- 期刊
Outcome Analysis of the 1991 National Hospital Accreditation Survey
中華民國八十年度醫院評鑑結果之分析
摘要
行政院衛生署所主辦之「八十年度臺灣地區醫院評鑑暨教學醫院評鑑」目的在將受評醫院評為四個等級（分為醫學中心、區域醫院、地區教學醫院、地區非教學醫院四個等級）。本研究旨在分析這次評鑑結果，進而探討1.申請各級別醫院在各大項分數及總分之分佈，2.探究各層級醫院之醫院評鑑通過率，3.醫院評鑑所用評量表之信度與效度，4.各類醫院評鑑等級之分項最低標準（及格分數之切點），5.各層級醫院之缺點分析等。 由此次醫院評鑑之分析我們發現：1.各分項評鑑成績之分佈大都不是常態分佈，而總分（各分項之總和）之分佈較對稱，2.評鑑成績平均通過率為71%，尤以區域醫院最高83.3%，地區教學醫院最低63.6%，3.評鑑之信度及效度仍不甚理想，可經由評量表之重新設計及委員之行前說明來改善，4.由各項最低標準未通過率可了解各層級醫院應努力之方向，5.缺點數分析反應出地區非教學醫院之缺點數反較地區教學醫院、醫學中心及區域醫院少，顯示缺點之不能以「數目」來計算，應考慮其相對應之權數。 總而言之，1.政策如鼓勵「專科」醫院之發展或容許各醫院發展其特色則不應以總分作為評鑑之依據，2.為因應全民健保之需求，目前評鑑合格之地區教學醫院仍嫌不足，應輔導改進，3.應借助信度之提高，評量表之設計及缺點之分析仍可幫助改善現有制度之效率。
並列摘要
The Health Department of R.O.C. performed the Hospital Accreditation Program again in I99lfor evaluating the four levels of accredited hospitals. The data from this program were used to explore: 1. the score distribution and accreditation rate among variable accreditation levels of hospitals, 2. the passing rate among each accreditation level of hospitals, 3. the cutting boundary of each accreditation level for each studied item, 4. the shortcomings analysis among four different level of hospitals, etc. Review of this program has provided several findings: 1. The score distributions of most subitems don't appear to be normal, while that of total seems to be more symmetric, 2. The average passing rate is 71%, with the highest 83.3% of regional hospital, lowest 63.6% of the district teaching hospital, 3. The defect analysis reveals that the district non-teaching hospital have the no. of defects, less than that of district teaching, medical center and regional hospitals. In short, if hospitals are allowed to develop its own specialty character, the accreditation consideration should not be based on total score. Instead, the specialized subitem scores should be heavily weighted. However, if general hospitals are advocated by policy, the accreditation concern based on total score seems suitable.
延伸閱讀
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