醫療照護適當性：概念性定義、測量與國際倡議

醫療照護適當性為醫療品質的面向之一，概念性定義為正確的病人、正確的治療地點、正確的照護提供者、正確的時間，提供或使用正確照護的組合。測量方法包括內隱指標、明確指標及混合指標，國際醫療照護適當性倡議與實踐可分為概念建構期、指標建立期、減少浪費及避免低價值服務期、政策結合期。本文簡要回顧醫療照護適當性之定義、測量及國際倡議經驗，並討論研究與政策發展意涵，供後續學術與政策之應用。

關鍵字

醫療照護適當性；醫療品質；健康服務研究

並列摘要

Appropriateness of medical care is a crucial dimension of medical quality. The most common conceptual definition is the provision of the right care for the right patient, the right setting, the right service provider, and the right time. Measurement methods include implicit, explicit, and combined criteria. International initiatives and practices of appropriateness in medical care can be divided into the concept construction period, the indicator establishment period, the waste reduction and low-value care reduction period, and the policy implementation period. This narrative review reports the conceptual definition, measurement methods, and international initiatives of appropriateness of medical care. Implications for future research and policy development are discussed.

並列關鍵字

appropriateness of medical care ； medical care quality ； health services research

參考文獻

林志遠、鄭鳳翔、李玉春：時間敏感性狀況：分類、測量及對可避免急診與住院之意涵。台灣衛誌 2021；40：615-30。doi:10.6288/tjph.202112_40(6).110101。 Lin CY, Cheng FS, Lee YC. Time-sensitive conditions: classification, measurement, and implications of preventable emergency department visits and hospitalizations. Taiwan J Public Health 2021;40:615-30. doi:10.6288/tjph.202112_40(6).110101. [In Chinese: English abstract]

譚延輝：台灣推行醫療科技評估 (HTA) 制度之近況與未來發展。醫療品質雜誌 2009；3：19-23。doi:10.30160/JHQ.200911.0003。 Tarn YH. Status quo and future prospects of the promotion of the health technology assessment system in Taiwan. J Healthcare Qual 2009;3:19-23. doi:10.30160/JHQ.200911.0003. [In Chinese]

Hicks NR. Some observations on attempts to measure appropriateness of care. BMJ 1994;309:730-3. doi:10.1136/bmj.309.6956.730

Cascade PN. The American College of Radiology. ACR Appropriateness Criteria project. Radiology 2000;214(Suppl):3-46. doi:10.1148/radiology.214.1.r00ja493

Derlet RW, Nishio DA. Refusing care to patients who present to an emergency department. Ann Emerg Med 1990;19:262-7. doi:10.1016/s0196-0644(05)82041-4

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