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研究生:張雅雯
研究生(外文):Chang YA-wan
論文名稱:病人就醫資訊需求-以乳癌為例
論文名稱(外文):Demand for Provider Information –A Case for Breast CancerDemand for Provider Information –A Case for Breast CancerDemand for Provider Information-A Case for Breast Cancer
指導教授:王惠玄王惠玄引用關係
指導教授(外文):Hui-Hsuan Irene Wang
學位類別:碩士
校院名稱:長庚大學
系所名稱:醫務管理學研究所
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:2005
畢業學年度:93
語文別:中文
論文頁數:113
中文關鍵詞:就醫資訊品質指標就醫選擇
外文關鍵詞:Provider informationQuality indicatorsSelection of providers
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在顧客滿意度愈來愈受重視的時代,民眾的資訊來源變得愈來愈多,且愈來愈容易,因此民眾在就醫前也開始收集醫療服務提供者的比較性資料,如針對住院病患對就醫選擇資訊的調查發現,43%的民眾在住院前曾打聽醫院的消息,而52%的民眾在住院前打聽過醫師的消息。
在我國的健保制度下,民眾有自由選擇醫療服務提供者的權利,但卻沒有足夠的資訊以幫助民眾選擇醫療提供者,因此本研究希望針對特定疾病病患,探討其在選擇醫療機構時所需要的就醫資訊,以做為病患在就醫時有更多參考資訊。
研究方法採用焦點團體的方式,共進行三場焦點團體訪談,焦點團體訪談一次成員約6-10人,對象皆為乳癌病友,參與受訪者共21人,及增加二場個別深度訪談,共2人。訪談乳癌病人所需要的就醫資訊為何,並依照焦點團體訪談的結果,整理乳癌病人所需要的資訊內容。
乳癌病人需要的資訊內容,可分為醫院、醫師兩個面向。醫師方面可分成下列六個項目:醫療硬體設備、手術的種類、科別及醫師的介紹、檢驗檢查的品質、後續追蹤的情形、乳癌病友團體;在醫師方面可分為下列五項:解釋病情的程度、尊重病人的感受、臨床經驗及年資、進修情形、手術成功率及誤診率。
滿意度中以「對病人的尊重」及「診斷的解釋程度」最為病人重視;而乳癌品質指標則為「動情激素測量百分率」,及「50歲以上侵犯性乳癌輔助性荷爾蒙治療百分率」,為病人接受度最高並可幫助他們選擇醫療機構。
建議將來衛生政府機構公開就醫資訊,以提供民眾在就醫前有更多資訊內容,並做為就醫選擇的參考依據。資訊內容可以具比較性資訊,如病人滿意度及醫療品質指標,可分階段性公開,首先試行少許指標,增加民眾的接受度。
Consumers pay much attention to patient satisfaction. The general public has much more information source, and gathers provider information before selecting health care providers. Provider information consists of service in hospital, profile of health professions, performance of hospital, medical quality, expect for general medical knowledge. There is a growing study of evidence that public want more provider information.
But the general public doesn’t have enough information about providers at present. The objective of this study is exploring what factors of patients went provider information from the breast cancer patients’ perspective.
The research was made by focus group research. We hold three focus groups to gather information about patients’ experience with care, and perceptions of provider information. A focus group brought together six to ten participants for face-to-face discussion. Recruiting participants were conducted by two medical centers in north Taiwan. A total of 23 participants are breast cancer patients.
Patients need more information about hospital and physician. Hospital information consist of six items: hospital equipment, kind of surgical operation, introduction of physician, quality of diagnostic services, follow-up, breast cancer support group; Physician information consists of five items: explanation of diagnosis, respect patients’ feeling, clinical competence and seniority, advanced education, percentage of operation successfully and erroneous diagnosis.
An aspect of patient satisfaction, participants pay much attention to respect patients’ feeling and explanation of diagnosis. Most interesting and helpful quality indicators of breast cancer are percentage of ER and PR test, and percentage of above fifty years old with invasive tumor receive endocrine therapy.
To help patients have sufficient and correct provider information, the health authority should collect and disseminate provider information. The information should include patient satisfaction and quality indicators. Step by step to disclose information, and so that to make the public to accepts the information.
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 預期貢獻 …………………………………………………3
第二章 文獻探討………………………………………………………5
第一節 就醫資訊公開的發展 ……………………………………5
第二節 就醫資訊公開意涵………………………………………18
第三節 就醫資訊公開的影響……………………………………25
第四節 我國就醫資訊公開的潛在需求…………………………27
第五節 乳癌病人對就醫資訊的潛在需求………………………31
第六節 文獻小結…………………………………………………46
第三章 研究方法 ……………………………………………………48
第一節 研究問題…………………………………………………48
第二節 焦點團體訪談……………………………………………49
第三節 訪談方式…………………………………………………53
第四節 資料分析…………………………………………………57
第五節 研究限制…………………………………………………59
第四章 訪談結果 ……………………………………………………62
第一節 訪談對象…………………………………………………62
第二節 就醫過程及就醫資訊來源………………………………63
第三節 乳癌病友需要的就醫資訊內容…………………………69
第四節 資訊呈現方式及取得管道………………………………80
第五節 乳癌病友其他相關意見…………………………………83
第五章 討論 …………………………………………………………86
第一節 就醫資訊內容……………………………………………86
第二節 資訊呈現方式及形式相關討論…………………………91
第三節 乳癌病人重視的相關議題………………………………94
第六章 結論與建議 …………………………………………………98
第一節 結論………………………………………………………98
第二節 建議………………………………………………………99
參考文獻………………………………………………………………103
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