understandings, attitudes, and applicable model of family physician system by survey research. The study used a systematic sample of 1,095 selected from 10,949 primary care physicians registered in the Department of Health in April 2003. A mailing survey was conducted to collect applicable data. There were 241 questionnaires returned which yielded a response rate of 22%. The test of goodness-of-fitness found that the sampled patients are similar to the research population in terms of age (p=0.220) and gender (p=0.157). After eliminating those with missing data on the questionnaire, the sample size was 229. The Chi-square and t-test were used to explore the relationships between physicians' sociodemographic characteristics and their willingness to attend a family physician program. A logistic regression analysis was also conducted to identify factors associated with the physicians' willingness to attend a family physician program. The results found that 20.5% and 41.5% of respondents were ”very willing” and ”willing,” respectively to attend a family physician program. The majority of respondents thought that (1) family physicians have to provide mental consultation (72.9%), pharmaceutical advise (86.0%), and preventive care (91.3%); (2) the specialties which are considered to be the most appropriate candidates for family physicians are family practice (93.4%), general internal medicine (77.7%), and pediatrics (53.7%); (3) enrollees can change their family physicians every year (41.1%). It is suggested that (I) family physicians can provide preventive medicine as well as regular treatments, psychotherapy, weight loss treatment, and ambulatory surgeries; (2) physicians specializing in family practice, internal medicine, and pediatrics can be family physicians; and (3) consumers can choose to change their own family physicians very year.

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