區域醫院因應醫師人力不足策略的比較研究 —以台灣，香港，新加坡為例

Abstract

本研究經由訪談法、記錄分析法與德菲法蒐集國內外文獻及資料，研究區域醫院如何因應醫師人力不足的情形及未來策略發展。研究發現香港醫療界主要使用公私營合作的模式讓社會更可善用私營醫院的人力資源，解決公營界資源短缺的問題，而新加坡的部分則偏好使用國際挖角，以高薪來吸引優秀人才、維持人力供給，接著再逐漸增加內部供應，等待本土醫師訓練成熟。而台灣的因應方式目前偏向於不同層級醫院整合支援，及院內不同科別整合模式，另外各區域醫院也自行發展非傳統醫療類別，如發展自費醫療、進入社區、與長照中心合作等等方式來增加財源，或者減少高耗用人力而獲益較小的醫療項目，另外也利用薪資結構改變，增加誘因的方式，增加困難羅致的人力，進而解決醫師人力不足的問題，讓醫院可以有持續穩定地發展。

This study focuses on the strategy to doctor shortage of regional hospitals. I collect past studies, articles and data. I use record analysis, deep interview and modified Delphi method to complete this study. Research shows that public hospitals cooperate with private hospitals to deal with medical labor shortage in Hong Kong. In Singapore, hospitals hunt excellent doctors abroad with decent salary and then the government gradually increase internal supply of doctors. However, regional hospitals in Taiwan work the process and develop their strategy independently to reach their financial goals and then solve the problem of labor shortage. The way they use may develop self-pay services, enter the community, develop long-term care plan, and cooperate with different hospitals or different departments in the same hospital. They also try to decrease service of high labor demand with low financial benefit. Increase income of doctors in some special departments is another possible strategy.