省市立醫院負擔政策責任項目之專家評估

The Policy-Related Responsibilities of Provincial and Municipal Hospitals, Demarcation Utilizing Delphi Technique

陳琇玲(Hsiu-Ling Chen) ； 楊志良(Chih-Liang Yaung)

《中華公共衛生雜誌》 13卷5期 (1994/10) Pp. 395-404

https://doi.org/10.6288/CJPH1994-13-05-04

摘要

全民健康保險實施後，公私立醫院將面對相同服務對象，接受相同醫療費用給付。故未來對公立醫院之角色與功能需重新定位。而合立醫院應如何定位之決定因素，首在於其所承擔之政策責任。至於公立醫院政策責任究竟為何，尚無研究問世，加上此類責任不易定義，且涉及個人主觀判斷，故採用專家效度法(DelPhi Method, Delphi Technique)以界定其範圍。其中又因公立醫院主管機關不一，性質各異，故先以省市立醫院為對象，進行探討。
本研究資料之收集，是透過專家徒度法，郵寄問卷，來探討學者專家所認為省市立醫院應有之“政策責任”範圍。研究結果顯示，若經75%以上專家學者認定，則界定其屬“政策責任任”或“社會責任”時，可依據各項工作屬性歸為五大類，並建議政府分別探取不同措施，以作為公立醫院未來定位之參考。

關鍵字

政策責任 ； Delphi Method ； Delphi Technique ； 省市立醫院

並列摘要

The scheduled implementation of the plan of National Health Insurance at the end of 1994 in Taiwan will inevitably result in two things: 1) hospitals, public or private, will face patients of only one status-insured; 2) healthcare prices will be unified and fixed. Therefore, the role and function of public hospitals will need to be redesigned.
Public hospital bears policy-related responsibilities bestowed by the government and those responsibilities in return determine the public hospital's role and function. However, no previous research or document ever define the policy-related responsibilities of public hospitals. Moreover, defining this kind of responsibility is ofentimes difficult and involves a great deal of subjective judgement. As far as the definition goes, this paper utilizes the Delphi Method, or Delphi Technique, to lay the basis of demarcation. Since different system of public hospital is dictated by different authorities, this paper focuses on provincial and municipal hospitals. Data used in this research paper is collected through mailing questionnares to experts whose opinions then provide the demarcation criteria for determining the policy-related responsibilities of public hospitals.
The demarcation criterion of social or policy-related responsibilities is finalized when over 75 percent of experts approve of it. According to this research, there are five major groups of responses. It is then this paper suggests the authorities concerned make different policy accordingly to handle different kind of responsibilites. Eventually, those policies should be the reference for redesigning the role and function of public hospitals in the future.

並列關鍵字

policy-related responsibilities ； Delphi Method ； Delphi Technique ； Provincial and Municipal Hospitals