- 學位論文
偏遠地區巡迴醫療點寬頻升速需求之研究
A Study on Broadband Upgrading Demand of Mobile Clinics in Remote Areas
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摘要
中央健康保險署積極強化山地離島等偏遠地區民眾的照護，將全國山地離島偏遠地區，納入健保的「全民健康保險山地離島地區醫療給付效益提昇計畫（簡稱IDS計畫）」，將充足的醫療人力及資源送到偏遠地區服務，彌補當地醫療資源不足之困境。 本研究針對西元2012年49個IDS巡迴醫療點做問卷調查，主要蒐集相關人員在巡迴醫療點使用醫療資訊系統與寬頻網路的現況資料，及該人員對網路使用及醫療資訊系統與醫療品質關係之相關評估資料，以分析偏遠地區巡迴醫療點寬頻升速之需求。並根據IDS計畫執行目標，評估其服務品質與醫療資訊系統之關連性，藉以了解寬頻升速需求程度及預期改善效益。 研究結果顯示，多數的受訪者對於偏遠地區使用網路的經驗表示未達良好的程度，並希望網路品質穩定以利其作業。但是在部分巡迴醫療點無法申請有線線路，而無線網路又因山區地形、天候干擾的影響，多數僅有使用醫療資訊系統的部分功能。另外，對於寬頻速率的要求，不若預期中的殷切，網路品質的影響程度超出對網路頻寬的需求。多數認為評估應使用網路頻寬與目前使用網路頻寬相符，而且已經申請到相同連線方式下最大的網路頻寬。提高偏遠地區之網路頻寬、提升網路品質，並配合巡迴醫療點的作業需求，持續增加偏遠地區的電信機房及行動基地台的數量，應可有效增加巡迴醫療點使用醫療資訊系統功能的意願，進而提升整體巡迴醫療服務的品質。
並列摘要
The National Health Insurance Administration is actively improving the care provided for people living in remote areas such as mountains and offshore islands. Specifically, remote areas (mountains and offshore islands included) across Taiwan have been included in the “Project for Enhancing the Efficiency of Medical Benefit Payment in the National Health Insurance Provided in Mountains and Offshore Islands,” also called the integrated delivery system (IDS) project. Hence, sufficient medical manpower and resources are delivered to remote areas, thereby resolving the problem of insufficient medical resources in these areas. This study has conducted 49 questionnaire surveys for all IDS sites recorded in 2012. It gathers the status of the use of both health information systems and broadband network and the related data of the relationship between the quality of medical service and the use of health information systems to assess the broadband upgrading demand of mobile clinics in remote areas. Based on the objectives of the IDS project, we explore the relationship between service quality and health information systems to understand the broadband upgrading demand in these clinics and the expected improvement in the efficiency of medical services. The results show that numerous respondents deemed the Internet experience they had in remote areas unsatisfactory and expected network quality of enhanced stability for improving their operations. However, installing cables for mobile clinics is impossible in particular areas. In addition, wireless networks are subject to the influences of mountainous terrain and the weather; consequently, only several functions of health information systems can be accessed in most mobile clinics. Furthermore, we determined that the broadband upgrading demand was not as high as anticipated. By contrast, the demand for high network quality was stronger than that for improved network bandwidth. The majority of the respondents stated that the assessment should be performed using a network bandwidth identical to that of the currently used bandwidth. In addition, these people indicated that they are already using the maximum network bandwidth available under a given connection. In conclusion, increasing the network bandwidths in remote areas, improving network quality, and continuing to increase the numbers of telecommunication facilities and mobile base stations based on the needs of mobile clinics stationed at remote areas can effectively enhance the willingness of personnel serving at mobile clinics to use the functions of health information systems. Thus, the overall quality of services provided at mobile clinics can be improved.
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