醫療品質管理及門診服務品質定性指標

A Review on Health Care Quality Management and a Proposal upon Indicators for Evaluating Hospital OPD Services

韓揆(Kuei Han)

《中華公共衛生雜誌》 13卷1期 (1994/02) Pp. 35-53

https://doi.org/10.6288/CJPH1994-13-01-05

摘要

經濟愈發達，民眾愈重視醫療權益，全民健保實施後，就醫之經濟障礙排除，病人之注意力將轉向品質訴求。唯台灣文化不同於歐美，台灣醫師團體甚少從事品質建設或自律，民間不得不仰仗公權力執行權益保障，將來品質保證或提升工作不可避免要由醫療體系或醫院行政當局扮演重要角色。最近一項調查也顯示醫院有意推行品質管制活動，但缺乏對品質的了解及工作範例，因此加強醫院主管，包括醫師對品質之認識有其必要。
醫療品質形式易懂，其實頭緒紛繁，醫師及行政工作者對其涵義及管理每多歧見，可能也是難以進行之原因。本文著者試圖從浩瀚文獻及實務資料中，以適當篇幅探索醫療品質之內容及其管理問題，並藉在台大醫院工作體驗及參酌全省其他醫院狀況，採用“專職團體腦力激盪研究法”開發了一套整體評估門診服務品質的定性指標，另將管理工作上慣用的表式作業概念化，成為一個模型，以容納這一指標，希望能幫助有志者對醫療品質之涵義及其管理問題快速進入情況或加深了解。關於門診評估指標模型，則可供醫院試用或供研究者進一步發掘。

並列摘要

Medical quality is a term not clearly defined. According to a survey by the National Defence Medical Center, ROC, hospital administrators were enthusiastic for applying quality assurance programs, but had difficulties to implement them owing to the lack of knowledge pertaining both the reality of medical quality practice and the means to select proper indicators for implementation. This paper in one hand, after reviewing literatures and the nature of hospital care, abridged and explained the various aspect of medical care quality and management problems; on the other hand, after utilizing a large hospital's data and using the nominal group brainstorming technique, developed a set of qualitative indicators and a tabulation model for the sake of reviewing hospital OPD services. It is hoped that this exploration and the model indicators can help the health care administrators more accessible in embracing the concept of medical care quality and in conducting their management programs.

並列關鍵字

Medical care quality ； Hospital administration ； ambulatory care