慢性病患對慢性病連續處方箋認知與態度之探討–以台南縣為例

Exploration of Cognition and Attitude of Chronic Disease Patients on Refilling Card –An Example of Tainan County

陳正宗(Cheng-Tsung Chen)

指導教授 ： 陳麟慶

高雄醫學大學/藥學院/藥學研究所/碩士(2008年)

https://doi.org/10.6832/KMU.2008.00062

摘要

本研究目的在探討慢性病患對慢性病連續處方箋（以下簡稱慢箋）認知及態度，期能瞭解影響慢性病患持慢箋選擇至健保藥局調劑領藥意願之因素，以提供作為日後相關單位決策及宣導之參考。
本研究採立意抽樣調查方式，以台南縣醫療機構及健保藥局領藥之慢性病患為研究對象，自民國97年1月14日至2月15日共發出570份問卷，總共回收570份，有效樣本數為557份。研究重要結果如下：
一、受訪者年齡層以51歲以上中老年慢性病患族群為主。
二、慢性病患之性別與使用慢箋無顯著差異性（P值＞0.05）。
三、慢性病患之年齡及教育程度與使用慢箋有顯著差異性（p值＜0.05）。
四、在慢箋使用認知部份，有88.3%受訪者聽過慢箋，58.9%清楚使用方法，60.5%清楚使用目的。
五、慢箋資訊來源以醫師為主要來源（45.4%），其次依序親友（33.6%），藥局藥師（31.9%）。而有受訪者係經另類管道：電視（19.9%）、報章雜誌（12.85%）及廣播（8.4%）等途徑獲得訊息。
六、受訪者針對持慢箋到健保藥局領藥既省錢又經濟之認知，有55.5%表示清楚；到健保藥局領藥不需另外支付任何費用之認知，亦有53.5%之受訪者表示清楚。
七、在慢箋使用態度部份，「曾使用過」之受訪者在「健保藥局領藥能減少醫療支出」、「病患有權知道服用什麼藥物」、「健保藥局能提供醫師所開立藥物」、「政府提倡持慢性病連續處方箋到健保藥局領藥的政策是成功」之認同度，高於「沒有使用過」受訪者。
八、「節省時間」、「健保藥局離家近」及「節省金錢」是慢性病患願意持慢箋至健保藥局調劑領藥之重要前三項因素。
九、「習慣到醫院領藥」、「擔心領不到和醫院相同的藥品」、「醫院的藥品較安全」是慢性病患不願意持慢箋到健保藥局領藥前三項因素。
本研究結果，建議衛生政策管理者持續加強大眾傳播媒體宣導慢箋釋出之好處及使用方式，並提升健保藥局設置比率與普遍性及有效整合醫藥事機構資源，建立良好互動合作關係，以提供病患調劑領藥之方便性，進而提升慢性病患持慢箋到健保藥局調劑領藥之比例。

關鍵字

慢性病 ； 慢性病連續處方箋 ； 認知 ； 態度

並列摘要

The purpose of this research is to explore the cognition and attitudes of patients of chronic diseases on refilling card in the hope to understand the factors affecting such patient willingness to have refilling card at national health insurance pharmacies to serve as reference of decisions and publicity of the authorities.
The research adopts decides sampling with targets of patients with chronic diseases having refilling card at medical institutes and national health insurance drugstores. A total of 570 questionnaires were issued from 14 January to 15 February 2008 with 557 valid returned questionnaires. The findings are:
1.Most of the respondents are people over 51 with chronic diseases.
2.Gender of chronic patients with used refilling card not reveals the difference (P-value＞0.05）.
3.Age of chronic patients with used refilling card have reveals the difference (P-value＜0.05）.
4.In cognition, 88.3% respondents are aware of refilling card; 58.9% of them know the usage and 60.5% of them are aware of the purposes.
5.Source of information of refilling card is mainly physicians (45.4%), followed by friends (33.6%) and pharmacists at drugstores. Respondents also have alternative sources of TV (19.9%), newspapers and magazines (12.85%) and radio programs (8.4%).
6.55.5% of respondents are clearly aware of the time saving to have refilling card at national health insurance drugstores and 53.5% of them know that no extra fee is needed to have refills there.
7.In the attitude of usage, identification with having refilling card at national health insurance drugstores helps reduce the medical expenses, patients are entitled to know the medicine they take, the policy by the government of asking people to obtain refilling card at national health insurance drugstores is successful, and national health insurance drugstores can provide medicine prescribed by physicians of those having used is higher than that of respondents that have not used.
8.The top three factors making patients with chronic diseases to have refilling card at national nealth insurance drugstores are time saving,close to the homes and money saving
9.The top three factors preventing patients with chronic diseases from having refilling card at national health insurance drugstores are being used to have refills at hospitals, worrying to have different kinds of medicine and the medicine at the hospitals are safer.

Based on the preceding findings, the research suggests Department of Health keep publicity the advantages and usage of refilling card available at national health insurance drugstores, enhance the percentage and availability of national health insurance drugstores, effectively integrate medical institutes and establish good interaction relation in order to provide patients with convenience of prescription to increase the percentage of patients with chronic diseases to have refilling card at national health insurance drugstores.

並列關鍵字

chronic diseases ； refilling card ； cognition ； attitude

參考文獻

中文文獻

1.CHCA電子報（2002），「疏散門診量健保局以利誘之」，第42期，http://www.mmh.org.tw/chca/newspaper/42/%E9%9B%BB%E5%AD%90%E5%A0%B142.htm，下載日期：2008/1/30。

2.Google網站（張新銅、吳莉蓉，2004），「從教學中觀察學生語文學習態度之行動研究─以五結國小六年級為例」，http://cmc53.sivs.chc.edu.tw/93-action-research/%A6U%AE%D5%BA%EB%C2%B2%BD%D7%A4%E5/%A4%AD%B5%B2%B0%EA%A4p.doc，下載日期：2008/4/16。

3.Google網站（2008），「取藥規定放寬持慢箋調劑省錢」，http://mag.udn.com/mag/life/storypage.jsp?f_ART_ID=44627/，

下載日期：2008/1/29。