設立台灣醫院品質審查機構模式之探討

Exploring Appropriate Quality Review Organization for Hospitals in Taiwan

張文麗(Wen-Li Chang) ； 林恆慶(Herng-Ching Lin) ； 陳楚杰(Chu-Chieh Chen) ； 張敏琪(Min-Chi Cheng)

《醫護科技學刊》 5卷1期 (2003/01) Pp. 26-44

https://doi.org/10.6563/TJHS.2003.5(1).4

摘要

目標:本研究的主要目的在確認醫院認為最適當的醫療品質審查組織的模式及其對醫療品質審查項目之意見。方法:以行政院衛生署九十年度醫院評鑑合格地區級(含)以上540家醫院,扣除精神專科醫院33家,共有507家醫院為研究對象,全面施以普查,採取郵寄問卷的方式來蒐集所需的資料,郵寄問卷的時間為2002年3月至5月。使用SPSS10.0進行問卷回收資料之建檔及統計分析。在描述性統計分析方面,以次數、百分比及累積百分比表示之。在推論性統計分析方面,以卡方檢定(χ2檢定)分析變數之間有無關聯性存在。結果:回收之有效問卷為174份,回收率為34.3%。在成立專責 醫療品質審查組織的可行性方面:高達86.3%的回答者認為成立專責醫療品質審查組織產可行的。在醫院對專賣醫療品質審查組織的模式方面:1.權屬單位: 37.7%的回答者認為應由醫策會負責管理; 2.審查組織地區劃分: 39.9%的回答者認為以台灣行政高域劃分為北、中、南、東四個組織方式較佳; 3.審查組織成員:應包括醫師、護理人員、藥師及行政人員; 4.審查方式; 67.5%的回答者認為應採回溯性審查; 5.審查層級: 54.2%的回答者認為應採用二審制; 6.審查重點:前五項依序為院內感染、抗主素使用不當、不適當的住院天數、十四天再入院及合併症產生。結論:成立專賣醫院書療品質審查組織是可行的,醫院認為最適當的醫療品質審查組織的模式及其對醫療品 建審查重點之意見如結果所述。

關鍵字

醫療品質 ； 同儕審查組織 ； 醫療品質審查組織

並列摘要

This study aims to understand the attitudes of hospitals concerning the most appropriate model of a quality review organization and potential issues. This study sampled 507 hospitals accredited by the Department of Health in 2001 as medical centers, regional hoSpitals, or district hospitals. Structured questionnaires were mailed to sampling hospitals between March and May 2002. Then the collected data were analyzed by SPSS 10.0 to measure the mean, frequency, percentage, and accumulated percentage. Chi-square test vas also used to investigate whether variables were correlated. The number of returned juestionnaires was 174, and the response rate was 34.3%. 86.3% of the respondents thought establishing a quality review organization was feasible. 37.7% of respondents prefer that such an organization be operated by the Taiwan Joint Commission on Hospital Accreditation. 39.9% thought that a quality review organization could be divided into north, center, south and east regions for management. The quality review organization should include physicians, nurses, pharmacists and administrative personnel. 67.5% prefer the retrospective review method, and 54.2% consider the two-tier review system to be applicable. The most preferred items for review are inpatient infections, antibiotic nisuse, inappropriate lengths of stay, readmission within 14 days, and complications. The establishment of the quality review organization is concluded to be feasible.

並列關鍵字

quality of medical care ； peer review organization ； quality review organization

參考文獻

全民健康保險統計

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台灣醫務管理學會(2001)。台灣醫療品質指標。台北:

何宜真(1998)。住院病人醫療品質之認知及其評估能力之初探(碩士論文)。台灣大學。

辛炳隆(2001)。全民健保體檢小組報告書。國家衛生研究院網站。