家庭醫師整合照護制度試辦計劃－台北地區民眾滿意度調查

A Satisfaction Survey of Family Physician Integration Program-From People of Taipei Region

賴瑆元(Shing-Yan Lai)

指導教授 ： 王俊文博士

中山醫學大學/醫學院/醫學研究所/碩士(2007年)

摘要

為提升台灣基層醫療功能，健保局在2004年推動「家庭醫師整合照護制度試辦計畫」，本研究採橫斷面調查法(cross-sectional study)，以自填式結構性問卷，探討健保局台北分局轄區民眾對家庭醫師功能的期望(重視程度)、與知覺(滿意程度)，問卷內容包括人口學變項醫療需求與行為及家庭醫師功能等三部份。總共回收問卷781份，其中參與家庭醫師照護制度的家戶會員與非家戶會員約佔各半。
本研究在探討台北地區民眾在家庭醫師整合照護制度試辦計畫執行後，對家庭醫師功能在期望與知覺的態度。對參與家庭醫師整合照護計畫之基層診所，以隨機抽樣方法選取，在診所的配合下，針對登錄於該診所的家戶會員及在該診所就醫的一般民眾(非家戶會員)，以結構式問卷做測量。總共回收問卷共781份，家戶會員受訪者佔50.3%非家戶會員受訪者佔49.7%。首先以卡方檢定來進行民眾個人特性分析及民眾對家庭醫師功能於期望、知覺及缺口的影響作描述性統計，再以Paired T檢定來分析民眾個人特性及不同組別受訪者對家庭醫師功能五個構面中於期望、知覺與缺口影響的差異，以ANOVA、t檢定以paired t 檢定對不同組別受訪者對家庭醫師功能於期望、知覺與缺口影響分析。
研究結果發現，民眾對家庭醫師期望的程度平均分數為4.20分，而滿意程序平均分數為4.06分，顯示民眾對家庭醫師整合照護制度給予高度肯定，但對家庭醫師的服務品質也有高標準的要求。在檢定分析顯示，利用基層診所及固定醫師看診的民眾，對家庭醫師功能有較高的期待與滿意度。複回歸分析顯示，家庭醫師功能在醫療照護的持續性對民眾在家庭醫師服務的整體滿意度最具有解釋能力。

關鍵字

家庭醫師 ； 家庭醫師整合照護制度 ； 基層醫療

並列摘要

To improve Taiwan’s Primary Health Care function, The Bureau of National Health Insurance has already promoted the Family Physician Integration Program since 2004. The research has adopted the Cross-sectional Study method by using a structural formula questionnaire to investigate PMC function’s satisfaction and significance from all Taipei area residents. The questionnaire has contained three major investigations. First the expectations of family physician function, second the needs from the change demography. The research has received total 781 questionnaires. The result has shown that 50.3 percents of interviewee are from the program membership, and other 49.7 percents are out of membership.

This research study has investigated the results of family physician function’s expectation and satisfaction after the “Family Physician Total Integrated Health Care System” plan was executed to all residents. All participants are chosen in random and are the members and the patients of all clinics. All participants are investigated by the a structural formula questionnaire. The research has received total 781 questionnaires, and about 50.3 percents of interviewee are from the program membership, and other 49.7 percents are out of membership. To explain and describe the different influences between all participants’ personal characteristic, awareness, influences and expectation of family physician function. At the first, the research has utilized the卡方 to analyze all participants Moreover; the research has contrasted all participants’ results by using a Paired T method and the ANOVA T method. In conclusion, the purpose of utilizing Paired T method, Chi-Square Tests and ANOVA T method is to evaluate the different influences and results between all methods.

According to the result, the expectation of family physician function had 4.20. However, the satisfaction of family physician function only had 4.06.The figures have shown that most of residents have a higher expectation on the “Family Physician Total Integrated Health Care System”. Furthermore, they also have a high standard of expectation for the service quality. Beside, it shows that most people who utilize out-hospital clinics service or have a regular doctor service they have a higher expectation and satisfaction from the family physician function. In consequence, as result shows that family physician function has a duty of continuing medical follow-up for all the patients in its own area.

並列關鍵字

Family physician ； Family Physician Integration Program

參考文獻

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