疾病分類人員工作資源與工作表現之研究

A Study on Coders of Disease Classification Resources and Performance of the Work

周淑鈴(Shu-Ling Jou)

指導教授 ： 秦兆瑋

長榮大學/健康科學學院/醫務管理學系(所)/碩士(2016年)

摘要

疾病分類為病歷管理中極具專業的部分，與衛生統計、醫療費用申報有著重要關係。隨著2016年1月1日起ICD-10-CM/PCS的轉換，疾病分類編碼人力的短缺更是各級醫療院所目前所面臨的問題。疾病分類人員最常被以編碼品質導致給付差異來評定工作績效，而其所擁有的工作資源面臨工作壓力與情緒負荷所產生的影響，卻往往被忽略。因此，本研究運用資源保存理論探討疾病分類人員的工作資源對工作表現之影響，並進一步探討情緒耗竭、組織承諾在工作資源與工作表現之間的中介效果。
本研究之為橫斷面之研究，研究對象為全國評鑑合格之地區醫院以上之疾病分類人員，以便利抽樣選擇三十家願意協助填寫之醫療機構，採問卷調查法，總共發放310份問卷，回收273份，有效問卷為265份，有效回收率為85%。本研究以SPSS 22.0與AMOS 21.0為分析工具，利用描述性統計、驗證性因素分析、信效度分析、結構方程式來驗證本研究之假說。
本研究結果顯示，工作資源中非工作資源的效果較正式工作資源明顯，主管支持與組織承諾呈現正向關係，顯見員工感受主管的支持，可增進員工對組織的向心力，與工作績效、工作滿意呈現顯著的正向關係，表示員工的組織承諾程度越高，則員工的工作表現越佳。主管支持亦與情緒耗竭則呈現顯著負向關係，工作場所提供的資源越充足，工作倦怠感受則越低。本研究結果可讓醫療機構主管瞭解工作資源對疾病分類人員的影響，用來建議組織如何選擇適當的資源，幫助員工適應工作壓力，提升組織之承諾，進而增進員工的工作滿意與績效。

關鍵字

疾病分類 ； 彈性工時 ； 主管支持 ； 組織承諾 ； 情緒耗竭 ； 工作表現

並列摘要

Classification of diseases is a important part in the field of chart management because it is closely correlated with health statistics and application of medical cost. The execution of ICD-10-CM/PCS on 2016/1/1 cause obvious shortage of human force for classification of disease. The coders of disease classification are often scored by the disease coding related payment. However, the impact of stress and emotional burden of these coders from working resource are often neglected. Therefore, the aim of this study is to analyze the impact of working resource on the coders of disease classification by using the resource conservation theory. In addition, we further discuss the effect of emotional exhaustion and organizational commitment for the working performance.
This is a cross sectional study including coders of disease classification in the qualified institute in at least regional hospital accreditation or above. We finally choose thirty institutes that were willing to support this study. By using questionnaire method, we totally sent 310 copies and there were 273 copies returned. In those copies returned, 265 copies were valid questionnaire (effective response rate: 85%). This study used software SPSS 22.0 and AMOS 21.0 as statistical tool. This study use descriptive statistics, confirmatory factor analysis, reliability and validity analysis, structural equation to prove our hypothesis.
In this study, the impact of non-working resource is better than formal working resource.Supervisory support is positively correlated with organization commitment. This means that supervisory support could enhance the coherence to organization and organization commitment could improve working performance and satisfaction. In addition, supervisory support is negatively correlated with emotional exhaustion. This result supports that more resources the working place provided is aaosicated with less burnout of members. This result help managers understand the impact or working resource on coders of disease classification. It also help managers of organization choose appropriate resources to help members adapt themselves to working pressures. Promotion of organization commitment could further improve the working performance and satisfaction.

並列關鍵字

Coders of disease classification ； Flextime ； Supervisory support ； Organizati onal commitment ； Emotional exhaustion ； Work performance

參考文獻

張婷婷、陸洛、郭靜宜(2012)。工作資源對工作-家庭衝突及工作表現之影響。組織與管理，2，101-135。

翁志成，簡俊成(2003)。主計人員性格調節過程中情緒耗竭之研究。中華管理學報，1，1-19。

賴憲堂、楊志良、范碧玉(1998)。全民健康保險下疾病分類編碼品質與相關影響因素研究。中華衛誌，4，337-348。

游文杉(2013)。組織文化與工作滿意關係之研究-以行政體育人員為例。嘉大體育健康休閒期刊，3，61-70。

洪贊凱、卓明德、洪詩晴(2011)。主管知覺互動不正義、主管不當督導與部屬績效關係之研究—主管與部屬適配的干擾角色以及情緒耗竭的中介歷程。中原企管評論，3，67-92。