以系統動態學觀點探討臺灣醫師人力供需之影響因子─以兒科專科醫師為例

Abstract

醫療產業充斥不確定性，醫師執業所面對之疾病複雜程度相異，內科、外科、婦產科以及兒科等四大科，往往面臨相對更高的醫療風險。在醫師執業工時長，所得未必適當反映其所承擔之風險與投入的醫療環境下，醫學系畢業生有意願選擇四大科的人數逐年減少，而較願意選擇執業風險相對較低之科別。 由於兒童與兒科醫學皆與國家生產力息息相關，且臺灣正面臨高齡化、少子化的社會變遷，本研究應用系統動態學模型，以歸納整體兒科醫師人力面臨之醫療環境，與系統背後之關鍵影響因素。並由管理學角度予以探討，分析影響臺灣兒科醫師人力供需之關鍵影響因子分別為「醫院醫師工時」、「醫院資源分配」，以及「醫病關係」。本研究進而系統性分析可行之改善方向，向政府及醫院管理者提出相關建議，以期對於臺灣當前醫療環境面臨之問題釐清有所助益。

The uncertainty of medical combines with the specialties including internal medicine, surgery, obstetrics and gynecology, and pediatrics facing relatively higher risk at work. The number of medical graduates selecting the four specialties has decreased in recent years while the medical graduates seem more willing to choose those medical specialties with relatively lower risk, such as dermatology, ophthalmology, otolaryngology and so on. It is a serious issue that Taiwan is facing the era of aging population, and low birth rate. And the amount of children and pediatric medicine are closely associated with national productivity. Therefore, this study is aimed to explore the demand and supply side of pediatrician workforce and the relevant impact factors in Taiwan. By using system dynamics and modeling, we expect to summarize the overall pediatrician human structure system and the key factors influencing the system in a view of systematic thinking, and to clarify the current pediatric healthcare environment in Taiwan.