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頁籤選單縮合
題 名 | A Qualitative Study of Multidimensional Perceptions about Healthcare Quality=對醫療照護品質不同觀點之質性研究 |
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作 者 | 張碩芳; | 書刊名 | 醫療品質 |
卷 期 | 1:1 1998.05[民87.05] |
頁 次 | 頁24-41 |
分類號 | 419.2 |
關鍵詞 | 醫療品質; 全方位; 成本控制; Healthcare quality; Multidimensional; Cost containment; |
語 文 | 英文(English) |
中文摘要 | 「品質」是一個多元的主題。特別是醫療業涵蓋多種不同領域的專業人才(兩百 種以上),使得醫療品質管理愈趨複雜。這個研究欲探討不同角色的醫療業者-醫師、護理 人員、行政管理人員以及醫療服務的對象-病人,對於醫療品質的不同看法。期望以「全方 位」的角度分析現今醫療品質的問題。 本研究地點在紐約哥倫比亞長老教會醫學中心-此乃美國大東北地區最大的醫學中心。此研 究分別針對行政管理人員、醫護人員及病人而設計三種「開放式」訪談大綱。作者並分別面 訪了十五位紐約哥倫比亞醫學中心的人員:包括二位高階行政主管、二位中階主管、三位醫 師、二位護理人員以及六個病人。本報告針對幾個醫療品質的重要課題分別比較了醫療業者 與病人之間、行政管理人員與醫護人員之間、高階及中階管理者之間、醫師及護理人員間不 同的認知及想法。這些問題包括:醫療品質的定義,病人滿意度的問題、成本控制及品質改 進的取捨、臨床醫療品質和病患生活品質的比重問題。 此研究報告重新定義品質改進和成本控制的關係。針對臨床醫療品質和病患生活品質的重視 程度,不但醫護人員和病人之間差異大,病人亦因疾病的嚴重性而有極大的差異。此外,醫 療行政兩者的溝通,及對民眾開放更充足的資訊亦是不可忽視的課題。最後,本研究亦建議 「管理式照護」及「健康照護網路」乃解決品質與成本問題的極佳途徑。 |
英文摘要 | Quality of care is a multidimensional subject, especially in the healthcare industry, where many people from different fields are involved. This study was designed to understand perceptions about quality issues from a variety of providers of health care, and from patients, the ultimate recipients of their actions. The study was done at Columbia-Presbyterian Medical Center New York City. It is the largest medical center in the Northeastern America. Three types of the open-ended interview guides were designed for administrators, medical staff, and patients. Fifteen individuals were selected for interviews, including two senior executive managers, two middle managers, three physician directors, two nurses, and six patients. The analysis compares the different perceptions between providers and patients, administrators and medical staff, senior and middle managers, and physicians and nurses on the same important issues: the definition of healthcare quality, cost versus quality, patients' satisfaction, and health outcome versus quality of life. The findings of the study demonstrate the relationships between quality improvement and cost containment. In addition, the emphasis on health outcome and quality of life is different between providers and patients, and among patients with different severities of illness. Also, we found that the education and communication between medical staff and administrators about quality issues are needed, and a trend toward more public release. "Managed care" and "healthcare networks" are recommended as good ways to solve healthcare quality and cost problems. |
本系統中英文摘要資訊取自各篇刊載內容。