篇名 | 臺灣地區醫療品質指標適用性之探討 |
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卷期 | 16:2 |
並列篇名 | A Study on the Applicability of Medical Quality Indicators in Taiwan |
作者 | 陳佩妮 、 鄭守夏 、 鍾國彪 、 林王美園 |
頁次 | 133-142 |
關鍵字 | 醫療品質 、 指標 、 德菲法 、 Medical quality 、 Indicators 、 Delphi technique 、 TSCI |
出刊日期 | 199704 |
本研究之目的為瞭解醫療品質指標在國內各級醫院的適用情形,以及目前醫院提報品質資料之可信程度,並利用實證資料探討各品質指標間之關係。經以結構式問卷對國內14位醫療品質專家學者,以德菲法(Delphi technique)進行兩回合的調查研究發現,大部份目前常用的醫療品質指標均被視為重要與適用的,其中以院內感染發生率被公認是「非常重要且適用」的品質指標。但在資料可靠性方面,只有結構面及少數結果面品質指標較為可靠。資料不可靠的理由可歸因於「環境」、「組織」及「資料本身」三大因素。以相關檢定分析實證資料發現,結構面的品質指標,除專科醫師比率外,隨醫院評鑑等級越高,各指標間呈一致而顯著的正相關。而絕大多數的過程與結果面品質指標之間,都沒有顯著相關存在。在醫療結構一過程一結果面品質指標間的相關性,只有各死亡率與結構面品質指標呈現較顯著的正向相關。實證分析的結果與專家們的意見是相符合的,唯目前似乎尚無可靠而適用的過程與結果面指標可茲應用。(中華衛誌 1997;16(2):133-142)
The main purposes of this study are to understand the applicabilitydesigned and distributed to collect experts'opin-ions via Delphi technique.According to the response of 14 medical car quality experts, almost allcurrently used indicators are considered important and applicable, whilehospital-acquired nosocomial infections is considered the most importantquality indicator. However, only structural and a few outcome indicators arereliable. Factors affecting the reliability of quality measures can beclassified into three categories-environmental, organizational and dataproblems. According to the empirical analyses, positive relationship are foundamong structural indicators except the rate of specialists. No consistentcorrelation can be found among trocess-outcome indicators except several deathrates. Empirical findings are consistent with those experts' opinions. However,under current situation, there is no reliable and applicable outcome indica-torwhich can be employed for hospital accreditation.(Chin J Public Health.(Taipei):1997;16(2):133-142)