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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 董鈺琪(Yu-chi Tung) | |
| dc.contributor.author | Szu-Yung Liao | en |
| dc.contributor.author | 廖思詠 | zh_TW |
| dc.date.accessioned | 2021-05-13T06:40:52Z | - |
| dc.date.available | 2018-09-12 | |
| dc.date.available | 2021-05-13T06:40:52Z | - |
| dc.date.copyright | 2017-09-12 | |
| dc.date.issued | 2017 | |
| dc.date.submitted | 2017-07-12 | |
| dc.identifier.citation | 1. 賴文源, 顏兆熊. 急性心肌梗塞. 當代醫學 2012; 第 39 卷 第 3 期.
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Trends in Acute Myocardial Infarction Event Rates and Risk of Recurrences After an Incident Event in Norway 1994 to 2009 (from a Cardiovascular Disease in Norway Project). The American Journal of Cardiology 2014; 113:1777-81. 37. 衛生福利統計處. 民國103年死因統計結果摘要. Available at: http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=5488. Accessed 38. 衛生福利部. 2015年群體健康服務品質指標報告. 2015. 39. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013. Available at: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-Expensive-Hospital-Conditions.jsp. Accessed 40. Likosky DS, Zhou W, Malenka DJ, Borden WB, Nallamothu BK, Skinner JS. Growth in Medicare Expenditures for Patients With Acute Myocardial Infarction: A Comparison of 1998 Through 1999 and 2008. JAMA internal medicine 2013; 173:2055-61. 41. 衛生福利部統計處. 103年度全民健康保險醫療統計年報. Available at: http://www.mohw.gov.tw/CHT/DOS/Statistic.aspx?f_list_no=312&fod_list_no=6003. Accessed 42. 衛生福利部中央健康保險署. 全民健康保險統計動向. 2013. 43. Schwalm JD, McKee M, Huffman MD, Yusuf S. Resource Effective Strategies to Prevent and Treat Cardiovascular Disease. Circulation 2016; 133:742-55. 44. Pilote L, Califf RM, Sapp S, et al. Regional Variation across the United States in the Management of Acute Myocardial Infarction. New England Journal of Medicine 1995; 333:565-72. 45. Carlhed R, Bojestig M, Wallentin L, et al. Improved adherence to Swedish national guidelines for acute myocardial infarction: The Quality Improvement in Coronary Care (QUICC) study. American Heart Journal 2006; 152:1175-81. 46. Feltner C, Jones CD, Cené CW, et al. Transitional care interventions to prevent readmissions for persons with heart failure: A systematic review and meta-analysis. Ann Intern Med 2014; 160:774-84. 47. Landman AB, Spatz ES, Cherlin EJ, Krumholz HM, Bradley EH, Curry LA. Hospital collaboration with emergency medical services in the care of patients with acute myocardial infarction: perspectives from key hospital staff. Ann Emerg Med 2013; 61:185-95. 48. Kripalani S, Theobald CN, Anctil B, Vasilevskis EE. Reducing hospital readmission rates: current strategies and future directions. Annu Rev Med 2014; 65:471-85. 49. Anderson JL, Adams CD, Antman EM, et al. ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction. American College of Cardiology/American Heart Association 2007:e148-e304. 50. Xian Y, Pan W, Peterson ED, et al. Are quality improvements associated with the Get With the Guidelines-Coronary Artery Disease (GWTG-CAD) program sustained over time?: A longitudinal comparison of GWTG-CAD hospitals versus non–GWTG-CAD hospitals. American Heart Journal 2010; 159:207-14. 51. Makdisse M, Katz M, Corrêa AdG, et al. Effect of implementing an acute myocardial infarction guideline on quality indicators. Einstein 2013; 11:357-63. 52. Weston CF. Performance indicators in acute myocardial infarction: a proposal for the future assessment of good quality care. Heart 2008; 94:1397-401. 53. 全民健康保險醫療品質資訊公開網. Available at: http://www.nhi.gov.tw/mqinfo/Content.aspx?List=1&Type=AMI. Accessed 54. Krumholz HM, Anderson JL, Brooks NH, et al. ACC/AHA clinical performance measures for adults with ST-elevation and non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures on ST-Elevation and Non-ST-Elevation Myocardial Infarction). J Am Coll Cardiol 2006; 47:236-65. 55. Schiele F, Gale CP, Bonnefoy E, et al. Quality indicators for acute myocardial infarction: A position paper of the Acute Cardiovascular Care Association. Eur Heart J Acute Cardiovasc Care 2016. 56. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/2488 | - |
| dc.description.abstract | 背景：在台灣，心血管疾病位居前十大因死因，急性心肌梗塞的發生率與死亡率有下降的趨勢，然而在不同醫院照護結果存在差距，醫院執行醫院策略，提升照護結果，但是目前醫院策略與照護結果的相關性仍不明確。
目的：瞭解台灣醫院目前針對急性心肌梗塞的照護品質改善策略實施的狀況，並探討醫院策略與照護過程及結果的相關性。 方法：本研究使用郵寄問卷調查，研究對象為中央健康保險署醫療品質資訊公開網，所公開之急性心肌梗塞疾病照護醫院，共98家醫院。將問卷結果與醫療品質公開網過程及結果指標結合，控制醫院特性與病人特性，使用複迴歸分析，探討醫院策略與策略數量與照護過程及結果之相關性。 結果：本研究回覆問卷共71家醫院，回收率達72.45%，且具樣本代表性。執行醫院策略與照護過程及結果有關，且醫院策略執行數量與照護過程呈現正相關。 討論與結論：醫院策略與照護過程及結果有相關性，衛生主管機關可藉由政策引導，鼓勵醫院推行改善急性心肌梗塞照護過程及結果的策略；醫療服務提供者也可逐步提升醫院策略執行的數量，或可改善急性心肌梗塞病人的照護過程及結果。 | zh_TW |
| dc.description.abstract | Objective: The objective of this study was to understand the current situation of hospital quality improving strategies for acute myocardial infarction (AMI) in Taiwan. Furthermore, this study also explored the associations of hospital quality strategies with processes and outcomes of care for acute myocardial infarction.
Method: A total of 98 hospitals were selected as study samples. A structured questionnaire was developed and mailed to executive officers of the hospitals to measure the implementation of hospital strategies. The study combined the public data of acute myocardial infarction report cardfrom the National Health Insurance Administration with the results of questionnaire. Multiple regression analysis was applied in this study in order to explore the associations of implementation of hospital strategies with processes and outcomes of care for acute myocardial infarction. Results: The response rate was 72.45%. The response sample was representative.The implementation of hospital strategies was associated with better processes and outcomes of care for acute myocardial infarction, and the number of hospital strategies was associated with better processes. Conclusion: The implementation of hospital strategies was associated with processes and outcomes of care. According to the result, health policy makers can encourage hospitals to implement strategies for improving AMI care. Moreover, health services providers can also focus on increasing the numbers of hospital strategies to improve processes and outcomes of care for AMI. | en |
| dc.description.provenance | Made available in DSpace on 2021-05-13T06:40:52Z (GMT). No. of bitstreams: 1 ntu-106-R04848016-1.pdf: 1993087 bytes, checksum: e49e8eb6977d000e135cc3265d477bb8 (MD5) Previous issue date: 2017 | en |
| dc.description.tableofcontents | 目錄
致謝 II 中文摘要 III 英文摘要 IV 目錄 V 表目錄 VII 圖目錄 IX 第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的 3 第三節 研究重要性 3 第二章 文獻探討 4 第一節 急性心肌梗塞之現況 4 第二節 醫院品質改善活動 8 第三節 急性心肌梗塞照護品質測量指標 12 第四節 醫院策略與照護過程及結果關係之實證研究 17 第五節 文獻小節 22 第三章 研究設計與方法 23 第一節 研究設計與架構 23 第二節 研究假說 25 第三節 研究對象 26 第四節 資料來源 27 第五節 研究變項與操作型定義 29 第六節 統計分析方法 36 第四章 研究結果 37 第一節 描述性分析 37 第二節 雙變項分析 43 第三節 多變項分析 58 第五章 討論 67 第一節 研究方法討論 67 第二節 假說驗證 69 第三節 研究限制 72 第六章 結論與建議 73 第一節 結論 73 第二節 建議 75 參考文獻 77 附錄 83 | |
| dc.language.iso | zh-TW | |
| dc.subject | 照護過程 | zh_TW |
| dc.subject | 急性心肌梗塞 | zh_TW |
| dc.subject | 醫院品質策略 | zh_TW |
| dc.subject | 照護結果 | zh_TW |
| dc.subject | hospital quality strategies | en |
| dc.subject | acute myocardial infarction | en |
| dc.subject | outcomes of care | en |
| dc.subject | processes of care | en |
| dc.title | 探討改善醫院品質策略與急性心肌梗塞照護過程及結果之關係 | zh_TW |
| dc.title | Association of Hospital Quality Strategies with Processes and Outcomes of Care for Acute Myocardial Infarction | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 105-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 黃瑞仁(Juey-Jen Hwang),鍾國彪(Kuo-piao Chung) | |
| dc.subject.keyword | 急性心肌梗塞,醫院品質策略,照護過程,照護結果, | zh_TW |
| dc.subject.keyword | acute myocardial infarction,hospital quality strategies,processes of care,outcomes of care, | en |
| dc.relation.page | 85 | |
| dc.identifier.doi | 10.6342/NTU201701508 | |
| dc.rights.note | 同意授權(全球公開) | |
| dc.date.accepted | 2017-07-12 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 健康政策與管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
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