放射腫瘤科門診病患接受跨院區轉介之意見調查

An Opinion Survey of Trans-hospital Outpatient Referral across District for Radiotherapy

翁麗慧(Li-Hui Weng) ； 蔡介生(Chien-Sheng Tsai)

《放射治療與腫瘤學》 20卷1期 (2013/03) Pp. 57-63

https://doi.org/10.6316/TRO/201320(1)57

摘要

目的：某教學醫學中心的放射腫瘤科，因為門診治療的待排人數超過其正常負荷量，為避免病患等候就醫的時間延宕，所以轉介病患至位於鄰近縣市，但擁有相同治療設備的區域醫院以及早就醫。本研究希望瞭解接受轉介的病患及家屬，對此醫療服務方式的看法及需求，以作為未來放射腫瘤科醫療品質改進的參考。材料與方法：自2010年12月至2012年1月，共計有65名醫學中心的病患接受轉介至區域教學醫院接受門診放射治療。本研究採自擬的結構式問卷，依門診放射治療病患的特性設計而成，分析病患願意轉介的原因及轉介後的滿意度。結果：病患在決定是否要接受轉介的考量時，以不想拖延治療／或因等待而產生的焦慮為最重要因素（56.9%），其次是基於信任同一醫療體系的關係而願意轉介（23%），再其次則是因為醫院有提供交通及停車優惠（20.1%）。其中最滿意的項目，是專屬治療時段的方便性（55.4%），其次是交通的便利（33.8%）（有免費專車接送）。整體而言，大多數的病患是肯定此跨院區轉介的模式，對區域醫院的醫療服務品質感到滿意的比例89.2%。結論：癌症是重大疾病，不論是病患本身或是醫院，都希望能儘早完成治療；但若遇到醫療資源無法滿足需求，不得不轉介至他院時，醫院有責任提供妥善規劃。同一醫療體系內跨院區的轉介模式，優點是可以確保癌症治療計畫的執行能做到無縫接軌，以維持醫療品質。藉由此調查瞭解病患及家屬就醫時的考量與意見，可提供相關醫療經營管理政策制定時的參考。

關鍵字

放射線治療 ； 門診病患 ； 轉介 ； 意見調查

並列摘要

Purpose: Owning to the extended waiting list and the possibility of treatment delay, the department of radiation oncology at a medical center referred its waiting outpatients to another regional hospital which was affiliated to the same health care system and equipped with similar linear accelerator facility, but located across the Taipei basin. The purpose of this study is to survey the opinion and demand of referred patients and their family member to this service mode, and to provide a reference for future quality improvement.Material and Method: Between December 2010 and January 2012, there were 65 patients referred to the regional teaching hospital for radiotherapy. A self-constructed structural questionnaire was designed according to the characteristic of outpatient at department of radiation oncology. Statistical analysis was performed to investigate the consideration and satisfaction with this referral mode.Results : When patient considering to accept trans-hospital referral or not, the most critical factor in decision making was fear of being delayed or the anxiety associated with waiting (56.9%), the second was the confidence in the same health care system (23%), and the third was the convenience in transportation and parking (20.1%). The service patients most satisfied with were the exclusively reserved daily treatment schedule (55.4%), and the free transportation shuttle to and fro the medical center and regional hospital. In general, most patients (89.2%) acknowledged this referral mode and the service quality of this regional hospital.Conclusion: Cancer is a serious disease, and both patients themselves and hospital hope to complete the treatment as soon as possible. In circumstances when medical resources can not meet the needs and referral are suggested, hospital must provide proper arrangement. In spite of transportation across district, referral within the same health care system has advantages in ensuring the execution and consistency of cancer treatment. The considerations and opinions to this referral mode can provide useful reference for medical business management and health policy making.

並列關鍵字

Radiotherapy ； Outpatient ； Referral ； Opinion survey