牙醫師臨床處置操作時間之探討

Procedure Time for Dental Treatment Procedures in Taiwan

陳琇玲(Hsiu-Ling Chen) ； 黃文駿(Wen Jiun Huang) ； 溫信財(Hsyien-Chia Wen) ； 楊志良(Chih-Liang Yaung)

《台灣公共衛生雜誌》 20卷4期 (2001/08) Pp. 265-274

https://doi.org/10.6288/TJPH2001-20-04-03

摘要

目標：本研究試圖探討牙醫師臨床操作各項處置之時間，作為進一步修訂牙科診療支付標準之基礎。方法：由牙醫師全聯會推薦專家小組，選定25個處置項目，以之從事問卷調查。問卷調查係以全體會員為研究對象，依執業場所及地區別，分層隨機抽取360個牙醫師樣本，進行德菲法(Delphi Technique)二輪問卷調查，請求樣本醫師依據具體病例描述及Ｘ光片或照片、圖片，估測每個處置在臨床操作時所需要的時間。問卷結果再由第二個專家小組成員外推至其餘未調查之處置的臨床操作所需時間。結果：（１）問卷調查結果信度頗佳(R=0.883)，並由專小組據以外推後，獲得79個牙科處置之醫師所需要的臨床操作時間。（２）79項牙科處置所需醫師時間雖未包含執業成本，但結果與現行健保支付標準表之相關性高達0.772。結論：（１）以問卷調查及專家外推之方法，可合理建立我國牙科79個處置的醫師臨床操作時間。（２）問卷調查25項處置之牙醫師臨床操作時間，不因執業場所在醫院或診所而有所差異。（３）問卷調楂25項處置中，大部份處置（22項）之牙醫師臨床操作時間，不因執業地點位於城鄉與否而有所差異。（４）健保支付標準尚能合理反應問卷調查中19項處置之牙醫師臨床操作時間。外推後79項處置時間值與健保支付標準的相關性亦高。

關鍵字

牙醫師 ； 臨床操作時間 ； 支付標準

並列摘要

Objectives: The purpose of this study was to investigate the duration of various dental procedures, In order to establish a basis for reasonable reimbursement of dentists in hospitals or dental clinics in the future. Methods: Upon recommendation of the National Dental Association of the Republic of China, the first Technical Consulting Group (TCG) was formed to select the dental services and procedures (S/Ps) to be investigated. After stratified random sampling by practice setting and region, a questionnaire was developed for the survey. Using the Delphi Technique with a two round questionnaire, we asked dental practitioners to estimate the length of time required for each of the S/Ps. We then asked the second TCG to evaluate the results and to estimate the duration for on-surveyed S\Ps. Results: (l) Showing excellent validity (r=0.883), the time required for 79 dental procedures was established. (2) Although other factors such as costs were not included, the results of the present study correlated well (r=0.772) with the dental payment system of the National Health Insurance (NHI). Conclusions: (1) We have established the usual duration of 79 dental procedures by questionnaire and TCG exploring. (2) Procedure duration was not affected by the location of the practice in hospital or clinic. (3) In most cases, 22 items, procedure duration was not affected by the location of the practice in urban or rural. (4) The NHI dental fee schedule matched adequately the duration of 19 surveyed procedures. The time required for all 79 procedures also correlated highly with the NHI fee schedule.

並列關鍵字

Dentist ； procedure time ； payment system.