醫療資源綜合評估指標之建立

Development of a Holistic Index to Evaluate the Distributions of Health Care Resources

洪正芳(Cheng-Fang Hung) ； 楊銘欽(Ming-Chin Yang) ； 黃子賢(Tzyy-Shyan Huang) ； 虞善琦(Shan-Chi Yu) ； 楊錦坤(Chin-Kun Yang) ； 張彥輝(Yen-Hui Chang)

《中華公共衛生雜誌》 17卷6期 (1998/12) Pp. 485-494

https://doi.org/10.6288/CJPH1998-17-06-06

摘要

民眾醫療可近性是國家醫療體系相當重要的課題，由於目前國內醫療資源分佈不均，城鄉差距過大，造成部份地區醫療資源的重複浪費，而有些地區之醫療資源卻不足。固然政府相關單位有心評估並解決此一問題，卻缺乏能真正反映醫療資源分佈狀況之整體性評估指標。本研究之目的在發展一套方法來建立綜合評估指標，以瞭解醫療資源分佈之情況，並作為改善醫療資源分佈不均之決策參考。本研究運用多目標決策模式(MAUT)透過國內相關領域六位專家之電話訪談與專家會議建立起一綜合評估指標。會後我們提供每位專家有關全台灣六十三個醫療次區域之相關資料，由每位專家來評定每個次區域醫療資源需求之程度。這些主觀判斷與專家所建立之綜合評估模式所得之六十三個次區域評估分數做比較，我們發現，此模式能可靠的預測專家之判斷，其中模式解釋每位專家81%以上之變異，亦解釋專家評估平均值之93%的變異，另外傳統單一評估指標與綜合評估指標之評估結果明顯不同，本研究可以做為改善民眾醫療可近性之參考。

關鍵字

醫療資源 ； 多目標價值模式 ； 綜合評估指標 ； 醫療可近性

並列摘要

The accessibility of health services is an important issue in our health care system. The unbalanced distribution of our health care resources results in the inefficient utilization of the resources. In recent years our government intend to evaluate and alleviate the problems, and need a holistic index to understand the variation of the distributions of the resources. This research uses the Multi-Attribute Utility Technique (MAUT) to develop a holistic index. We hold an expert panel meeting that consists of six related experts in the field to build the MAUT model. After the meeting, every expert rates the sixty-three sub-areas in Taiwan. In a comparison of every expert subjective judgment and the model scores, we find that the MAUT model can predict experts' judgments well. This model explains at least 81% of the variance of each expert, and 93% of the variance of the experts' average scores. The holistic index also shows quite different results from those of the conventional index. The results can be used as a reference to improve the accessibility of health services in Taiwan.

並列關鍵字

health care resources ； MAUT Multi-attribute Technique ； holistic index ； the accessibility of health services