台灣醫院護理人力增長的初步分析

A Preliminary Analysis of the Increasing Workforce of Hospital Nurses in Taiwan

范國棟(Kuo-Tung Fan) ； 陳美霞(Meei-Shia Chen)

《台灣公共衛生雜誌》 28卷1期 (2009/02) Pp. 26-34

https://doi.org/10.6288/TJPH2009-28-01-03

摘要

目標：護理人員是台灣醫療產業中的主要照護人力，也是醫療團隊中執行醫師醫囑的關鍵成員，本研究試圖藉由護醫比值的變動，探討護理人力變遷在醫院產業發展上的特殊意涵。方法：本研究以南台灣一家私立醫學中心的人力變化與醫事人員薪資分佈，和全國醫院護醫人力的變動為材料，藉由檢視醫療產業中護醫人力比值的歷史變遷，我們分析護理專業人力變化與醫院經營策略之間的關係及其社會意涵。結果：我們發現，該醫學中心護醫比從1975年的1.03上升至2007年的2.52；然而，護理人員的平均薪資卻相對比醫師及其他醫療及非醫療人員低。1989至2007年之全國醫院護醫比變動也大致呈現上升趨勢。結論：我們認為，上述護醫比值的上升趨勢主要反映醫院利用薪資較低的護理人員為主要人力以節省投資成本的經營策略，然而，台灣護理人員工作環境或福利並未因護理專業人數增加而增進。

關鍵字

護醫比 ； 醫院產業

並列摘要

Objectives: Nurses are the majority of the workforce in the medical industry in Taiwan, and are key medical team members in carrying out physicians' orders. In this study, we examined trends in the nursing workforce and discussed special implications for the hospital industry by analyzing the changing ratio of nurses to physicians in Taiwan's hospitals. Methods: This study is based on data on workforce changes and differences in wages among different medical professionals in a medical center in southern Taiwan, and on governmental data about changes in the hospital medical workforce in Taiwan as a whole. We examined historical changes in the nurse physician ratio, and analyzed the relationship between the changes in nursing workforce and hospital management strategies and their social implications. Results: We found that the nurse physician ratio increased from 1.03 in 1975 to 2.52 in 2007 in this medical center. Additionally, we found that the average wage for nurses was much lower than that of physicians and other medical and non-medical professionals. The changes in this ratio for all hospitals in Taiwan generally show similar increasing trends. Conclusions: We argue that this increasing trend of nurse physician ratio in both the southern Taiwan medical center and in all of Taiwan's hospitals mainly reflects the hospitals' management strategy of employing nurses with lower wages in order to decrease investment costs. The increase in the nursing workforce has not been accompanied by an improvement in the nursing profession's working conditions or welfare.

並列關鍵字

nurse-physician ratio ； hospital industry

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