醫師服務量與極低出生體重新生兒照護品質關係的實證研究

An Empirical Evidence Study between Physician Volume and Quality of Care in Very Low Birth Weight Infants

翁新惠(Shin-Huey Wung) ； 黃昱瞳(Yu-Tung Huang) ； 楊長興(Chiang-Hsing Yang) ； 呂庭輝(Ting-Hui Lu)

《台灣醫學》 9卷4期 (2005/07) Pp. 448-454

https://doi.org/10.6320/FJM.2005.9(4).02

摘要

本研究旨在探討醫師服務量在極低出生體重新生兒的照護上，是否與其照護結果存有相關性。研究進行是以全民健保資料庫2000年出生體重介於500-1499公克的1185位極低出生體重新生兒為研究對象，針對照護醫師及醫療機構特性等資料進行分析。本研究在控制新生兒特性、醫療機構特性及疾病嚴重度後顯示，醫師服務量與其所照護新生兒的存活率呈顯著正相關，其存活勝算比為1.39。因此，建議在實務管理上，應局部採行集中化照護、建立實證醫院／醫師轉介條件、參酌高服務量醫師之照護模式發展臨床照護指引、以及新生兒專科醫師訓練應集中於服務量大的醫院進行。

關鍵字

醫師服務量 ； 醫院服務量 ； 照護品質 ； 極低出生體重新生兒

並列摘要

The aim of this study is to empirically evaluate the relation of physician volume on quality of care with initially hospitalized, very low birth weight infants. Claim data of 1,185 very low birth weight (500g-1499g) infants in this study were collected from the National Health Insurance Database. After controlling for patient characteristics, hospital characteristics, and five main complications, the positive association was found between physician volume and infant survival rate, the odds ratio (OR) was 1.39. Based on the research findings, we suggested providing centralization care for very low birth weight infants, set up the evidence-base hospital physician referral volume standard, build up the clinical guideline from the physician practice pattern with high volume, and establish the specialist training program in high volume hospital for the manager and policy maker.

並列關鍵字

physician volume ； hospital volume ； quality of care ； very low birth weight infants