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設立台灣醫院品質審查機構模式之探討

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設立台灣醫院品質審查機構模式之探討

張文麗;林恆慶;陳楚杰;張敏琪

Abstract

目標:本研究的主要目的在確認醫院認為最適當的醫療品質審查組織的模式及其對醫療品質審查 項目之意見。方法:以行政院衛生署九十年度醫院評鑑合格地區級(含)以上 540 家醫院,扣除精 神專科醫院33 家,共有 507 家醫院為研究對象,全面施以普查,採取郵寄問卷的方式來蒐集所需 的資料,郵寄問卷的時間為 2002 年 3 月至 5 月。使用SPSS10.0 進行問卷回收資料之建檔及統 計分析。在描述性統計分析方面,以次數、百分比及累積百分比表示之。在推論性統計分析方面, 以卡方檢定(χ2 檢定)分析變數之間有無關聯性存在。結果:回收之有效問卷為 174 份,回收率為 34.3%。在成立專責 醫療品質審查組織的可行性方面:高達 86.3%的回答者認為成立專責醫療 品質審查組織產可行的。在醫院對專賣醫療品質審查組織的模式方面:1.權屬單位: 37.7%的回 答者認為應由醫策會負責管理; 2.審查組織地區劃分: 39.9%的回答者認為以台灣行政高域劃 分為北、中、南、東四個組織方式較佳; 3.審查組織成員:應包括醫師、護理人員、藥師及行政 人員; 4.審查方式; 67.5%的回答者認為應採回溯性審查; 5.審查層級: 54.2%的回答者認為應 採用二審制; 6.審查重點:前五項依序為院內感染、抗主素使用不當、不適當的住院天數、十四 天再入院及合併症產生。結論:成立專賣醫院書療品質審查組織是可行的

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李定洋 a a.台北醫學大學醫學資訊研究所 m110091010@tmu.edu.tw,ctliu@tmu.edu.tw