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社區醫療群醫師提供居家照護服務意願之調查

A Survey of Integration Trial Plan Family Physicians Intent on the Home Care Services

摘要


背景:隨著我國人口老化,對長期照護的需求亦隨之提升,而居家照護為其中重要之一環。同時,自民國92年3月在基層照護體系開始實施「家庭醫師整合性照護制度試辦計畫」。為了提升長期照護服務意願與品質,本研究探討參與該計畫的醫師對於提供居家照護服務的意願與傾向。研究方法:本研究為橫斷性研究,郵寄自填式結構問卷給參與家庭醫師整合性照護制度試辦計畫之基層醫師。於民國95年11月20日共寄出1790份問卷,至民國96年2月20日截止回覆收件。結果:問卷有效回覆率為31.28%(560份)。社區醫療群醫師對於「健保局審核標準過嚴,剔退率高(平均4.0分)」和「病人用藥複雜,多重開具處方易被剔退(平均4.0分)」兩項提供居家照護服務意願之阻力因素認同度最高。若推行社區醫療群醫師提供居家照護服務的計畫,有39.7%的社區醫療群醫師願意參加。結果顯示,有參加醫療給付方案、有出診經驗及有居家照護經驗的醫師,他們顯著地願意提供居家照護服務。結論:根據本研究結果建議,衛生主管機關擬定適當且合理的誘因與配套措施,建立透明之審查機制;與提供居家照護的醫療機構和長期照護單位,辦理居家照護等相關的長期照護繼續教育,使社區醫療群醫師更加願意參與提供居家照護服務的相關計畫。

並列摘要


Background: With the decrease of the total fertility rate and the increase of the life expectancy, the population in Taiwan is getting older and longs for the long-tern care services imminently. Home care services are essential to long-tern care system. The Integration Trial Plan was started in March 2003. To promote the quality of home care services, we investigated intentions of family physicians on home care services. Methods: The study was a cross-sectional study. Family Physicians who joined Integration Trial Plan received a questionnaire in last November 2006 and replied until February 20, 2007. Results: The effective response rate of this is 31.8%. Major physicians are male (94.8%) and average age is 49.6-year old. They work average 12.8 years in current place. There are 39.74% Physicians willing to enroll in home care services in the future. Conclusion: Under the complementary measures and financial incentive, the Integrated Family Physicians may show their intention on participation in home health care services.

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