診所醫師轉診行為意向及相關因素之研究-以北部某醫學中心周邊院所為例

A Study on Peripheral Clinic Physicians' Referral Behavior Intention and Related Factors – A Case Study of a Medical Center In Northern Taiwan

林我權(Lin Wo-Chuan)

指導教授 ： 董貞吟

國立臺灣師範大學/教育學院/健康促進與衛生教育學系/碩士(2022年)

https://doi.org/10.6345/NTNU202201231

摘要

目的：本研究為瞭解基層診所醫師轉診行為意向影響因素，探討醫師特性、院所特性、轉診認知、轉診經驗等因素是否會影響醫師轉診行為意向，以提供衛生單位及醫院做為政策制定。

方法：本研究採橫斷式研究設計，收集時間為2022年3月1日至2022年4月20日經電話同意後寄送網路問卷表單連結提供填寫，總計發放450份問卷回收254份。研究對象以個案醫院醫療服務80%之病人來源五個行政區周邊診所登記負責醫師進行調查，採簡單隨機抽樣進行調查。

結果：在診所醫師轉診行為意願得分排名前三名依序為「合作醫院提供轉診病人就醫保留號」、「合作醫院即時提供轉診病人就醫病歷報告」、「合作醫院主動提供轉診服務窗口掛號服務」在上述情形時，醫師轉診意願較高，且轉診認知整體答對率為75%。「近一個月轉出人數」、「是否有加入家庭醫師計畫」、「轉診認知」、「每日平均門診量」、「開業年資」等情形時，會影響醫師整體轉診行為意向。

結論：(一) 轉出人數、加入家庭醫師計畫、每日門診量、開業年資對於轉診行為意向都有影響，建議可評估上述條件優先建立聯繫管道。(二) 轉診認知與轉診行為意向呈正向影響，表示能提升基層診所更瞭解轉診政策的內容，對於轉診行為意向的意願也會越好，個案醫院可主動與鄰近基層診所推廣相關政策。

關鍵字

轉診經驗 ； 轉診認知 ； 轉診行為意向

並列摘要

Purpose: This study to understand the influencing factors of physicians' referral behavior intention in primary clinics, this study explores such as physician characteristics, institution characteristics, referral cognition, and referral experience affect physicians' referral behavior intention, and provide health units and hospitals as policy formulation.

Method: This study is conducted through cross-sectional research. The research materials had been collected from March 1, 2022 to April 20, 2022. After the consent of the telephone, the online questionnaire form link is provided to fill in. A total of 450 questionnaires were distributed and 254 were recovered. The objects of this study from five major areas who provided 80% of the hospital's medical service. The survey was conducted by simple random sampling.

Results: The top three in the clinic's physician referral behavior willingness are cooperating hospital provides referral patient reservation number, cooperating hospital immediately provides referral patient medical record report, and cooperating hospital provides referral registration service proactively. In the above situation, physicians were more willing to make referrals, and the overall response rate of referral cognition was 75%. Physicians’ overall referral behavior intention will be affected in number of referrals in the past month, whether you have joined the family physician integrated care program, referral awareness, daily average outpatient, and practice years.
Conclusion:
1. The number of referrals, joining the family physician integrated care program, daily outpatient visits, and years of practice all have an impact on the intention of behavior. It is recommended to evaluate the above conditions and establish contact channels first.
2. Referral cognition and referral behavioral intention have a positive impact, which means that clinics can better understand the content of referral policies, and their willingness to make referrals will be better. The hospitals should actively promote relevant policies with clinics.

並列關鍵字

referral experience ； referral cognition ； referral behavioral intention

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