臺灣醫院人力相關研究之回顧與評析

Review and Analysis of Manpower Issues in Taiwan's Hospitals

扈克勛(Ke-Hsun Hu) ； 黃毓瑩(Yu-Ying Huang) ； 李世珍(Shyh-Jane Li)

《醫務管理期刊》 12卷3期 (2011/09) Pp. 143-165

https://doi.org/10.6174/JHM2011.12(3).143

摘要

目的：我國政府針對醫院各類執業醫事人力配置均有明文規定，但民眾仍覺得醫療品質與照護人力時有不足。全民健保的實施讓醫院致力於管控醫療成本，也影響了醫護人力的配置，顯見醫院人力的問題不能只是在數量上予以政策規範。本研究試圖透過醫院人力議題的文獻回顧，指出以往研究發展的主軸脈絡與重要特性。方法：針對2001－2010收錄在華藝CEPS資料庫中有關醫院人力議題的期刊論文共140篇，以內容分析法針對五個面向（研究議題、研究對象、研究區域、研究方法、統計方法）予以分析。結果：「研究議題」會隨著時代變遷調整重點研究方向，但不算廣泛。「研究對象」在放射、營養、檢驗、藥劑、呼吸治療、語言治療、醫管等職類之人力相對少有研究發表。「研究區域」方面，部分研究以便利取樣的方式選擇某區域範圍，是否有反映區域的地方特性可再作深入討論。「研究方法」係以量化分析為主，建議未來可發展其他研究方法。「統計方法」的運用多採敘述性統計、差異性分析（含t檢定與變異數家族），呈現出高度雷同性。結論：本研究透過文獻回顧從五個面向找出待解決的問題缺口及未來可以發展之研究方向，期許未來有更多元化的醫院人力議題研究出現。

關鍵字

醫院 ； 人力 ； 文獻回顧 ； 內容分析

並列摘要

Objectives: The Taiwanese government has created regulations for hospital staffing allocation, but people still think that the quality of medical care and medical manpower is still insufficient. The implementation of National Health Insurance led to changes in hospitals' medical costs and their employment of health care manpower; however, problems with hospital manpower cannot be solved simply by regulation. The main purpose of this study was to understand current hospital manpower issues in Taiwan by reviewing the existing literature. We identified important features in the existing literature, and, based on these, suggested possible directions for future research.Methods: We reviewed a total of 140 studies related to Taiwan's hospital manpower between 2001 and 2010 in the CEPS. The content analysis covered research topics, subjects, areas, methodology, and statistical methods.Results: The research topics were relatively narrow and can be expanded to include the viewpoints of other fields such as service management and organizational theory. As to the research area, some studies conducted their studies in some specific areas and with convenience sampling; however, if their results reflected regional characteristics are needed to be discussed further. With regard to research methodology, quantitative analysis was the main method used and other research designs (such as quasi-experimental or qualitative analysis) can be developed in the future. Statistical methods were primarily descriptive statistics or analysis of differences (t-tests and variances), and showed a high degree of similarity and other methods can be utilized.Conclusions: Through a literature review, this study identified gaps in research in the studies of hospital manpower in Taiwan, and made suggestions for future development.

並列關鍵字

Hospitals ； Manpower ； Literature Review ； Content analysis

參考文獻

Culyer, A. J.(ed.),Newhouse, J. P.(ed.)(2000).Handbook of Health Economics.North Holland:Elsevier Science.

盧瑞芬、謝啟瑞(2003)。臺灣醫院產業的市場結構與發展趨勢分析。經濟論文叢刊。31(1)，107-153。

行政院衛生署：民國98年醫療機構現況及醫院醫療服務量統計分析。行政院衛生署統計公佈欄，2011.01.29.摘自http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=9511&class_no=440&level_no=1。

范國棟、陳美霞(2009)。台灣醫院護理人力增長的初步分析。臺灣公共衛生雜誌。28(1)，26-34。

中華民國區域醫院協會：臺灣醫院協會、臺灣私立醫療院所協會、臺灣醫學中心協會、中華民國區域醫院協會、臺灣社區醫院協會、中華民國醫師公會全國聯合會等六大公協會聯合聲明。中華民國區域醫院協會，2011.01.29.摘自http://www2.rha.org.tw/init/default/news?height=500&width=600&action=detail&id=2945。