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題 名 | 基層醫師對國內實施論人計酬制度可行性認知調查研究=A Survey Study of the Feasibility of Capitation Payment System from Primary Physicians' Point of View |
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作 者 | 許銘恭; 林恆慶; | 書刊名 | 臺灣家庭醫學雜誌 |
卷 期 | 13:4 2003.12[民92.12] |
頁 次 | 頁157-170 |
分類號 | 419.55 |
關鍵詞 | 醫師; 論人計酬; Capitation payment system; Primary care physician; Gatekeeper; |
語 文 | 中文(Chinese) |
中文摘要 | 本研究旨在探討基層執業醫師對實施論人計酬支付制度之看法,並了解基層執業醫師認為最適當的論人計酬支付模式。本研究採用郵寄問卷調查法,抽樣全國十分之一的基層執業醫師共1,022位為研究對象,問卷回收率為21.14%。在統計分析部分,以邏輯斯迴歸來分析影響基層醫師參與論人計酬意願之相關因素。研究結果顯示只有24%表示瞭解論人計酬支付制度之實質內涵,而又僅有19%醫師非常願意或願意參與論人計酬支付制度,由邏輯斯迴歸分析結果發現,在調整其他變項之影響效應後,醫師年齡(OR=1.084; 95% CI 1.031~1.141; p=0.002)、執業地點健保分區(東區分局vs.臺北分局)(OR=12.133; 95% CI 1.372~107.260; p=0.025)、執業型態(受人雇用vs.單獨執業)(OR=16.524; 95% CI 3.668~74.429; p<0.001)、不願意改變現狀(OR=0.409; 95% CI 0.208~0.802; p=0.009)及對論人計酬支付制度瞭解與否(OR=0.184; 95% CI 0.043~0.794; p=0.023)等變項與基層執業醫師參與論人計酬支付制度意願之間達統計顯著差異。本研究顯示多數醫師皆不甚瞭解論人計酬之真正意涵,因此建議主管單位將來若要實施此一制度,能事先對醫師進行廣泛宣導,期能使醫師先行對此制度有更深入之認識,使制度之推行達事半功倍之效。 |
英文摘要 | The purposes of this study were to understand the attitudes of primary care physicians toward the implementation of a capitation payment system and to explore the most appropriate model of capitation payment system for primary care. This study used a mailing survey research. The study sample included 1,022 primary care physicians selected by systematic sampling from the population. The response rate was 21.14%. A multiple logistic regression analysis was performed to identify the statistically significant factors related to the willingness of primary care physicians to join the capitation payment system. The results showed that 24% of respondents understand the capitation payment system. Only 19% were “very willing” or “willing” to join the capitation payment system. After adjusting the effects of other variables, the results showed that the physican's age (OR=1.084; 95% CI 1.031~1.141; p=0.002), practice location (OR=12.133; 95% CI 1.372~107.260; p=0.025), practice type (OR=16.524; 95% CI 3.668~74.429; p<0.001), unwillingness to change the current status(OR=0.409; 95% CI 0.208~0.802; p=0.009) and whether a physician understands the capitation payment system (OR=0.184; 95% CI 0.043~0.794; p=0.023), were all significantly related to the willingness of a primary care physician to join the capitation payment system. The study indicated that the majority of the primary care physicians did not understand the capitation payment system. It is suggested that health authorities educate primary care physicians regarding the issue of the capitation payment system. This can facilitate a smooth implementation of the capitation payment system in the future. |
本系統中英文摘要資訊取自各篇刊載內容。