國內診所資訊化與病歷電子化之相關因素探討

TExploring the Factors of Computerization and Computer-based Patient Record of Clinics in Taiwan

邱政元(Jeng-Yuan Chiou) ； 馮兆康(Chao-Kang Feng) ； 潘麗卿(Li-Chin Pan) ； 余偉綸(Wei-Lung Yu)

《弘光學報》 49期 (2006/11) Pp. 209-218

摘要

在病歷電子化的過程之中，醫療院所資訊系統之應用及發展程度是成功的要件，因此本研究目的在於探討醫療院所資訊化及病歷電子化的相關因素。方法：本研究使用衛生署「全國醫療院所病歷電子化現況調查」所建立的資料庫進行次級資料分析，探討本國診所資訊化及病歷電子化的相關因素。結果：結果顯示有76.7%的診所已資訊化，在已經資訊化的診所中，已病歷電子化的有63.5%。經過邏輯斯複迴歸分析結果顯示：西醫診所資訊化的勝算比牙醫診所高(OR=1.33，95%CI=1.1-1.6)，診所醫師愈多、診所有專職的資訊人員、每年編列有資訊預算愈多、愈同意政府推動因素的診所，其資訊化勝算比較高。在已資訊化的診所中每年編列有資訊預算愈多、愈同意政府推動因素、已建置內部區域網路、掛號系統已資訊化、個人電腦越多的診所，其病歷電子化勝算比較高，但是與診所類別、是否有專職資訊人員及醫師人數無關。結論：此研究之貢獻在於找出診所資訊化及病歷電子化之相關因素，未來可以以這些相關因素為基礎，做進一步的分析，亦可做為 推廣病歷電子化及其他衛生保健資訊政策之建議與參考。

關鍵字

電子病歷 ； 資訊化 ； 診所

並列摘要

Objects:The application and development of clinics and hospitals information system are the essential components in the process of computer-based patient record. However, there is few studies have explored the factors of computerization and computer-based patient record of clinics in Taiwan. Methods:This study used the database of ＂Survey of Current Status of Clinics and Hospitals Computerization and Computer-based Patient Record in Taiwan＂ from Department of Health to further analyze the factors of computerization and computer-based patient record of clinics. Results: The resulted revealed that 76.7% of the clinics have been computerized and among them, there is 63.5% of the clinics utilized computer-based patient record. In addition, the multiple logistic regression analysis results showed that western clinics have higher possibility of computerization than the dental clinics (OR=1.33, 95%CI=1.1-1.6). Other characteristics are more likely to be associated with computerization of clinics, the more the doctors and full time informatics professionals in the clinics, the more the funding of information system is provided, the more willing to cooperate with the government. Among those computerized clinics, certain characteristics are more likely to be associated with utilizing computer-based patient record, the more the funding of information system is provided, the more willing to cooperate with the government, using local area network in clinic, using patient register system, the more the personal computers. Conclusions: This study identifies the factorsof computerization and computer-based patient record of clinics. The findings may help policy makers in developing computer-based patient record and a better health information system for clinics and hospitals in Taiwan.

並列關鍵字

computer-based patient record ； computerization ； clinic

參考文獻

王大為、劉敦仁、陳怡璋（1999），〈電子病認證機制研究〉，《醫療資訊雜誌》頁71-84。

朱海成、陳澤雄、簡守維（2002），〈 醫療資訊系統之前瞻性－以電子病歷為例〉，《產業論壇》3：2，頁215-239。

行政院衛生署（2005），〈行政院衛生署中程（九十四至九十七年度）施政計畫〉，網址：（http://www.doh.gov.tw/cht/list.aspx?dept=R&now_fod_list_no=7054&class_no=112&level_no=2&divNo=&divCount=）。

余偉綸（2004），〈臺灣西醫、中醫和牙醫診所資訊化及病歷電子化影響因素探討〉，《台中健康暨管理學院健康管理研究所碩士論文》。

林四海（2001），〈醫療機構病歷管理之法律責任與趨勢〉，《醫事法學》9：2，頁24-34。