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  • 學位論文

信仰型非營利組織偏鄉醫療模式-以埔里基督教醫院山地巡迴醫療為例

Faith-based Organizations Non-profit Organizations.Remote Area Medicine.Puli-Christian Hospital Mobile Clinic Services in the Mountain Village Case Study.

指導教授 : 林吉郎
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摘要


本研究主要目的在探討以埔里基督教醫院執行山地巡迴醫療模式為例,探討以信仰型非營利組織在偏遠地區執行醫療服務角色的扮演與樣態,從仁愛鄉醫療給付效益提昇計畫(簡稱IDS)所執行的情形與困境做分析,瞭解山地巡迴醫療如何醫療資源整合,創造出永續發展的醫療模式,期盼透過多方的實施現況,以作為提升山地巡迴醫療服務之參考。 本研究主要探討信仰型非營利組織偏鄉醫療模式-以埔里基督教醫院山地巡迴醫療為例,在原鄉部落所扮演的角色與未來永續經營與發展,找出可依循的樣態,研究透過質性的深度訪談,研究結果發現如下: (ㄧ)醫療站設置是解決偏鄉醫療最佳的方式。(二)除提供門急診外,增進醫療服務可彌補醫療之缺乏。(三)外來的醫療投入機構,應加以管理及監控。(四)硬體設備與醫療人力之經費補助。(五)交通問題待政府部門關心與解決。(六)山地醫療醫護人員聘用原住民為優。(七)必須宣導正確用藥觀念(八)緊急醫療後送之協助與任務。(九)節制飲酒計畫需要繼續推動。(十)專科巡迴醫療以遠距視訊會診共照模式。 基於上述研究發現,本研究提出建議如下: (ㄧ)政府經費有限,必須符合經濟效益。(二)缺醫村設站的模式是值得推動的。(三)政府推動山地醫療相關之計畫應整合。(四)醫整合當地醫療機構與建立資訊平台。(五)透過鼓勵公費生到山地鄉服務,彌補醫護人力之不足。(六)山地醫療服務品質的提升,需導入品質監控指標。(七)信仰是連繫彼此的信任與認同不可或缺的元素。 關鍵詞:信仰型非營利組織;山地巡迴醫療;醫療給付效益提昇計畫

並列摘要


Our study primarily is base on PuLi-Christian Hospital implementing "mobile medical clinic services"in the mountain village as a model & example,research base on "faith based non-profit"organizations on remote area implementing the role of medical services,from Ren-Ai village medical clinic,Integrated Delivery System(IDS),making analysis in the difficulties & problems in implementation,understanding on how the "mountain village mobile medical clinic services" background & it's organization in preparing for the resources,to create a continuous progression of medical service model,hoping to use multiple aspect of present and actual condition as an example to increase effectiveness of the "mountain village mobile medical clinic services"in remote area as our example. Our main concern is to search on "faith based non-profit"organization on remote mountain village medical clinic service model base on Pu-Li Christian Hospital's mobile medical clinic services in the mountain village as an example,at the village of origin playing it's role and it's future continuous management and progress,finding out the possible effective mode of action on the in-depth interview,the result of the finding as follow: 1.Construction of the medical station is the best way of solving the remote mountain village medical needs. 2.Aside from providing out-patient and emergency clinic,the increase in medical follow-up services can cover-up of any medical treatment deficiency. 3.The "outsider" medical group or organization need to be under our surveillance and control. 4.The need for financial support for structural medical facilities and medical personnel. 5.Transportation problems needs governmental support and assistance. 6.Mountain village medical personnel should consider in selecting and using local aboriginal inhabitant as a priority. 7.Need to teach or instruct on the proper use of drugs. 8.Provide the duty of follow-up care and assistance for the post emergency medical service. 9.Alcoholic abuse patient needs to be in constant encouragement and support. 10.Availability for tele-communication in specialists mobile medical services. Base on the above study research and finding, we suggest the following: 1.Need to build a cost-effective program due to limited government budget. 2.The "mountain village mobile medical clinic services"in remote area is the model worthy to be push ahead and implemented. 3.Everything regarding governmental planning need to be reorganize. 4.Reorganize the local medical service organization and build up information services. 5.Encourage the publicly funded medical/nursing students to joint the "mountain village mobile medical clinic services"in order to fill up the medical personnel deficit. 6.In order to improve the quality of "mountain village mobile medical clinic services"the guideline should be set up. 7.Faith based is the fundamental element of mutual trust and respect. KEY WORDS:Faith-based non-profit organization;Mountain village mobile medical clinic;Integrated Delivery System.

參考文獻


ㄧ、中文部分
1.卜長莉(2008)。社會資本與社會和諧(一版二刷)。北京市:社會科學文獻出版社。
2.王允士(2008)。我國宗教型非營利組織募款策略之研究。私立東海大學行政管理暨政策研究所碩士學位論文,未出版,台中市。
3.王䓪鳴(2002)。社會資本之網絡聯繫、信任及互惠狀況的研究(一版一刷)。 香港:香港青年學會青年研究中心。
4.中央健康保險局(1999)。「全民健康保險山地離島地區醫療給付效益提昇計畫(修正版)」,中央健康保險局。

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