我國轉診與分級醫療相關政策之制訂、實施與成效

The policy-making, implemention and outcomes of referral and the hierarchy of medical care policy in Taiwan

林依瑩(Yi-Ying Lin)

指導教授 ： 鄭守夏

國立臺灣大學/公共衛生學院/衛生政策與管理研究所/碩士(2005年)

https://doi.org/10.6342/NTU.2005.02972

摘要

轉診制度與分級醫療一直是一個很受重視的政策問題，這樣的制度可以使我們得到完整且持續的醫療照護，也可以使得醫療資源的使用更有效率，但至今仍無令人滿意的結果。因此本研究以政策分析的方式，希望能達到下列研究目的：（一）瞭解從過去到現在，轉診制度及分級醫療的概念或理念。（二）整理轉診制度及分級醫療發展歷程、政策制訂目的及成效評估。（三）瞭解轉診制度及分級醫療目前的實施概況、推動策略及未來成效預估，並提出政策建議。
研究方法為檔案分析法，政策分析的模式，以W. N. Dunn所建構「以問題為中心的政策分析模式」（problem-centered policy analysis）為主，並將利害關係人加入分析架構。
結果發現我國轉診及分級醫療的相關政策，可分為勞保時期、醫療網時期、健保開辦至2000年和2000年以後四個時期，轉診制度及分級醫療在各個時期被賦予的意義不同。並提出對於衛生主管機關、中央健康保險局及醫療提供者的政策建議。

關鍵字

轉診,分級醫療

並列摘要

The referral system and the hierarchy of medical services are importanr policy. The referral system and the hierarchy of medical services may help people to obtain comnplete and continual health cars, to allocate the medical resources more efficiently. But the policy of the referral system and the hierarchy of medical services have not been implemented in Taiwan. The purpose of the study includes: 1. to identify the meaning of referral system and the hierarchy of medical services in the past and nowadays. 2. to study the referral system and the hierarchy of medical services, the policy purposes and policy assessment. 3. to analysis policy objectives, the policy strategies and policy suggestions.
The method of this study is archives analysis and the model of policy analysis is the problem-centered policy analysis by W. N. Dunn. The analysis framework is also inclueded the analysis of stakeholers.
The main result is that the referral system and the hierarchy of medical services were separated into four periods: Labor Insurante, Medical Care Network Program, the National Health Insurance in 1995 until 2000 and the National Health Insurance after 2000. The policy meanings were differenc in each period. Base on the study results, we purpose some policy suggestions for the government, the Bureau of National Health Insurance and the providers of health care serices.

並列關鍵字

referral, the hierarchy of medical care

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