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探討台灣醫院使用品質報告卡之意願與能力

Exploring Hospital Willingness and Ability to Use Report Cards

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Abstracts


目的:本研究指旨在探討台灣醫院使用品質報告卡之意願與指標公佈能力,研究結果可做為政府與民間相關單位未來堆行醫院品質報告卡之參考或依據。材料與方法:本研究以通過醫院評鑑的醫學中心、區域醫院與地區醫院等三層級之醫院(不含精神車科醫院)為研究對象,共有495家醫院,其中包括醫學中心17家,區域醫院62家,地區教學醫院49家,地區醫院367家。本研究採取郵寄問卷的方式蒐集所需的資料,首先對每一個變項進行敘述性分析,其次以克-瓦二氏單因子等級變異數分析(Kruskal-Wallis)探討醫院評鑑等級與使用品質報告卡之意頹是否具有相關性。結果:問春回收總共183份,總回收率達37%。有52%的醫院“很有意願”或“有意願”使用醫院品質報告卡;另一方面,有21.3%的醫院“很沒意願”或“沒意願”使用醫院品質報告卡。經克-瓦二氏單因子等級變異數分析檢定後,發現醫院使用品質報告卡的整體意願不因醫院評鑑等級(p=0.932)不同而有所差異。結論:醫院對使用醫院品質報告卡之整體意順超過五成,衛生主管機關應予以重視。又醫院總額預算制度實施之際,建議將醫院品質報告卡列入總額預算協商重點,要求預算執行機構必需定期提出醫院品質報告,亦不失為總額制度下監測與促進醫療品質之良策。

Parallel abstracts


Objective: The purpose of this article is to explore hospital willingness to use report cards and hospital ability to publish quality indicators. Materials and Methods: The study used 495 hospitals including 17 medical centers, 62 regional hospitals, 49 teaching district hospitals, and 367 district hospitals as the study sample. A mailing survey was performed to collect applicable data. A Kruskal-Wallis analysis was performed to examine the relationship between hospital level and hospital willingness to use report cards. Results: There were 183 questionnaires returned and yielded a 37% of response rate. In total, 52% of hospitals are very willing or willing to use hospital report cards. On the contrary, 21.3% hospitals are ”very unwilling” or ”unwilling” to use report cards. A Kruskal-Wallis analysis shows no significant relationship between hospital level and hospital willingness to use report cards. Conclusions: Over 50% of hospitals are willing to use report cards. It is recommended that policy makers consider initiating hospital report cards. In particular, the publication of hospital port cards should be included as a negotiating factor with the implementation of global budget.

References


Anderson, P.(1999).England publishes first tables of hospital performance.BMJ.318,1715.
Bentley, J. M.,Nash, D. B.(1998).How Pennsylvania hospitals have responded to publicly released reports on coronary artery bypass graft surgery.Jt Comm J Qual Improv.24(1),40-49.
Chassin, M.R.,Hannan, E. L.,Debuono, B.A.(1996).Benefits and hazards of reporting medical outcomes publicly.N Engl J Med.334(6),394-398.
Fogg, D. M.(1998).Health care report cards.AORN Journal.67(3),669-672.
Harris, N.(1994).Report cards, Part 2: How hospitals measure up.Bus Health.12(8),20-22, 24.

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葉玉清(2009)。探討骨科醫師對醫療品質資訊公開之看法與影響醫療行為意向改變之研究-以人工膝關節置換手術品質報告卡為例〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2009.00939
陳楚杰(2005)。醫院品質報告卡指標之篩選及以結構方程模式分析住院病人對其創新特性之知覺、態度與使用意願〔博士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2005.01242
徐富坑(2005)。中央健康保險局高屏分局「醫院醫療服務品質報告」 的實施成效評估-門診病人之就醫資訊選擇、態度與期望〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200714550267

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