探討影響台灣基層開業醫師轉診意願之因素

Influences on Willingness of Primary Care Physicians Make Patient Referrals in Taiwan

陳楚杰(Chu-Chieh Chen) ； 林恆慶(Herng-Ching Lin)

《醫護科技學刊》 6卷4期 (2004/10) Pp. 414-428

https://doi.org/10.6563/TJHS.2004.6(4).8

摘要

本研究旨在探討台灣基層開業醫師的轉診經驗、意願和滿意度、影響其轉診意願的因素、轉診意願與影響轉診意願因素之相關性。方法：本研究以2002年4月在行政院衛生署醫政處登記執業的10,223位基層開業醫師爲研究對象，採用系統抽樣法，共得到3,407位，以郵寄問卷的方式蒐集所需的資料，回收512份，回收率為15.1%。使用SPSS10.0進行問卷回收資料之建檔及統計分析。結果：樣本醫師中有92.9%有轉診病人的經驗，有63%有轉診意願，卻只有36.8%對目前的轉診制度滿意。影響基層開業醫師轉診意願最重要的因素爲轉診係基於病人病情的需要。認爲轉診可以有效減少醫病紛爭、轉診醫院實施半開放式醫院制度愈重要的醫師願意轉診病人的機率較高、政府推動家庭醫師制度愈重要的醫師願意轉診病人的機率較高；認爲轉診會流失病人、轉診醫院提供迅速順暢的回覆系統及指定轉診醫師愈重要的醫師願意轉診病人的機率較低。結論：樣本醫師中有63%有轉診意願，因此，建議相關單位改善並繼續推動轉診制度。

關鍵字

轉診 ； 基層開業醫師

並列摘要

This study explored the experience, willingness, and satisfaction of primary care physicians with patient referrals, and the factors affecting the willingness to make patient referrals. Methods: The study used a systematic sample of 3,407 physicians selected from among 10,223 primary care physicians registered in the Department of Health in April 2002. A survey was mailed to collect applicable data. Five-hundred and twelve questionnaires were returned, for a response rate of 15.1%. The Statistical Package for the Social Sciences (SPSS) was used for data analysis. Results: Of the sample, 92.9% had experience of treating referrals, 63.3% were willing to treat referrals, and only 36.8% were satisfied with the current referral system. The biggest influence on physician willingness to refer patients was patient needs. Multiple logistic regression analysis showed that physicians who considered referrals could decrease malpractice lawsuits, that hospitals should adopt semi-open systems, and that government should implement a family physician system were more willing to refer patients than physicians without these attitudes. Meanwhile, physicians who feared referrals would result in the loss of patients, who thought receiving hospitals provided a quick response system for referral patients, and who saw appointed physicians as important factors were less likely to refer patients than other physicians without these attitudes. Conclusions: Of the sample group of physicians, only 63% were willing to refer patients. Therefore, this study recommends that the referral system should be improved.

並列關鍵字

Referral ； primary care physician

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