醫院人員對癌症診療品質認證試評計畫之認知探討－以八家試評醫院爲例

Perceptions of Hospital Staff with Regard to the "Accreditation on Cancer Care Quality Program"

劉湫美(Chiou-Mei Liu) ； 劉滄梧(Tsang-Wu Liu) ； 李莉鈺(Li-Yu Lee) ； 邱昌芳(Chang-Fang Chiu) ； 許怡欣(Yi-Hsin Elsa Hsu) ； 黃國哲(Kuo-Cherh Huang)

《醫務管理期刊》 10卷3期 (2009/09) Pp. 201-219

https://doi.org/10.6174/JHM2009.10(3).201

摘要

目的：探討參與國民健康局2007年「癌症診療品質認證試評計畫」之醫院人員，對認證基準的重要性、相關性、準備難易度及執行成效之認知，研究結果應可提供相關當局進行後續基準修訂時之參考。
方法：針對參與認證試評之八家醫院共295位人員進行資料收集及分析。研究人員先使用t檢定及單因子變異數分析探討研究對象之人口學特性、所屬醫院特性及癌症照護品質的相關經驗等自變項，與癌症診療品質認證基準及癌症診療品質認證執行成效面認知等應變項之關連性，再進一步使用複迴歸分析來檢定上述自變項對於應變項之預測能力。
結果：分析結果顯示，受訪者之性別、年齡、職務別、最高學歷、及工作總年資等人口學特性，以及癌症照護品質的相關經驗等變項，皆會影響受訪者對癌症診療品質認證基準之認知。而年齡、職務別、醫院評鑑等級及2005年癌症新診斷個案數等變項，則會影響受訪者對認證執行成效之認知。
結論：本研究發現醫院人員相當認同本次試評對醫院提升癌症診療品質之幫助，因此建議衛生主管機關除對參與認證之醫院持續進行輔導外，應可考慮將癌症預算獨立於醫院總額預算制度之外，以保障癌症病患之就醫品質。另一方面，規劃通過認證醫院之相關獎勵措施，以鼓勵醫院能積極地參與認證。

關鍵字

癌症 ； 醫療品質 ； 醫院評鑑

並列摘要

Objectives: This study investigated hospital staff perceptions of the approved standards and potential benefits of the ”Accreditation on Program of Cancer Care Quality” which was implemented by the Bureau of Health Promotion (BHP) in 2007.
Methods: Structured questionnaires were completed by 295 staff members of eight hospitals that participated in the Accreditation on Program of Cancer Care Quality. T-tests and one-way ANOVA were used to analyze the relationships between related variables, such as the demographic characteristic of respondents and the characteristics of hospitals. Respondents’ perceptions of approved standards and potential benefits of this program were also examined. Multiple regression analysis was then used to examine the effects of independent variables on dependent variables.
Results: Results indicated that demographic characteristics (including gender, age, job position, level of education, total working years and relevant experience with cancer diagnosis and treatments) affected staff perceptions of the approved standards. Moreover, age, job position, hospital level and number of newly diagnosed cancer patients in 2005 predicted staff perceptions of the potential benefits of the program.
Conclusions: This study found that hospital staff were positive about this program with regard to its potential for improving the quality of cancer care. Based on the findings, some recommendations were proposed to BHP: (1) Assist hospitals in preparing related documents when participating in the program. (2) Under the current global budget system, the budget for cancer prevention and treatment is limited. Therefore, the government should consider allocating some budget exclusively for the promotion of quality cancer care. (3) Encourage hospitals to participate in the program by providing financial incentives.

並列關鍵字

Cancer ； Quality of care ； Hospital accreditation

參考文獻

魏玉容、鍾國彪、鄭守夏(2005)。醫療品質評估的發展－從專業評鑑到報告卡系統。台灣公共衛生雜誌。24(4)，275-283。

Baker R,Robertson N,Farooqi A.(1995).Audit in general practice: factors influencing participation.British Medical Journal.311,31-34.

Bennett JA,Brewer C,Beyko S,Bennett SAL.(1999).Cancer Control Strategies in Eleven OECD Countries.(Final report).

Chambers R,Bowyer S,Campbell I.(1996).Investigation into the attitudes of general practitioners in Staffordshire to medical audit.Quality in Health Care.5(1),13-19.

Cheater FM,Keane M.(1998).Nurse' participation in audit: a regional study.Quality in Health Care.7,27-36.