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探討醫院門診病人之轉診意願及其相關因素

張嘉莉;陳楚杰;林恆慶

摘要

本研究目的旨在探討醫院門診病人的轉診經驗、意願、對目前轉診制度的瞭解與滿意度,及影響 其轉診意願的相關因素。本研究以台北縣、市三家醫療院所 700 位門診病人為研究對象,共發出 問卷 700 份,回收有效問卷 675 份,有效回收率為 96.4%。採 SPSS for Windows 10.0 統計軟體進 行回收問卷資料之建檔及統計分析處理。首先以描述性統計描述各變項,其次以 t 檢定進行雙變 項分析,再進行向前邏輯斯迴歸(forward logistic regression)模式之建立,探討影響醫院門診病人 轉診意願之因素。研究結果發現,僅有 8.7%門診病人當次看診是由原來看診的院所轉診。在接 受轉診的意願方面,僅有 37.6%的醫院門診病人回答願意或非常願意。對於目前轉診制度的滿意 程度,僅佔 8.3%的醫院門診病人回答滿意或非常滿意。在影響醫院門診病人轉診意願之因素方 面發現,愈同意「轉診可以使病人得到更完善的醫療照護」、「過去至醫院或診所就醫的經驗」、「診 所護理人員的服務態度」、「醫院的部份負擔費用」及「醫院的科別或醫師數」會影響其轉診意願 的醫院門診病人,其接受轉診的意願愈高;愈同意「醫院的醫師的醫術」及「轉診制度尚未建立 好」會影響其轉診意願者,其接受轉診的意願愈低。建議衛生主管機關可定期追蹤、評估轉診制 度的實施成效,且推行轉診制度時,應考慮不同患者之就醫需求,諸如:精神病患、癌症病患(如 乳癌等),以及該科別的診所比率。轉診制度的對象是否應包括所有患者,抑或可排除部分特殊 醫療需求的病患,都值得衛生主管機關再三思考。

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