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題名 醫師工作量對其醫療行為之影響： 以產科醫師為例
The Impact of Physicians` Workload on Their Behavior - A Study from Obstetrician in Taiwan作者 林宜蓁
Lin, Yi Chen貢獻者 連賢明
Lien, Hsien Ming
林宜蓁
Lin, Yi Chen關鍵詞 剖腹產
工作負荷量
固定效果
Cesarean Section
Physician`s workload
Fixed Effect Model日期 2012 上傳時間 1-Dec-2014 14:20:57 (UTC+8) 摘要 婦產科醫師乃為目前人力短缺情形最為嚴重之科別，本研究首先欲觀察臺灣婦產科是否因為人力萎縮，使得產科醫師工作量提高？進一步討論產科醫師工作負荷量之增加，是否會偏向選擇較療程較簡易之醫療服務，即以剖腹接生方式取代自然接生。本研究利用健保資料庫之「住院醫療費用清單明細檔」，篩選2006年至2010年醫師接生之案件，發現從2006年至2009年，產科醫師平均接生次數有增加之趨勢。若以之衡量醫師工作量，產科醫師其工作負荷量確實有因人力減少而增加。另外，以固定效果模型估計結果皆發現，醫師工作量對剖腹產機率有正向顯著之影響，表示工作負荷量之增加確實會提高產科醫師採取剖腹接生之機率。支持本文對於工作負荷量增加會偏向選擇較簡單之醫療行為之預測。 參考文獻 英文文獻：Aiken LH, Clarke SP, Sloane DM, et al. (2002), “Hospital Nurse Staffing and Patient Mortality, Nurse Burnout and Job Dissatisfaction,” JAMA, 288(16):1987- 93.Amaravadi, RK, Dimick JB, Pronovost PJ, Lipsett PA. 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國立政治大學
財政研究所
99255026
101資料來源 http://thesis.lib.nccu.edu.tw/record/#G0992550261 資料類型 thesis dc.contributor.advisor 連賢明 zh_TW dc.contributor.advisor Lien, Hsien Ming en_US dc.contributor.author (Authors) 林宜蓁 zh_TW dc.contributor.author (Authors) Lin, Yi Chen en_US dc.creator (作者) 林宜蓁 zh_TW dc.creator (作者) Lin, Yi Chen en_US dc.date (日期) 2012 en_US dc.date.accessioned 1-Dec-2014 14:20:57 (UTC+8) - dc.date.available 1-Dec-2014 14:20:57 (UTC+8) - dc.date.issued (上傳時間) 1-Dec-2014 14:20:57 (UTC+8) - dc.identifier (Other Identifiers) G0992550261 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/71726 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 財政研究所 zh_TW dc.description (描述) 99255026 zh_TW dc.description (描述) 101 zh_TW dc.description.abstract (摘要) 婦產科醫師乃為目前人力短缺情形最為嚴重之科別，本研究首先欲觀察臺灣婦產科是否因為人力萎縮，使得產科醫師工作量提高？進一步討論產科醫師工作負荷量之增加，是否會偏向選擇較療程較簡易之醫療服務，即以剖腹接生方式取代自然接生。本研究利用健保資料庫之「住院醫療費用清單明細檔」，篩選2006年至2010年醫師接生之案件，發現從2006年至2009年，產科醫師平均接生次數有增加之趨勢。若以之衡量醫師工作量，產科醫師其工作負荷量確實有因人力減少而增加。另外，以固定效果模型估計結果皆發現，醫師工作量對剖腹產機率有正向顯著之影響，表示工作負荷量之增加確實會提高產科醫師採取剖腹接生之機率。支持本文對於工作負荷量增加會偏向選擇較簡單之醫療行為之預測。 zh_TW dc.description.tableofcontents 謝辭 I摘要 II目次 III圖表目錄 IV第一章 前言 1第一節 研究緣起 1第二節 研究背景 5第三節 研究目的 10第二章 文獻回顧 12第一節 工作量與醫療品質 12第二節 醫師服務量與醫療品質 15第三節 剖腹產率影響因素 17第三章 研究方法 22第一節 實證模型 22第二節 變數定義及說明 24第四章 資料來源與處理 27第一節 資料來源 27第二節 資料處理 29第五章 實證結果 32第一節 敘述統計 32第二節 實證結果 36第六章 結論與檢討 48第一節 結論 48第二節 研究限制 50參考文獻 51 zh_TW dc.format.extent 1193512 bytes - dc.format.mimetype application/pdf - dc.language.iso en_US - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0992550261 en_US dc.subject (關鍵詞) 剖腹產 zh_TW dc.subject (關鍵詞) 工作負荷量 zh_TW dc.subject (關鍵詞) 固定效果 zh_TW dc.subject (關鍵詞) Cesarean Section en_US dc.subject (關鍵詞) Physician`s workload en_US dc.subject (關鍵詞) Fixed Effect Model en_US dc.title (題名) 醫師工作量對其醫療行為之影響： 以產科醫師為例 zh_TW dc.title (題名) The Impact of Physicians` Workload on Their Behavior - A Study from Obstetrician in Taiwan en_US dc.type (資料類型) thesis en dc.relation.reference (參考文獻) 英文文獻：Aiken LH, Clarke SP, Sloane DM, et al. 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