臺灣博碩士論文加值系統

臺灣的全民健康保險，是全世界最成功的健康保險制度之一。為減少不同醫院間重複用藥問題及降低用藥錯誤，台灣的健保署建置了「健保雲端藥歷系統」，提供藥師查詢病人近3個月的用藥紀錄，為病人的用藥安全把關。雖然健保藥歷系統扮演著協助藥師提升藥事作業成效的功用，但若藥師不使用雲端藥歷系統，勢必無法達到預期的成效。本研究的目的即在探討影響藥師採用雲端藥歷系統意圖的因素。
本研究結合科技接受模式 (Technology Acceptance Model)、自我效能及知覺風險(Perceived Risk)等理論，發展出影響藥師採用雲端藥歷系統之研究模式，再利用隨機抽樣之問卷調查方式收集台灣藥師的意見。研究結果發現，影響藥師採用雲端藥歷系統最重要的3個因素是藥師使用系統的自我效能、知覺系統有用及知覺心理風險。研究結果可以協助台灣的健保署有效地推廣藥師使用雲端藥歷系統，以達到提昇全民用藥安全的目的；另外，本研究成果也可以作為其他國家導入雲端藥歷系統的參考，幫助他們善用雲端科技提昇人民的用藥安全。

Taiwan’s National Health Insurance (NHI) is one of the most successful insurance programs in the world. The National Health Insurance Administration (NHIA) established the NHI-PharmaCloud as a platform to reduce medication duplication and other medication errors among the NHI-contracted facilities. The NHI-PharmaCloud can help pharmacists access patient medication information from the preceding 3 months to improve drug safety. The use of NHI-PharmaCloud can improve the quality of healthcare, but improvements cannot occur if pharmacists are unwilling to use the platform. Therefore, the main objective of our study is to investigate the factors affecting pharmacists’ adoption of the NHI-PharmaCloud. This study develops a research model using theories of technology adoption, self-efficacy, and perceived risk and uses randomly distributed survey questionnaires to collect data from local pharmacists. The results show that self-efficacy, perceived usefulness, and perceived psychological risk are 3 critical factors that could affect pharmacists’ willingness to use the NHI-PharmaCloud. The research results may also help NHIA to effectively promote the usage of the NHI-PharmaCloud in Taiwan. In addition, governments in other countries may refer to the results of this study when implementing their own PharmaCloud-type systems to improve drug safety.

中文摘要 ii
英文摘要 iii
目錄 v
表目錄 vii
圖目錄 viii
壹、 緒論 1
一、 研究背景 1
二、 研究動機 3
三、 研究目的 3
四、 研究流程 5
貳、 文獻探討 7
一、 藥師的醫療角色定位與作業進展 7
二、 健保雲端藥歷系統 11
三、 科技接受模式 15
四、 自我效能 20
五、 知覺風險 25
參、 假說推導與研究模型 29
一、 主觀規範及形象 29
二、 知覺有用性及知覺易用性 31
三、 自我效能 31
四、 知覺風險 33
肆、 研究方法 36
一、 構面定義與操作化 36
二、 問卷設計與抽樣 37
三、 統計分析方法 43
四、 開放性問卷訪談 49
伍、 資料分析與結果 51
一、 敘述性統計分析： 51
二、 信效度分析： 53
三、 結構模式配適度分析 57
五、 路徑分析及假說驗證 58
六、 訪談結果分析 61
陸、 研究討論 68
一、 量化研究實證討論 68
二、 質化問卷訪談回饋討論 74
柒、 管理意涵與理論貢獻 82
一、 管理意涵 82
二、 理論貢獻 85
三、 研究限制 86
捌、 參考文獻 87
附錄一 95
附錄二 100
附錄三 101
附錄四 102

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