探討家庭醫師整合照護試辦計畫成效滿意度之分析

研究背景與目的：我國從民國93年開始推動家庭醫師試辦計畫，期能落實家庭醫師制度，推展社區民眾疾病與健康照護管理。本研究之目的在探討醫師加入計劃之後的家庭醫師功能改善認知以及醫師個人特質、功能改善認知、政策因素和滿意度之間的關係。材料與方法：本研究採用橫斷面問卷調查法，針對醫師個人特質、家庭醫師功能(整合性照護、醫病關係、連續性照護、社區功能及預防保健)，政策因素(政策目標、政策誘因、認知意願)、試辦計畫滿意度等四部份進行調查。於95年5月1日至95年8月30日,針對全國家庭醫師試辦計畫醫療群(294群)，每一群抽一位醫師，共計從262個不同試辦計劃醫療群回收262份有效問卷。研究結果：受訪醫師對家庭醫師試辦計畫的認同度高，家庭醫師功能、政策因素等變項平均值都在3.6間。平均滿意度為73.6分。家庭醫學專科醫師在家醫功能改善認知顯著高於非家醫背景醫師。在基層執業年限越長，對連續性照護、社區功能、預防保健的改善越明顯。執行中心醫師在整合性照護、連續性照護、社區功能有明顯差異。滿意度迴歸分析:顯著預測自變項為：預防保健及政策因素認知差異是醫師滿意度的預測變項。結論：一、醫師個人特質(家庭醫學專科背景、執行中心、執業年限)，對家庭醫師功能認知有顯著影響。二、醫師個人特質(家庭醫學專科背景、執行中心、服務單位型態)，對政策認知有顯著影響。三、家醫功能改善認知、政策因素能預測滿意度。四、醫師個人特性不是滿意度的解釋變項。建議：一、有計劃的逐步推動社區醫療。二、加強住院醫師的社區醫學訓練。三、提供開業醫師更多參與計劃及家庭醫學訓練的機會。四、藉由醫師參與改善試辦計畫的政策誘因。

關鍵字

家庭醫師；家庭醫師試辦計劃；家醫功能；醫療群；滿意度

並列摘要

Introduction: Taiwan began to implement Family Physicians Program(FPP) since 2004.The main goals are to empower family physicians system and to encourage community healthcare and health behaviors. Purpose: to investigate the physicians perceived achievement and the relationships between physicians characteristics, perceived achievement, policies factors and satisfaction of the FPP. Materials and methods: This study adopt a conducted a cross-sectional mailing survey. The questionnaires included: physician's characteristics, perceived achievements of the family physician functions (comprehensive care, patients' relationship, continuity care, community care, preventive care), policies factor (goals of the Policies, policies incentives, attitudes and willingness.). We selected one physician from every Family Physician Practice Groups (294, FPPGs).There were 262 valid questionnaires returned from 262 different FPPGs. Result: Physicians identify themselves with the FFP, Means of physicians perceived achievements, Policies factor: 3.6, Mean of satisfaction: 73.6. Family medicine specialists’ perceived achievements significantly higher than those of other physicians. Physicians who have longer professional practices experience reflex significant Continuity care, Community care, and Preventive care improvement. Physicians who in charge of executive center are significantly improve their comprehensive, continuity and community care. Multiple regressions found: significant predictable variables of physician satisfaction were preventive care, policy factors. Conclusions: 1. physician characteristics (family medicine specialist, executive center, professional experiences) are significantly related to perceived achievements. 2. Physician characteristics (family medicine specialist, executive center, clinic pattern) are significantly related to perceived policies factor. 3. Perceived achievements, Policies factors are predictable variable of satisfaction. 4. Physician characteristics are no likely a significant predictable variable of physician satisfaction. Suggestions: 1. Empower community primary healthcare fallowing strategic steps. 2. Include community-base healthcare education curriculum in the regular resident training program. 3. Encourage participation of primary health professions by developing a graduate level family medicine education program. 4. Increase FPPs incentives.

並列關鍵字

Primary health professions ； Family Physician Program ； Family Physician ； Practice Group ； satisfaction

參考文獻

陳慶餘(2000)。家庭醫學與社區健康營造，台灣醫界，5(2)，188-193。

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探討家庭醫師整合照護試辦計畫成效滿意度之分析

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