台灣地區醫院牙科現況調查－建立牙科評鑑之先驅研究

為瞭解台灣地區醫院牙科人力、設置、醫療品質、教學訓練及研究水準現況，並提供未來實施醫院牙科與牙科教學醫院評鑑標準釐定之參考，本調查針對台灣地區163所醫院牙科進行問春調查，並參照實地訪查及舉辦研討會，以頻率分析及AN○VA等方法分析。合計回收66份問卷，包括17所醫學中心、30所區域醫院、19所地區醫院，回收率達40.5%。結果發現，部份醫院牙科現況與醫院評鑑等級出現甚大落差，其數據亦影響醫學中心牙科部之整體水平；其次，目前90%的醫學中心每治療台僅佔15平方公尺面積，然依中華牙醫學會1997年所建議之標準則為60平方公尺/台，此種現況與理想之差距應如何調整，是必須面對的課題。醫院牙科之人力現況，以醫學中心為優，平約每院有34位專任醫師、24.7位牙科輔助人員，每位醫師平約分配0.81位輔助人員；區域醫院平約每院有8.5位專任醫師、7.5位牙科輔助人員，輔助人員／醫師比為1.09；地區醫院平約每院有3.2位專任醫師、3.8位牙科輔助人員，輔助人員／醫師比為1.72；目前90%的醫學中心有17位以上的專任醫師；9位牙科輔助人員及18台牙科治療台（中華牙醫學會1997年建議之標準為50台）。從醫院牙科分科觀察，目前80%醫學中心至少有8科、區域醫院有6科、地區醫院有5科。因此從調查中瞭解台灣地區醫院牙科之各項標率有非趨中性之特性，未來在凝集共識與調整差距上需作更大的努力，或可考慮先從醫學中心之評鑑作起，分期進行區域及地區醫院之評鑑。

關鍵字

醫院評鑑；牙科；先驅調查

並列摘要

The purposes of this investigation are to understand the contemporary manpower, facilities, quality of service and teaching status of hospital dentistry in Taiwan. It also serves as reference data in making the criteria of hospital dentistry accreditation system at Taiwan in near future. We mailed a structured questionnaire to 163 dental departments in hospital and visited parts of them. A conference was held as the last part of this investigation. All data were processed with frequency, percentile and ANOVA tests by SPSS 11.0/pc software. The response rate was 40.5%, including of seventeen medical centers, thirty regional hospitals and nineteen district hospitals. We found the standards of some dental departments were far behind from the others and many were not compatible with its accreditation result of belonged hospital. In the case of fifteen meter square per dental unit in a dental department of medical center was required, 90% of those meet the standard. Comparing to the criterion, which was 60 meter square per dental unit, made by the Association for Dental Sciences of the Republic of China (ADS-ROC) in 1997, it seemed as if the ideal standard was far ahead of the real status at present time. Generally the dental manpower of medical centers was better than that of regional and district hospitals. It showed thirty-four dentists and 24.7 dental auxiliary personnel in average. The number of dentists and dental auxiliary personnel in regional hospitals and were 8.5, 7.5 and those of district hospitals were 3.2, 3.8. The ratios of dental auxiliary personnel to dentist were 0.81 in medical centers, 1.09 in regional hospitals and 1.72 in district hospitals respectively. In the case of 17 dentists and 9 dental auxiliary personnel were the minimal requirement of a medical center, only 90% of those met this standard at present. Considering the numbers of dental unit in a medical center, 90% of which equipped with 18 dental units. This number is still far behind from the ideal standard which are 50 dental units, made by ADSROC. Eighty percent of the hospital provided dental services with eight sections in medical centers, six sections in regional hospitals and five in district hospitals respectively. This research showed that the current status of hospital dentistry at Taiwan existed the characteristic of nonconformity. Nonetheless, reconciling and adjusting between each hospital will be the first goal in the future.