牙科總額支付制度對台北市牙醫師醫療行為之影響探討

The Impact of Dental Global Behavior of Dentists in Taipei City

楊哲銘(Che-Ming Yang) ； 林文君(Wen-Chun angLin) ； 鍾季樺(Chi-Hua Chung) ； 周佳穎(Chia-Yin Chon)

《醫護科技學刊》 3卷3期 (2001/07) Pp. 255-266

https://doi.org/10.6563/TJHS.2001.3(3).4

摘要

目的：探討牙科總額預算制度對於台北市牙醫師行為改變的影響，並了解牙醫師對此制度的滿意程度、更換執業地點的意願及其他建議事項。方法：本研究以問卷調查法進行，針對1.收入及服務量、2.醫療品質、3.醫病關係、4.專業團體、5.保險行政等五個面向進行探討，研究對象為台北市牙醫診所，回收率　11.83%。結果：牙科總額預算制度對於牙醫師的收入及服務量無明顯影響、對於醫療品質可能有提升、對於醫病關係有助益、牙醫團體間的關係較緊張、行政作業較簡化但核刪率卻較高。分析牙醫師對制度的滿意度，有55.5%的牙醫師感到滿意；總額預算實施之後，77%牙醫師不考慮離開台北執業。結論：牙科總額預算制度對牙醫師行為有正面影響、牙醫師公會應健全審查制度、牙醫師普遍滿意牙科總額預算度、牙科總額預算制度對牙醫師人力分佈的影響可能有限。

關鍵字

總額預算制度 ； 牙醫師行為

並列摘要

Objective: This study is designed to evaluate the impact of global budget on the dentists practicing in Taipei City. It also analyzes dentists' satisfaction regarding global budget, their willingness to change practice locations and suggestions. Method: Question-naires were sent out to dental clinics located in Taipei to assess the following aspects: income and service volume, service quality, dentists and patients relationship, professional organizations, insurance claim administration. The response rate was 11.83%. Result: The implementation of global budget has no significant effect on income and service volume. However, service quality, and relationship between dentists and patients seem to improve after the implementation of global budget. On the other hand, the tension within dental professional organizations builds up. The claim processing procedure has simplified but the reimburse rate lowers. 55.5% of the dentists are satisfied with this budgeting system, and 77% will not move their clinics elsewhere after the implementation of global budget. Conclusion: Global budget has a positive impact on dentists' behavior; Taiwan Dental Association should strive to improve the peer review process during claim processing; most dentists are satisfied with global budgeting; and dentistry global budget may have little effect in dentists' geographic distribution.

並列關鍵字

Global Budget ； Dentists' Behavior