頁籤選單縮合
題 名 | 臺灣省各縣市衛生所執行中老年病防治業務及工作模式之探討=A Cost-efficient Nursing Model for a Community-based Adult Disease Control Program at Health of Stations in Taiwan Program |
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作 者 | 楊瓊珠; | 書刊名 | 中國醫藥學院雜誌 |
卷 期 | 7:1 1998.03[民87.03] |
頁 次 | 頁71-82 |
分類號 | 419.71 |
關鍵詞 | 縣市衛生所; 社區高血壓篩檢; 社區糖尿病篩檢; 傳統護理模式; 綜合護理模式; Adult diseases control program; Community diabetes screening; Community hypertension screening; Health station; Traditional nursing model; Cornprehensive nursing model; |
語 文 | 中文(Chinese) |
中文摘要 | 本研究係依據台灣省政府衛生處自民國79年到80年間執行「國民保健計畫- 中老 年病防治」業務,調查其所屬各縣市不同類型衛生所、及不同護理模式於辦理糖尿病及高血 壓篩檢工作之成本;發現一個慢性病患者的成本等,以評估不同工作模式間之效益差異以做 為我國日後持續推展中老年病防治計劃之參考。 本研究係對全省 21 縣市 335 個衛生所進 行調查。其中甲型衛生所為山地離島及偏遠地域者;乙型衛生所為一般鄉鎮者;丙型衛生所 為辦理群體醫療執業中心或設置群醫中心之衛生所;丁型衛生所為省、縣、轄市及人口較多 、交通方便者。傳統護理模式 205 所採用專責性者;綜合護理模式 130 所為採用地段服務 者。全部衛生所之參與中老年病防治工作人員共為 2,667 位,回收 2,556 份,其回收率為 95.8%。 本研究結果顯示:四型衛生所工作人員之平均薪資所得水準差異甚大,甲型衛生所 平均 25,587 元為最高,丙型衛生所之 21,467 元為最低。於投入中老年病防治計劃之費用 上,以甲型衛生所最高;丁型次之;乙型最低。實施傳統護理與綜合護理之不同工作模式衛 生所,其於投入中老年病防治計劃之經費、工作時間、收案成果等項目之分析上並無明顯差 異。依據以上分析結果本研究建議:(一)我國於推動「國民保健計畫-中老年病防治」業 務之際,今後宜依全省各地域之地理及社會、經濟、醫療環境之不同,訂定數種合適於不同 地域之推動方式,以利各該地域所屬衛生所據以推動執行。(二)台灣省所屬各縣市衛生所 現行高血壓及糖尿病篩檢之工作成本過高,建議改由全國衛生主管機關督導各縣市衛生局委 託民間檢驗機構辦理篩檢業務,其餘中老年病之收案管理、追蹤治療等業務則仍由衛生所辦 理。(三)台灣省所屬各縣市衛生所採用地段作業之綜合護理模式,雖已被公認為將來業務 推展之趨式,但其於執行諸如高血壓及糖尿病等大量篩檢( MASS SCREENING )之際,尤其 於偏遠離島地域,宜採用比較精確之檢驗方法(如以血糖值代替尿糖)以收績效。 |
英文摘要 | The study attempts to evaluate the efficiency of the 'National Health Promotion Scheme - Adult Diseases Control' program conducted by community-based hhealth stations in Taiwan. The cost-effectiveness (i.e. measured by the use of different nursing model according to locality) of the screening programs for diabetes and hypertension conducted between 1980 and 1982 is evaluated. A total 335 health stations locating at 21 townships in Taiwan provincial jurisdiction are classified into four types: "Type A" for remote stations: "Type B" for general rural stations: "Type C" for stations with medical clinic function and "Type D" for urben stations. Among them, 205 stations adopt the traditional nursing model which enroll their public health nurse with specific business duty. The other 130 stations participate in the comprehensive model which enroll their workers with duty defined by specific geographic area. All 2.667 public health workers who participated in this program are investigated, and the compliance rate is 95.8%. There is a significant difference in the average monthly salary income between wrokers in various types of station. The highest income is 25,587 NTD in "Type A" and the lowest income is 21,467 NTD in "Type D" station. The running cost of screening is highest in station "Type A", followed by "Type C", respectively. Differences in expenditure, working time and case collection between traditional and comprehensive nursing model used by various health stations are insignificant. The results suggest that: (1) To maximize cost-efficiency in the promulgation and promotiom of a nationwide project such as 'National Health Promotion Scheme - Adult Diseases Control' in Taiwan, flexible strategies should be employed by various types of health stations to fit into the local geographic, socioeconomic and medical environment. (2) As the cost and expenditure of the community-based screening progran of diabetes and hypertension are very can be entrusted to quality private health stations can still conduct certain compinents of the health authority. Nevertheless, health stations can still conduct certain compinents of the scheme such as case collection, follow-up and medical intervention. (3) Since the adaptation of a nursing model is an inevitable trend, other helth care services such as the detection of sugar in blood and urine should be provided in a mass screening program in health stations of remote/rural area. |
本系統中英文摘要資訊取自各篇刊載內容。