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研究生:郭幸萍
研究生(外文):KUO, Shing Ping
論文名稱:影響主治醫師生產力的相關因素研究
論文名稱(外文):A Study Of Factors Related To The Productivity Of Attending Physician
指導教授:陳潭陳潭引用關係
指導教授(外文):Chan Tam
學位類別:碩士
校院名稱:中國醫藥學院
系所名稱:醫務管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:1996
畢業學年度:84
語文別:中文
論文頁數:93
中文關鍵詞:主治醫師生產力全民健保
外文關鍵詞:Attending PhysicianProductivityNational Health InssuranceNHI
相關次數:
  • 被引用被引用:21
  • 點閱點閱:290
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:5
  全民健康保險於84年3月開辦以來,各醫療院所與中央健康保險局之間因為醫療給付的問題,展開了一場拉距戰,由於各種相關政策的相繼實施,醫院本身不得不更加重視人部的成本控制,醫院管理也逐漸朝向企業化經營的趨勢,凡是牽涉到醫院內人事物方面的決策,都常採用一些經濟評估的方法。本研究最主要的目的在參考國內外的相關文獻,找出可以代表主治醫師的醫療服務產出項目和影響醫療服務產出的因素相互之間的關係,探討影響主治醫師生產力的相關因素,進一步在醫師人力資源管理方面提供相關的建議。 本研究取得某國立醫學中心全民建保前後各6個月的資料,以個案研究(study case)的方式§敦Q有關衛生政策的變化醫師特質及工作特性影響臨床科部主治醫師生產力的情形,以了解造成臨床科部主治醫師生產力差異之因素,本研究的目的在於:1.參考國內外 相關研究,了解影響醫師生產力的因素。2.以實証方法分析醫院臨床科部影響醫師生產力之因素。3.全民健康保險實施前後,醫院內醫師生產力是否有差異?影響醫師生產力的因素是否不,探討衛生政策的變化、醫師本身特質及工作特性影響科部主治醫師生產力的人力資源的相關建議? 本研究結果發現以下的幾點結論:1.就個案醫院而言,全民健康保險的前後,所有的醫療產出在統計上並無顯著差異。2.就個案醫而言,有較年輕化的趨勢。3.在全民健保前後,影響主治醫師生產力的因素無差異,其有顯著相關的因素如下:科別、年齡、畢業學校、工作年資、教學職稱、擔任委員、會數、研究經費。4.科別不同,其各項醫療產出。 本研究結果發現以下的幾點結論:1.就個案醫院而言,全民健出有顯著較高的情形。6.畢業醫學院的不同,其檢查檢驗人次數有顯著的不同。7.工作年資愈高,發表的論文總數有顯著的較高。8.教學職稱愈高,則與醫療產出呈正相關。9.擔任委員會數愈多與其醫療產出呈正相關。10.研究計劃愈多,並不會與醫療產出呈負相關,反而與醫療產出呈正相關。  醫院雖非營利機構,但仍必需重視生產效率,以期能在多變的環境中增加競爭的能力,達到永續經營,所以影響生產力的因素評估與管理日趨重要,除了可藉由影響因素的評估與管理來了解目前的現況及未來改進的方向,也可以根據過去的情形進而配合機構內的現況及激發將來的潛力,由這種動態過程(Dynamic Process),則可使組織維持長期且穩定的發展。
Since the NHI(National Health Insurance) sarted from
Marach,95. There is medical payment problem between every
Hospital and Bureau of National HealthInsurance. It is a start
of a seesaw battle. Beause of the continually imple-ment of
every related polices, hospital themselves have to pay more
attentionon their inner cost contral. Hospital is going into a
enterprise management. What ever it is related to the decision
on hospital personnel, business, and assets, it usually take the
economical way to judge. The goal on this study is to take
national and international cases as a reference to find out the
relat-ionship between the medical service production of the
Attending Physician and the influence of the medical service
production, and discuss the related factorsthat affect the
Attending Physician''s productivity. And also one step furtureto
supply related suggestion on Physician manpower management.
This study receives one national medical center''s information on
6 months beforethe NHI(National Health Insurance)start, and 6
months after it started.Use the wayof case study to discuss the
changes of the related sanitation policies, phys-ician''s
specialty and job characteristic that affect the situation of
the Att-ending Physician''s productivity in clinical department
to understand the causesof the difference of the Attending
Physician''s productivity in clinical depar-tment. The goal of
this study are:1. Take the domestic and foreign related stu-dies
as reference to understand the effects on Physician
productivity. 2. To pr-ove and analyze the factors that clinical
department affect the physician prod-uctivity. 3.If there is
difference on physician''s productivity in the hospitalbefore and
after the National Health Insurance imply? And is the effects
dif-ferent? 4.Discuss the way to improve physician''s
productivity and use this asthe reference to make decision.
5.Let the hospital management department to present the
suggestion on manpower source. The results of this study are
asfollowed:1. As this case, there is no obvious difference on
all medical serviceproduction before and after the NHI(National
Health Insurance) started. 2.There is a tendency to younger
people. 3. There is no difference effects thataffect the
productivity of Attending Physician. The related factors are:
Clini-cal department,Age, Graduated school,Year of work, Title
of teaching, The numb-er of counts in committees, study
expenses. 4.Different department there is avery obvious
differcnces in every medical service production. 5.The medical
service production higher in the Attending Physician''s age
between 41-45. 6. Different graduating school, the examination
inspectors number is different. 7.With higher working years,
the total numbeer of the essay that persented is higher. 8. The
higher teaching title is related to a postive medical service
production. 9.The relationship between taking charge in more
committees and medical service production is positive. 10.More
study plans did not affect a negative relaation between medical
service production. Actaly, it is positive. Hospital is not
a profit making institute, but it still need to pay more
attention on production efficiency. Therefore, it can be more
competitive inthis changing environment and to reach continually
business. So the effects ofthe productivity is becoming more
and more important in judgment and management We can use the
effects of the judgement and management to understand the
current situation and the direction to improve in the future.We
also can take the situation in the past to coordinate the
situation in the institute to evokethe potential in future.
Through this dynamic process, it can make the organ-ization in a
long term and steady development.
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