影響病患完成雙向轉診相關因素之研究

A study on patients’return factors of bidirectional referral system

林佩君(Pei-Chun Lin)

指導教授 ： 洪錦墩

中臺科技大學/管理學院/醫護管理研究所/碩士(2008年)

https://doi.org/10.6822/CTUST.2008.00004

摘要

目的：轉診制?建構可減少醫?資源?費與醫?費用上漲，本研究目的在探討轉診病患轉診之後再回到基層診所回診?及其影響因素，以提供制定轉診制?政策之?考。
方法：研究以中區社區醫?群所屬之診所轉診病患的資?為研究資
?，在選取樣本方面，基於可?性及診所願意配合研究計畫之考?，以?意取樣方式選取加入中區健保局的3 個社區醫?群之基層診所醫師和轉診病人為對象，以郵寄問卷配合電話追蹤訪問調查，評估其在過去2?，接受轉診後是否回診，?用?輯斯迴歸分析影響轉診病人回診與否之相關因素，研究共回收499 份有效問卷，回覆?為31.1%。
結果：轉診病患過去2 ?之回診?為27.5%，在控制所有相關因素，以?輯斯迴歸分析結果顯示回診病患之特質為原診所為經常就醫地點、其診所醫師有告知病患回診者會影響轉診病人回診與否。進一步加入醫師提及轉診?為與診所是否為病患經常就醫?變項之交互作用，交互作用分析結果，其受轉醫師提及回診且診所為轉診病患經常就醫地點者，較診所非轉診病患經常就醫地點者，發現此交互變項因素對轉診病人回診與否具有明顯之差?。
結?：為使轉診病人回診?提高達成轉診制?建構，強化民眾有固定就醫診所，強調醫師告知病患回診重要性，且透過診所與醫院醫師彼此間密??繫、以及醫?機構間垂直與水平整合方式，以達?實雙向轉診的目標，並建?整合式的健康照護體系提昇全民健康照護品質。

關鍵字

雙向轉診 ； 病人滿意? ； 健康?為

並列摘要

Objectives: The transferred system has been known to cut the medical cost, therefore, our current study is to explore the return rate of transferred patients to
general practice clinics and its related factors as the reference for formulating the policy of bidirectional referral system.
Methods: We applied the data of transferred patients in mid-Taiwan community medical groups as our research resources. The sampling is nonprobability mainly based on the intention and cooperation of each individual clinic to select basic clinical physicians and referred patients by judgement from 3 community medical groups of Central Region Branch Bureau of National Health Insurance
as our research subjects. We evaluate the frequency of returned checkup of those patients after being transferred by mailing or phone questionnaires by using logistic regression analysis to determine those factors affecting the returned rate. Our study has collected 499 effective questionnaires and the correspondence rate was 31.1%.
Results: The return rate of transferred patients in the past two years is 27.5%. Using the logistic regression analysis under all controlling related factors, our
results demonstrate the intention of patients to return to the original clinics was determined by the convenience of the clinic locations and the request from their
original physicians. Upon cross evaluation of these two factors, we found that co-existence of the convenience of the clinic locations and the request from their original physicians play the determined roles for the return rate as compared to each individual factor alone.
Conclusion: Increasing the return rate to make the referral satisfaction, we have to fortify the concept for patients to find a fixed clinic for their initial visit and
notify the referred physicians about the importance of patients’ return to their original doctors. Through close communication and cooperation between the clinic and hospital physicians in vertical and horizontal manners, the patients can then be taken in a much more integrative way with higher quality of health care system.

並列關鍵字

Patient satisfaction ； Bidirectional referral system

參考文獻

王乃弘(1999)。民眾就醫選擇之研究－分析層級程序法之應用。中華衛誌，18(2)，138-151。

?政院衛生署(2003)。後SARS健保體系改造計畫。

?政院衛生署(2004)。醫?法。台?：?政院衛生署。

?政院衛生署(2008)。http：//www.doh.gov.tw

余秀芳(2003)。台灣地區病人重複住院之分析。未發表的碩士?文，臺灣大學衛生政策與管?研究所，台?。