台灣醫院評鑑趨勢之探討

The Meta-Analysis for the Trend of Hospital Accreditation in Taiwan

王俊文(Jiunn-Wen Wang) ； 葉德豐(Te-Feng Yeh) ； 曾坤儀(Kun-Yi Tseng)

《中山醫學雜誌》 14卷4期 (2003/12) Pp. 513-522

https://doi.org/10.30096/CSMJ.200312.0004

摘要

醫院評鑑目的係為提升醫療服務品質，奠定分級醫療基礎，同時也可以使醫院經營者藉由評鑑的機會獲得專家建議，使醫院經營更上軌道。但是，民國91年發生一連串打錯針及給錯藥等嚴重的醫療疏失事件，造成國人相當大的震撼，也引發各界質疑醫療機構的服務品質以及醫院評鑑的成效。而近年來醫療科技迅速地發展與更新，實有必要對現行的醫療評鑑標準及方法進行檢討與改革，因為醫療服務品質的提升是無法僅以醫療服務「量」及「硬體」的進步或更新來衡量。
目的：整合國內外醫院評鑑相關研究之資料，以探討台灣地區醫院評鑑的發展趨勢。
方法：利用統合分析（Meta-Analysis）的精神，整合分析關於台灣醫院評鑑之文獻資料及研究結果。
結果：醫院評鑑能提升內科、外科、護理以及急診部門的醫療品質，且醫界對於醫院評鑑多數抱持正向的看法。目前我國醫院評鑑改革乃參酌美國JCAHO訂定之醫院評鑑國際標準，從「以病人為中心」的方向進行改革。醫院評鑑標準的配分，則是以減少結構面的配分，增加過程面及結果面的配分，以期提升醫療品質。

關鍵字

醫院評鑑 ； 醫療品質 ； 統合分析

並列摘要

Background: The purpose of hospital accreditation in Taiwan is to promote the quality of health care, classify how the organization delivers health care, and upgrade and maintain the expertise of hospital management. However, several well-known malpractice cases in Taiwan involving such mistakes as giving an injection to the wrong patient or prescribing incorrect have led the public to doubt the effectiveness of hospital accreditation and the quality of the health care providers. Because current medical technologies are developing rapidly and competition to have the technology and show it off to the pubic, accreditation should not be based on technological hardware alone.
Objective: To determine and compare trends in hospital accreditation in Taiwan and abroad. Methods: After reviewing all the literature on hospital accreditation in Taiwan, we did a meta-analysis of our findings and compared what is happening in Taiwan with what is happening in other countries.
Results: The hospital accreditation system should de-emphasize the importance or reduce weight given to technological advancement, i.e. the structural dimension, and, in addition to doing more to ensure patient safety, it should emphasize quality of internal medicine, surgery, nursing and emergency services, if the confidence of the public is to be restored. More should be done to improve the attitudes of health care professionals usually toward the hospital accreditation process.

並列關鍵字

Hospital Accreditation ； Quality of Healthcare ； Meta-Analysis