臺灣地區群體醫療執業中心之轉診模式研究

A Study of Referral Pattern of Group Practice Centers in Taiwan

許文燦(Wen-Chain Hsu) ； 劉宏文(Hong-Wen Liu)

《The Kaohsiung Journal of Medical Sciences》 7卷4期 (1991/04) Pp. 183-189

https://doi.org/10.6452/KJMS.199104.0183

摘要

為探討台灣地區群體醫療執業中心基層醫師之轉診模式（referral pattern），本研究乃以分層隨機抽樣方式將全省群體醫療執業中心分成東、北、中、南四區共抽取18處，研究其間從民國七十八年七月一日至民國七十九年六月三十一日共十二個月，以電腦輔助建立個案之基本與疾病診療資料，以及轉診結果。研究其間病患就診次數共有735,534人次，轉診次中共有1,647人次，平均轉診率0.22％％。在轉診病患的診斷分類是根據國際基層照顧健康問題分類法（ICHPPC-2），其中以徽象症狀或未明狀況最高，次依序為消化系統疾病，生殖泌尿系統疾病，循環系統疾病。在各系統的轉診率分析上，其中以先天畸形最高，其次依序為懷孕、生產、產後疾病，腫瘤，周產期罹病、死亡。而接受轉診顧問醫師之專科別中，以內科最多，其次依序為外科、婦產科、骨科、泌尿科和小兒科。針對未來的研究，定期評估動態的轉診變化是必須的，而且對醫療品質的提昇有助益。

並列摘要

To investigate the referral patterns of group practice centers in Taiwan, 18 group practice centers were studied. These study sites were sampled in a stratified random method over four districts (eastern, northern, central, and southern) in Taiwan. The study period took place between July 1989 and June 1990. Prospective referral forms were applied in every study site during the 12-month period. A computer-assisted data base for referral contents was established to follow up referral cases. During the study period, 1,647 referrals were generated from 735,534 patient visits, for an overall referral rate of 0.22 percent of all office visits. According to the International Classification of Health Problems in Primary Care, 2nd edition, most of the problems that needed referral were signs, symptoms, ill-defined conditions, digestive system diseases, genitourinary system diseases, circulatory system diseases, neoplasms and musculoskeletal, connective tissue diseases. The top 6 consulting specialties were internal medicine, surgery, obstetrics & gynecology, orthopedics, urology and pediatrics. Periodic evaluation of the dynamic referral contents is a useful method to improve the quality of primary medical care.

並列關鍵字

referral pattern ； group practice ； mdeical quality