- 學位論文
醫院人員對癌症診療品質認證試評之認知探討 －以八家試評醫院為例
Perceptions of Hospital Staff on the General Cancer Certification Program – Cases of Eight Pre-evaluated Hospitals
摘要
本研究之目的為瞭解參與國民健康局96年之「癌症診療品質認證試評計畫」之醫院人員，對認證基準的重要性、相關性、準備難易度及執行成效之認知。 本研究以全體普查方式，針對參與醫院實地認證之八家醫院共295位人員進行資料收集及分析。使用t檢定及單因子變異數分析來分析研究對象之人口學特性、所屬醫院特性及癌症照護品質的相關經驗等變數，與癌症診療品質認證基準及癌症診療品質認證執行成效面認知之關連性。另一方面，使用複迴歸分析來檢定上述自變項對於癌症診療品質認證基準及癌症診療品質認證執行成效面認知等應變項之預測能力。研究結果顯示，性別、年齡、職務別、最高學歷、工作總年資等人口學特性及癌症照護品質的相關經驗等變數，皆會影響受訪者對癌症診療品質認證基準之認知。而年齡、職務別及醫院評鑑等級及94年癌症病患服務量等變數，則會影響受訪者對認證執行成效之認知。 本研究發現醫院人員相當認同本次試評對醫院提升癌症診療品質之幫助，因此建議衛生主管機關：(1)應對參加認證醫院在基準的準備方面進行適當之輔導，以免醫院在實行初期因遭遇困難而對認證制度產生負面的認知。(2)在後續的教育訓練部分，應特別加強認證委員之評分共識。(3)在健保總額支付制度下，癌症照護品質不斷受到排擠，醫院開始限制醫師之服務量，衛生主管機關應考慮將癌症預算獨立於醫院總額預算制度之外，避免癌症病患成為就醫之人球。(4)亦應積極規劃認證通過醫院之相關獎勵補助措施，以鼓勵醫院積極正面的參與認證。
並列摘要
The main purpose of this research was to understand hospital staffs perceptions of approved standards and potential benefits of the〝General Cancer Certification Program〞which was administed by the Bureau of Health Promotion(BHP) in 2007. The study population included 295 staff members at 8 hospitals that have participated in the General Cancer Certification Program. Structured questionnaires were delivered to the respondents to collect need information. T-test and one-way ANOVA were used to analyze related variables such as demographic characteristic of respondents and hospital characteristics. Furthermore, respondents’perceptions of approved standards and potential benefits of this program were also examined. Multiple regression analysis was used to examine the effects of independent variables on dependent variables. Results indicated that demographic characteristics including sex, age, job position, the highest education, total working years and relevant experience of cancer diagnosis and treatments, would affect staffs’perceptions of the approved standards. And age, job position, hospital level and hospital volume of cancer patients in 2005, would influence staffs’perceptions of potential benefits of this program. The findings of this research also showed that hospital staffs were positive that this program can improve cancer care quality. Based on the findings, some recommendations to BHP were proposed: (1) Assisting hospitals in preparing related documents when participates the Cancer Certification Program. (2) Having an education program in place for surveyors to establishing their rating consistency. (3) Under the current global budget system, the budget of cancer prevention and treatment is limited. Therefore, the government should consider allocating some budget exclusively to promote cancer care quality. (4) Encouraging hospitals to participate the program with financial incentives.