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題名 | 臺灣地區全民健保對教學醫院牙科及基層牙醫診所之衝擊=Impacts of National Health Insurance on Local Clinics and Dental Teaching Hospitals in Taiwan |
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作者 | 鄭信忠; 邱弘毅; 林哲堂; 李勝揚; | 書刊名 | 中華牙醫學雜誌 |
卷期 | 20:2 2001.06[民90.06] |
頁次 | 頁109-122 |
分類號 | 419.58 |
關鍵詞 | 全民健保; 教學醫院; 牙醫診所; National health insurance; Teaching hospital; Dental office; |
語文 | 中文(Chinese) |
中文摘要 | 在臺灣地區,教學醫院牙科與基層牙醫診所分別扮演不同的角色與功能,本研究目的乃在瞭解全民健保實施後,有關牙科之各項保險制度與措施對上述兩者之影響,並探討其間差異,以作為政府衛生機構及民間團體之參考依據。研究權本之牙醫診所乃以牙醫全聯會登錄之近5000家診所,採集落系統抽樣法,依地區比例分組,以抽樣間隔20,共抽出245家,而教學醫院牙科則依衛生署公佈之522家教學醫院,用上述方法,以抽樣區隔5,共抽出105家。本研究採自主性問卷調查,將問卷郵寄至事先抽出之各單位,共回收醫院牙科31家,回收率29.52%,牙醫診所101家,回收率41.22%,經卡方配合度檢定回收樣本與預抽樣本之分佈狀況呈一致性(p>0.05),並以次數分配法分析問卷各題項,以卡方相關檢定分析教學醫院牙科及牙醫診所對各題項之差異性。研究結果如下:(1)對健保各項給付滿意度,除洗牙與樹脂填補外,其他全數嚴重不滿。(2)對各項申報及審查作業之看法,醫院牙科與牙醫診所間呈顯著差異(p<0.05)。(3)醫院牙科與牙醫診所對健保影響牙科發展之看法頗為一致,但對不願執行之健保項目則有顯著差異(p<0.05)。(4)不同層級之醫院牙科對健保申報及審查各項作業的反應有顯著差異(p<0.05),但不同健保行政區之醫院牙科及牙醫診所對健保各項措施則無顯著差異(p<0.05)。 因此,健保對醫院牙科及牙醫診所之影響確有不同程度之差異性,尤在總額預算實施後,猶需進一步探討! |
英文摘要 | The purpose of this study was to evaluate the effects of the National Health Insurance (NHI) system on dental departments of teaching hospitals and on local dental offices. The systemic cluster sampling method was used to select 254 of 5136 dental offices and 105 of 522 teaching hospitals. Questionnaires were mailed to the chief dentist of each study sample. There were replies from 31 dental departments of teaching hospitals (29.52%), and 101 from local dental offices (41.22%). The correlations between the demographic distributions of replies and analysis of each item in the questionnaire were performed using a biostatistic method. The results showed (1)Satisfaction with dental payments in the NHI system was low, except for operative dentistry scaling. (2)There were significant differences between the insurance processing systems of teaching hospitals and local dental offices. (3)There were significant differences (p<0.05) between low-motivational insurance items of teaching hospitals and local dental offices. (4)There were significant differences (p<0.05) in the insurance processing and checking systems of dental departments at different dental levels. In conclusion, there were different effects of the NHI system between dental departments of teaching hospitals and local dental offices. further study is needed to investigate the reasons. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。