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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 鄭守夏(Shou-Hsia Cheng) | |
| dc.contributor.author | Ta-Wei Luo | en |
| dc.contributor.author | 羅大維 | zh_TW |
| dc.date.accessioned | 2021-06-15T02:24:50Z | - |
| dc.date.available | 2009-09-16 | |
| dc.date.copyright | 2009-09-16 | |
| dc.date.issued | 2009 | |
| dc.date.submitted | 2009-08-18 | |
| dc.identifier.citation | 中文部份
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/43635 | - |
| dc.description.abstract | 研究目的：瞭解醫院的結構面特性與病患感受品質和專業觀點品質的相關性。
研究方法：本研究為橫斷性研究，資料來源為2002和2004二個年度對出院病人的調查問卷和全民健保資料庫的「住院醫療費用清單明細檔」。問卷調查對象是選取全國地區教學醫院等級以上醫院糖尿病、肺炎、中風和氣喘四類住院病人為研究樣本。結構面指標包括醫師病床比、護理人員病床比、護理師佔護士比率、高科技儀器數、急性病床數、加護病床數等。品質指標的測量方面，病患感受品質分為人際面和技術面的感受品質；專業的品質指標分為病患出院後30天內的再住院情形和30天內同科再住院情形。以線性迴歸模型及邏輯斯迴歸模型，檢驗醫院結構面特性與病患感受品質和專業觀點品質的相關性。 本研究結果顯示：(1)對於人際面病患的感受品質而言，醫院護理師佔護士的比率愈高，以及擁有較多高科技儀器數的醫院，其得分普遍顯著愈高。(2)對於技術面病患的感受品質，結構面品質愈佳(醫師病床比愈高、護理人員病床比愈高、護理師佔護士比率愈高、高科技儀器數愈多、急性病床數愈多、加護病床數愈多者)的醫院，其得分普遍顯著愈高。(3)護理師佔護士比率愈高的醫院，其再住院情形普遍愈低。 結論：結構面品質較佳的醫院，讓病患有較佳的感受品質和較低的再住院率及同科再住院率。建議衛生主管機關將醫院人力素質納為評鑑標準。 | zh_TW |
| dc.description.abstract | Objective: The objective of this paper is to examine the relationship between the structural measures of quality and outcome measures of quality.
Methods: This study was a cross-sectional design. The data used in this study came from two sources: the 2002 and 2004 Hospital Discharged Patient Surveys and the National Health Insurance Research Databases (NHIRD) in Taiwan. We included patient discharged from hospital accredited as district teaching hospital and above and included patients with a diagnosis of diabetes mellitus, stroke, asthma or pneumonia. The structural measures of quality included physician-to-bed ratio, nurse-to-bed ratio, the percentage of registered nurse, the number of high-tech equipments, the number of acute beds and the number of ICU beds. The outcome measure of quality was divided into two parts: subjective and traditional objective quality of care measures. Subjective patient-perceived quality of care was measured by ratings of interpersonal skill and clinical competence. The traditional objective quality of care was measured by the readmission within 30 days of index discharge. The linear regression and logistic regression were applied to examining the relationship between the structural measures of quality and outcome measures of quality. Results: Results indicated that (1) hospitals with high nurse-to-bed ratios and with high hi-tech equipments were associated with significantly better interpersonal skill scores than those with low nurse-to-bed ratios and with low hi-tech equipments. (2) In addition, we also found that hospitals with higher structural measures of quality (including physician-to-bed ratio, nurse-to-bed ratio, the percentage of registered nurse, the number of high-tech equipments, the number of acute beds and the number of ICU beds) were associated with significantly better clinical competence scores that those with low structural measures of quality. (3) We found that the negatively association between the percentage of registered nurses and readmission within 30 days of discharge. Conclusion: Hospital with higher structural measures of quality is associated with higher outcome measures of quality, in terms of either subjective quality or traditional objective quality. According to our findings, we suggested that the government should incorporate the quality of hospital staff in the hospital accreditation system. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-15T02:24:50Z (GMT). No. of bitstreams: 1 ntu-98-P93845108-1.pdf: 1164467 bytes, checksum: 19f69373be199346e58aa536851c4284 (MD5) Previous issue date: 2009 | en |
| dc.description.tableofcontents | 第一章 緒論 1
第一節 研究動機 1 第二節 研究背景 3 第三節 研究目的 4 第二章 文獻探討 5 第一節 醫療品質指標的發展與分類 5 第二節 專業觀點的品質指標 8 第三節 民眾觀點的品質指標 14 第四節 不同醫療品質範疇的相關性 19 第三章 研究材料與方法 23 第一節 研究架構與研究假說 23 第二節 資料來源及研究對象 26 第三節 研究變項與操作型定義 28 第四節 統計方法................................................................................................31 第四章 研究結果 32 第一節 研究資料描述 32 第二節 醫院結構面的品質與病患感受品質或專業的品質之相關性比較 39 第三節 影響病患感受品質及再住院情形之分析及描述 67 第五章 討論 78 第一節 醫院結構面特性，病患人際面感受和技術面感受的關係 79 第二節 醫院結構面特性，病患的再住院情形和同科再住院情形的關係 82 第三節 研究限制 85 第六章 結論與建議 86 第一節 結論 86 第二節 建議 87 參考文獻 88 | |
| dc.language.iso | zh-TW | |
| dc.subject | 結果面品質 | zh_TW |
| dc.subject | outcome quality | en |
| dc.title | 醫療照護市場中醫療結構面品質與結果面品質的相關性之研究 | zh_TW |
| dc.title | The research of health care structure quality and outcome quality in health care markets | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 97-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 楊長興(Chiang-Hsing Yang),鍾國彪(Kuo-Piao Chung) | |
| dc.subject.keyword | 結果面品質, | zh_TW |
| dc.subject.keyword | outcome quality, | en |
| dc.relation.page | 96 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2009-08-18 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 衛生政策與管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
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