請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/24264
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 周雍強(Yon-Chun Chou) | |
dc.contributor.author | Li-Shan Chen | en |
dc.contributor.author | 陳俐珊 | zh_TW |
dc.date.accessioned | 2021-06-08T05:20:07Z | - |
dc.date.copyright | 2011-08-03 | |
dc.date.issued | 2011 | |
dc.date.submitted | 2011-07-29 | |
dc.identifier.citation | 1. Anita, G. (2010). Computer Fundamentals: Pearson Education.
2. Caminiti, C., Scoditti, U., Diodati, F., & Passalacqua, R. (2005). How to promote, improve and test adherence to scientific evidence in clinical practice. BMC Health Services Research, 5(1), 62. 3. Hamilton, G. (2003). Measuring adherence in a hypertension clinical trial. European journal of cardiovascular nursing: journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 2(3), 219. 4. Lagoe, R. J. (1998). Basic Statistics for Clinical Pathway Evaluation. [Article]. Nursing Economic$, 16(3), 125-131. 5. Leveno, K. J. (2007). Williams 產科學手冊. 台北市: 麥格羅.希爾. 6. Lugtenberg, M., Zegers-van Schaick, J., Westert, G., & Burgers, J. (2009). Why don't physicians adhere to guideline recommendations in practice? An analysis of barriers among Dutch general practitioners. Implementation Science, 4(1), 54. 7. Milchak, J. L., Carter, B. L., James, P. A., & Gail, A. (2004). Measuring Adherence to Practice Guidelines for the Management of Hypertension: An Evaluation of the Literature. Hypertension, 44(5), 602-608. doi: 10.1161/01.HYP.0000144100.29945.5e 8. Ronellenfitsch, U., Rössner, E., Jakob, J., Post, S., Hohenberger, P., & Schwarzbach, M. (2008). Clinical Pathways in surgery—should we introduce them into clinical routine? A review article. Langenbeck's Archives of Surgery, 393(4), 449-457. doi: 10.1007/s00423-008-0303-9 9. Scribano, P. V., Lerer, T., Kennedy, D., & Cloutier, M. M. (2001). Provider Adherence to a Clinical Practice Guideline for Acute Asthma in a Pediatric Emergency Department. Academic Emergency Medicine, 8(12), 1147-1152. doi: 10.1111/j.1553-2712.2001.tb01131.x 10. Sterneckert, A. B. (2004). Critical incident management: Auerbach. 11. van de Klundert, J., Gorissen, P., & Zeemering, S. (2010). Measuring clinical pathway adherence. Journal of Biomedical Informatics, 43(6), 861-872. doi: DOI: 10.1016/j.jbi.2010.08.002 12. 李源德, 朱樹勳, 范碧玉, 林佐武, 吳坤龍, 林慧玲, . . . 蔡克嵩. (2000). 臨 床路徑 理論與實務. 臺北市: 臺大醫院出版委員會. 13. 陳盈穎. (2010). 使用網路服務與商業流程執行語言追蹤臨床路徑遵循度. 碩士, 慈濟大學, 花蓮市. Retrieved from http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22099TCU05 674003%22.&searchmode=basic 14. 詹益宏編, 謝., 郭春祺校閱, & 普萊查德, 麥. (1982). 威廉氏產科學. 台北 市: 幼獅文化. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/24264 | - |
dc.description.abstract | 在健保支付制度轉變成論病例計酬後,對醫院來說必須嚴格控管在醫療流程中的行為,以減少浪費。導入臨床路徑是目前醫療產業中對醫療品質、醫院資源管理與成本控管有效的方法之一。在過去的文獻中證實,若未確實依照路徑內容執行,將無法達到控管成本的目的。然而,目前研究中多以問卷調查的方式來做為評估執行一致性的方法,而無法從實際產生的資料中得知。
在本研究中將會提出評估臨床路徑一致性的方法。首先,由於目前臨床路徑所採行之表現方式,無法完整表達臨床路徑內容,因此研究中會先探討臨床路徑表示方法,並以重新以流程圖方式表現,以作為本研究之臨床路徑分析格式。其次,研究中會依照醫療步驟的本身的特色,給予每一步驟特定的屬性的。針對每種屬性,本研究提出相對的計算一致性的方式,使每一步驟可對應到符合屬性的評估式。評估結果將可說明目前執行的狀況。在本論文中,我們以剖腹生產臨床路徑作為範例展示。 | zh_TW |
dc.description.abstract | As changing fee-for-service system to case payment system, hospitals face more pressures than before. Under this circumstance, hospitals have to be strictly controlled behavior in the medical processes to reduce waste. Clinical pathway is one of the effective methods to control the quality of medical, hospital resource and cost. According to the past literature, not well executed clinical pathway may lead to unnecessary waste in the treatment. Therefore, it is necessary to establish a conformance measurement method to evaluate result of clinical pathway. However,current studies mostly provide questionnaire surveys to assess the conformance of clinical pathway, which may have reliability problem in the evaluation. In this research, we will use part of the medical record to build a method, hich can assess the conformance of clinical pathway.
First, we will define a unified representation of clinical pathway. In the previous representation provides limitation information in the real medical process. In this research, we will provide a flowchart approach as clinical pathway analysis format. After building a flowchart, based on the characteristic of the step, we will define property to the treatment steps. According to the property, we will build a suitable formula to analyze the conformance of the clinical pathway. With the new method at hand, we analyze caesarean section clinical pathway conformance at a hospital in Taiwan. | en |
dc.description.provenance | Made available in DSpace on 2021-06-08T05:20:07Z (GMT). No. of bitstreams: 1 ntu-100-R98546011-1.pdf: 2123344 bytes, checksum: 1f6b6cc062ce482145bf93f9712e2b85 (MD5) Previous issue date: 2011 | en |
dc.description.tableofcontents | 第一章 緒論............................- 1 -
1.1 研究背景............................- 1 - 1.2 研究目的............................- 2 - 1.3 研究議題............................- 3 - 1.4 研究架構............................- 6 - 第二章 文獻回顧.........................- 7 - 2.1 臨床路徑變異........................- 7 - 2.2 分析資料合適性..................... - 10 - 2.3 計算臨床路徑一致性................. - 11 - 2.4 作業流程圖..........................- 17 - 2.5 流程圖符號..........................- 18 - 2.6 流程圖結構..........................- 20 - 第三章 建構臨床路徑分析流程............ - 22 - 3.1 剖腹生產臨床路徑................... - 22 - 3.2 臨床路徑步驟表示................... - 23 - 3.3 建立臨床路徑流程圖................. - 29 - 3.4 資料類型合適性..................... - 34 - 第四章 臨床路徑一致性分析.............. - 35 - 4.1 臨床路徑一致性..................... - 35 - 4.2 資料內容描述....................... - 36 - 4.3 資料類型探討....................... - 38 - 4.4 一致性程度分析法則................. - 39 - 4.5 資料一致性程度計算................. - 45 - 4.6 住院天數比較....................... - 59 - 4.7 討論................................- 60 - 4.8 分析小結............................- 61 - 第五章 結論與建議...................... - 62 - 5.1 研究結論與貢獻..................... - 62 - 5.2 未來研究建議....................... - 63 - 參考資料................................- 64 - 附錄 A XX 醫院剖腹生產臨床路徑(節錄) ................................... - 66 - 附錄 B XX 醫院剖腹產手術醫囑單 .................................... - 67 - 附錄 C OO 醫院 剖腹產手術醫囑單 .................................... - 71 - 附錄 D 中央健保局提供之剖腹生產診療項目要求表..................................... - 73 - 附錄 E 產婦於入院檢查階段所接收到醫令列表..................................... - 74 - 附錄 F 產婦於手術階段所接收到醫令列表..................................... - 78 - | |
dc.language.iso | zh-TW | |
dc.title | 臨床路徑一致性評 | zh_TW |
dc.title | Conformance Analysis of Clinical Pathway | en |
dc.type | Thesis | |
dc.date.schoolyear | 99-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 吳政鴻(Cheng-Hung Wu),洪一薰(I-Hsuan Hong),陳瑞瑛(Rui-Ying Chen) | |
dc.subject.keyword | 臨床路徑,流程圖,一致性分析,剖腹生產, | zh_TW |
dc.subject.keyword | Clinical Pathway,Flowchart,Conformance Analysis,Caesarean Section, | en |
dc.relation.page | 80 | |
dc.rights.note | 未授權 | |
dc.date.accepted | 2011-07-29 | |
dc.contributor.author-college | 工學院 | zh_TW |
dc.contributor.author-dept | 工業工程學研究所 | zh_TW |
顯示於系所單位: | 工業工程學研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-100-1.pdf 目前未授權公開取用 | 2.07 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。