內科專科醫師人力問題之剖析－美國vs臺灣

Analysis of Internal Medicine Manpower: American V.S. Taiwan

宋文娟(Wen-Chuan Sung) ； 藍忠孚(Chung-Fu Lan) ； 洪錦墩(Chin-Tun Hung)

《醫務管理期刊》 2卷1期 (2001/03) Pp. 21-31

https://doi.org/10.6174/JHM2001.2(1).21

摘要

本研究目的在於綜研美國與臺灣內科專科醫師之問題及對策。研究方法採國內外文獻探究及十位內科專家深度訪談，期推古綜今，清晰點明內科專科人力現況及未來問題。
本研究發現：一、美國之內科人力存在著過度專科化與基層人力不足二問題。二、臺灣地區之內科專家認為1．達到內科及各次專科醫師人數比率較佳的方式首要在於健保支付制度。2．最容易招募的次專科別為心臟科及消化科。3．最不容易招募的次專科別為風濕免疫科。4．目前在內科及其次專科醫師人力上，關鍵的課題包括(1)全民健保支付影響醫師專科人力分配。(2)醫師人力分佈不均。(3)醫學教育訓練制度出現弊端。
本研究結果可提供中央衛生主管機關、中央健康保險局、台灣內科醫學會、各醫療機構等參考。

關鍵字

醫師人力 ； 內科 ； 專科醫師

並列摘要

The purpose of this study was to comprehend problems and policies of American and Taiwan's internal medicine physician manpower. This study is based on both analyzing review articles and in-depth interviews with internist recommended by the Society of Internal Medicine of Taiwan.
The results are as follows: First of all, American's internal medicine manpower is characterized by surplus of subspecialty and insufficiency of generalist. Secondly, Taiwan's internists believe that the balance between generalist and subspecialty is dependent on the national health insurance reimbursement, the most popular subspecialties are cardiology and gas troenterology, and the least attractive subspecialty is rheumatology & immunology. Thirdly, the national health insurance reimbursement system has a significant impact on the distribution of physician manpower. Finally, the medicine education and the training program appear to be defective.
This study may serve as a reference for Department of Health, Bureau of National Health Insurance, Society of Internal Medicine of Taiwan and all hospitals.

並列關鍵字

physician manpower ； internal medicine ； specialist