背景與目的:「健康存摺」是衛福部為讓國人的醫療資訊更為透明化,且方便一般民眾取得個人就診紀錄與用藥訊息,而發展的線上個人健康管理系統,但推出至今申請率仍然不高,因此為提高民眾申請、下載健康存摺的意願,須明確了解其所遇到的障礙為何,方能改善申請、下載資料率低落的問題。本研究目的為瞭解影響民眾使用健康存摺的因素為何。 材料與方法:依研究性質採用Pender的健康促進模式作為理論基礎發展研究架構。研究提出包括:認知效益、認知障礙、認知自我效能、認知健康狀態、認知健康價值、行動線索、社會影響等七個因素,採問卷調查法,以便利抽樣進行問卷發放,發放對象為進入南部某區域醫院滿20歲以上的民眾。 結果與討論:本研究共發放258份問卷,回收有效問卷221份,回收率86%。分析結果顯示認知障礙、認知自我效能與認知健康狀態會影響民眾下載健康存摺之行為,根據研究結果推論未曾使用過健康存摺的民眾認為,使用健康存摺申請的過程需要自備讀卡機、戶口名簿戶號與電腦環境作業的安裝等因素為一大障礙,對於自己能順利下載或申請的信心程度較為低弱,會降低其使用或申辦之意圖,而對於自身健康狀態認知較佳者,較會主動去申辦或使用健康存摺。本研究建議在政府機構方面,應降低民眾自行於家中申辦健康存摺之障礙,另外亦可參考澳洲E-health個人電子醫療資訊系統於2016年7月所推出的「自願退出」制度,去除所有申辦上的障礙。提升醫療院所內臨櫃查詢之功能,新增臨櫃申請之功能。
Background and purpose: My health bank, issued by the Ministry of Health and Welfare of Taiwan, aimes to make people to understand medical information more clear and enable people to get their medical record and medication knowledge conveniently. However, the system was applied rarely and the usage was not high till now, Why people did not want to apply My health bank is therefore the issue that should be understood and resolved. If people have difficulty and problem, it is necessary to help people to conquer the barrier and solve the problem in order to increase the application rate of My health bank. The aim of this study is to understand the influencing factors and enable people to make use of My health bank. Materials and methods: According to Pender's health promotion model, the research model includes seven factors: perceived benefits, perceived barriers, self-efficacy, perceived health status, health value, cues to action, social influence. The study utilized survey methodology and questionnaires were used to collect responses from individuals that was over 20 years old and came to a large regional hospital in southern Taiwan. Results and Conclusion: Totally, 258 questionnaires were distributed and 221 responses were collected, resulting in a response rate of 86%. The results of discriminant analysis showed that perceived barriers, perceived self-efficacy, and perceived health status significantly predict the use of My health bank. Based on the results, it is inferenced that the possible reason that individuals not applying for My health bank may be due to the requirement of card readers, household numbers of the household registers, computer harware and software. On the other hand, those who have applied for My health bank are in better health. This study suggests that the government should lower the barriers for the application of My health bank by individuals. Futher, the “opt-out system,” proposed by the Australia’ E-health, can also be adopted to reduce these obstacles. Finally, to increase the numbers of application counters for My health bank among hospitals are also suggested.
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