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教學醫院主治醫師與住院醫師之工作時數與相關因素之研究

An Analysis of the Work Hours and Related Factors Associated with Attending Physicians and Residents in Teaching Hospitals

摘要


目的:探討教學醫院主治及住院醫師在醫療服務、教學、研究與行政之工作時數及相關因素。方法:以郵寄自填式問卷蒐集實際工作時數與期望合理工作時數,並估算住院醫師之全職主治醫師當量(Full-Time Equivalent, FTE)。結果:回覆問卷之主治醫師其工作時數平均為89小時/週,研究醫師平均為102小時/週,總住院醫師平均為123小時/週,而住院醫師平均為112小時/週。醫師職級、科別及醫院層級別與工作時數顯著相關,其中外科及婦產科醫療服務時數較其他科的醫師高。根據受訪主治醫師的估計,平均1位住院醫師相當於0.86位全職主治醫師。結論:受訪主治醫師及住院醫師每週工作時間均超過80小時;醫師職級越低,工作小時數越長。未來可參採住院醫師相當於主治醫師當量之概念,估算醫院醫師所需之人力。

並列摘要


Objectives: To explore the work hours of attending physicians and residents at teaching hospitals in terms of medical services, teaching, research, and administration and to examine their associated factors. Methods: The dataset for this research was collected by mailing a self-administered questionnaire to physicians at various teaching hospitals. The residents' fulltime equivalent (FTE) of the attending physician was also estimated. Results: The average work hours were 89 hours/week for attending physicians, 102 hours/week for fellows, 123 hours/week for chief residents, and 112 hours/week for residents. The position of the physicians, their specialties and the accreditation level of the medical institution were factors that were significantly associated with the work hours. The medical service hours of surgeons and obstetrician/gynecologists were highest among all types of specialties. Based on the attending physicians' opinions, the weighted average of a resident's FTE was equivalent to 0.86 attending physicians. Conclusions: The total work hours for all physicians were over 80 hours per week and physicians who held lower position in the hospital worked longer hours. The estimated FTE of a resident can be used to calculate physician manpower needs in teaching hospitals in the future.

參考文獻


調查報告
Baldwin DC,Daugherty SR,Tsai R(2003).A national survey of residents` self-reported work hours: Thinking beyond specialty.Acad Med.78,1154-1163.
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Promecene PA,Schneider KM,Monga M(2003).Work hours for practicing obstetrician-gynecologists: the reality of life after residency.Am J Obstet Gynecol.189,631-633.

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