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題名 醫師對影響醫療檢驗資源有效使用因素之看法-以桃園縣執業醫師為例
A study of influencing factors related to efficient use of medical exanimation resources: the perspective of certified medical doctors in Taoyuan County, Taiwan
作者 劉麗文
貢獻者 陳敦源
劉麗文
關鍵詞 全民健保
醫療檢驗
醫療資源
適當醫療服務
National Health Insurance
Medical Examination
Medical Resources
Appropriate Health Care.
日期 2008
上傳時間 19-Sep-2009 13:53:54 (UTC+8)
摘要 研究動機與問題：本研究最主要的目的希望能夠將最易被大家忽略的健保醫療檢驗資源使用問題，從實務面上探討，並指認出有效使用醫療檢驗資源的關鍵因素，針對這些因素與措施進行評估，歸納出具體明確可行的方向，提供主管機關做為費用管控的參考，為我國健保永續經營貢獻一份力量。
本研究根據研究動機與目的，設定三個研究問題：1.影響醫師有效的使用醫療檢驗資源的因素有哪些？2.藉由桃園縣執業醫師的看法了解有效使用醫療檢驗資源關鍵因素為何？3.不同執業院所、服務科別、職別的醫師對有效的使用醫療檢驗資源看法是否有差異？
研究資料與方法：以文獻回顧法、問卷調查法、深度訪談法蒐集資料及驗證資料；研究過程分三個階段進行，第一階段為背景資料與文獻資料的蒐集，瞭解醫療檢驗資源使用現況與問題，並透過訪談實務界菁英驗證文獻與補充資料不足；第二階段依文獻分析與彙整內容設計問卷與訪談大綱；第三階段將回收的問卷編碼、整理後以Excel/2003版與SPSS for window12.0版套裝軟體進行資料分析；深度訪談資料透過內容分析法予以歸納整理分析。獲得研究答案，達成研究目的。
研究結果與建議：量化研究部分，本研究共分送488份問卷，回收318份，回收率為65.1％。並以卡方檢定樣本與母群體並無差異，可代表母群體。質化研究部分，深度訪談三位年資10年以上實務界菁英，建構本研究實務上的概念。歸納研究結果：醫療檢驗資源有效使用的關鍵影響因素有「醫療風險」、「病人就醫行為」與「照護之連續性」3項。根據研究結果，為有效使用醫療檢驗資源，必需減少醫療風險、規範病人就醫行為與進行照護流程改造。
Background:The purpose of this research is to find out the influencing factors related to the usage of resources for medical examinations under the Taiwanese National Health Insurance (NHI). From the practical point of view, this research focuses on, the first, defining the efficient use of medical test and then finding out the critical factors effecting the efficient usage from medial practitioners’ viewpoints in Taoyuan County, Taiwan. It is expected to provide advisory values to improve the global budget system of NHI.
Research Questions:
1.What are the factors influencing doctors to utilize medical examination efficiently?
2.What are the certified medical doctors of Taoyuan County thinking about these factors?
3.Concerning the above factors, do there exist systematic differences among medical doctors from different hospitals, rank of medical doctors and fields of profession?
Methods: In this study, author utilizes literature review, questionnaires, and in-depth interview. The survey was divided into three stages. First, related information was collected to clarify the problems of medical examination usage in present situation from both interviewing medical practitioners and literature review. In the 2nd stage, a general questionnaire was designed to administrate to selected medical doctors in Taoyuan County in mid-2008. The last stage was data coding and analyzing by using Excel/2003 and SPSS for Windows. The return rate was 65% (318/488) and there is no difference between population and sample after consistency test.
Results and Suggestions The results show that the key factors of efficient medical examination usage are medical risk-aversion of doctors, clinical shopping of patients, and the need to medical care continuity. These exist a greater viewpoint differences between different level of hospital than different ranks or specialties of doctors. These results will lead the author to suggest that the Bureau of NHI needs to promote adequate mediation mechanism to reduce medical risk, to promote inter-hospital patient information sharing system, and to improve the logistic of continuity care.
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報紙
郭正典（2002年11月8日）。「為何有醫師濫用健保資源？」。自由時報。
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描述 碩士
國立政治大學
行政管理碩士學程
95921067
97
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0095921067
資料類型 thesis
dc.contributor.advisor 陳敦源zh_TW
dc.contributor.author (Authors) 劉麗文zh_TW
dc.creator (作者) 劉麗文zh_TW
dc.date (日期) 2008en_US
dc.date.accessioned 19-Sep-2009 13:53:54 (UTC+8)-
dc.date.available 19-Sep-2009 13:53:54 (UTC+8)-
dc.date.issued (上傳時間) 19-Sep-2009 13:53:54 (UTC+8)-
dc.identifier (Other Identifiers) G0095921067en_US
dc.identifier.uri (URI) https://nccur.lib.nccu.edu.tw/handle/140.119/37459-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 行政管理碩士學程zh_TW
dc.description (描述) 95921067zh_TW
dc.description (描述) 97zh_TW
dc.description.abstract (摘要) 研究動機與問題：本研究最主要的目的希望能夠將最易被大家忽略的健保醫療檢驗資源使用問題，從實務面上探討，並指認出有效使用醫療檢驗資源的關鍵因素，針對這些因素與措施進行評估，歸納出具體明確可行的方向，提供主管機關做為費用管控的參考，為我國健保永續經營貢獻一份力量。
本研究根據研究動機與目的，設定三個研究問題：1.影響醫師有效的使用醫療檢驗資源的因素有哪些？2.藉由桃園縣執業醫師的看法了解有效使用醫療檢驗資源關鍵因素為何？3.不同執業院所、服務科別、職別的醫師對有效的使用醫療檢驗資源看法是否有差異？
研究資料與方法：以文獻回顧法、問卷調查法、深度訪談法蒐集資料及驗證資料；研究過程分三個階段進行，第一階段為背景資料與文獻資料的蒐集，瞭解醫療檢驗資源使用現況與問題，並透過訪談實務界菁英驗證文獻與補充資料不足；第二階段依文獻分析與彙整內容設計問卷與訪談大綱；第三階段將回收的問卷編碼、整理後以Excel/2003版與SPSS for window12.0版套裝軟體進行資料分析；深度訪談資料透過內容分析法予以歸納整理分析。獲得研究答案，達成研究目的。
研究結果與建議：量化研究部分，本研究共分送488份問卷，回收318份，回收率為65.1％。並以卡方檢定樣本與母群體並無差異，可代表母群體。質化研究部分，深度訪談三位年資10年以上實務界菁英，建構本研究實務上的概念。歸納研究結果：醫療檢驗資源有效使用的關鍵影響因素有「醫療風險」、「病人就醫行為」與「照護之連續性」3項。根據研究結果，為有效使用醫療檢驗資源，必需減少醫療風險、規範病人就醫行為與進行照護流程改造。		zh_TW
dc.description.abstract (摘要) Background:The purpose of this research is to find out the influencing factors related to the usage of resources for medical examinations under the Taiwanese National Health Insurance (NHI). From the practical point of view, this research focuses on, the first, defining the efficient use of medical test and then finding out the critical factors effecting the efficient usage from medial practitioners’ viewpoints in Taoyuan County, Taiwan. It is expected to provide advisory values to improve the global budget system of NHI.
Research Questions:
1.What are the factors influencing doctors to utilize medical examination efficiently?
2.What are the certified medical doctors of Taoyuan County thinking about these factors?
3.Concerning the above factors, do there exist systematic differences among medical doctors from different hospitals, rank of medical doctors and fields of profession?
Methods: In this study, author utilizes literature review, questionnaires, and in-depth interview. The survey was divided into three stages. First, related information was collected to clarify the problems of medical examination usage in present situation from both interviewing medical practitioners and literature review. In the 2nd stage, a general questionnaire was designed to administrate to selected medical doctors in Taoyuan County in mid-2008. The last stage was data coding and analyzing by using Excel/2003 and SPSS for Windows. The return rate was 65% (318/488) and there is no difference between population and sample after consistency test.
Results and Suggestions The results show that the key factors of efficient medical examination usage are medical risk-aversion of doctors, clinical shopping of patients, and the need to medical care continuity. These exist a greater viewpoint differences between different level of hospital than different ranks or specialties of doctors. These results will lead the author to suggest that the Bureau of NHI needs to promote adequate mediation mechanism to reduce medical risk, to promote inter-hospital patient information sharing system, and to improve the logistic of continuity care.		en_US
dc.description.tableofcontents 中 文 摘 要.....................I
Abstract
目 錄........................III
表目錄
圖目錄
第一章 緒 論...................p.8
第一節 研究緣起與動機
第二節 研究目的與問題
第三節 研究方法
第二章 文獻探討.................p.13
第一節 桃園縣醫療資源與醫療檢驗管理現況說明
第二節 醫療檢驗（查）於醫療中應用的適當性與管理現況文獻檢閱
第三節 影響醫療檢驗資源使用因素之文獻總結
第三章 研究設計.................p.40
第一節 研究架構
第三節 研究步驟
第三節 研究假設
第四章 結果與討論...............p.73
第一節 樣本回收
第二節 研究結果
第三節 假設驗證
第四節 討論
第五節 檢討與建議
第五章 總結.....................p.115
參考文獻........................p.116
附錄一 國外不適當檢驗之研究
附錄二 檢驗適當性分類標準範例
附錄三 適當與不適當檢驗與否的判定方法研究報告
附錄四 問卷變項內容與定義
附錄五 降低醫療檢驗資源使用關鍵因素調查之分析
附錄六 醫師對降低醫療檢驗資源使用措施與因素看法排序
附錄七 問卷及訪談大綱
附錄八 訪談逐字稿
附錄七 論文口試審查回應		zh_TW
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dc.language.iso en_US-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0095921067en_US
dc.subject (關鍵詞) 全民健保zh_TW
dc.subject (關鍵詞) 醫療檢驗zh_TW
dc.subject (關鍵詞) 醫療資源zh_TW
dc.subject (關鍵詞) 適當醫療服務zh_TW
dc.subject (關鍵詞) National Health Insuranceen_US
dc.subject (關鍵詞) Medical Examinationen_US
dc.subject (關鍵詞) Medical Resourcesen_US
dc.subject (關鍵詞) Appropriate Health Care.en_US
dc.title (題名) 醫師對影響醫療檢驗資源有效使用因素之看法-以桃園縣執業醫師為例zh_TW
dc.title (題名) A study of influencing factors related to efficient use of medical exanimation resources: the perspective of certified medical doctors in Taoyuan County, Taiwanen_US
dc.type (資料類型) thesisen
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