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E87172
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醫院推行品質管理相關活動的成本效益與成本效果分析
The Cost-benefit and Cost-effectiveness Analysis of Quality Management Activities in Hospitals
1.鍾國彪
1.Kuo-piao Chung
1.國立臺灣大學公共衛生學院醫療機構管理研究所
1.Institute of Health Care Organization Administration, College of Public Health, National Taiwan University
001,002,003,004
1.國立臺灣大學公共衛生學院醫療機構管理研究所
1.Institute of Health Care Organization Administration, College of Public Health, National Taiwan University
002
1.行政院國家科學委員會
1.National Science Council
A.14 計畫執行期間(起):1997-08-01
A.14 計畫執行期間(訖):1998-07-31
1998-06-101998-08-30
A.16 收到日期:1999-08-20
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問卷A:49 問卷B:42 問卷C:49


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C.2 聯絡日期:1999-08-23
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1.國立臺灣大學公共衛生學院醫療機構管理研究所
1.Institute of Health Care Organization Administration, College of Public Health, National Taiwan University
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C.7 資料公開日期:1998-08-01
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1.主觀績效評估
2.投入費用
3.品管圈
4.臨床路徑
1.Clinical Pathway
2.Implementation Model
3.Incremental Cost
4.Quality Control Circle
5.Subjective Performance Evaluation
本研究的主要目的,在探討品管活動中的品管圈與臨床路徑的推行模式、投入成本與主觀感受之期望效果與達成效果間的關係。針對地區教學以上醫院共131家,以 郵寄問卷進行普查,約三成多的回收率。 臨床路徑的採行率為71.4%,採行醫院平均推行12.4個月;主要收集的資料,以住院日與總費用為最多;推行的種類中以自然產與剖腹產超過九成為最高; 醫院平均採行14.5種路徑;平均每年投入臨床路徑的費用約 15萬元。評鑑等級與採行路徑總數有顯著相關;平均每年投入費用與推行年數有顯著負相關;平均每年投入費用與主觀達成效果總分間,無顯著相關。 在品管圈部份,樣本的採行率為73%,其中52.8%的醫院僅剛開始在某些部門推行,36%的醫院已經推行到全院,平均推行25.5個月。到87年6月底 之前,推行的醫院平均組33圈,以護理部門的圈數最多,以跨部門或科室的圈數最少。醫院平均每年教育訓練費用約61萬,平均每年品管圈費用約88萬元。品 管圈推行年數與平均每年教育訓練費用、平均每年其他費用及平均每年品管圈費用,都成顯著負相關。品管圈推行年數與達成效果總分有邊際正相關 (P<.10)。

The main purpose of this study is to explore the relationship between imple-mentation model, incremental cost, subjective expected and realized effects of quality control circle(QCC) and clinical pathway. A census was done by mailing questionnaires to 131 hospitals accredited above district teaching hospitals. The response rate is a little more than thirty percent. The adoption rate for clinical pathway is 73 percent in sample hospitals with average length of duration of 12.4 months. Most hospitals collect length of stay and total charge data. Normal Virginal Delivery and Cesarean Section are adopted by more than 90 percent of sample hospitals. Average, hospitals adopt 14.5 kinds of pathways. The average incremental cost is about 150,000 NT dollars each year and is negatively correlated with the length of implementation. The accreditation status is associated with number of pathways that hospitals adopt. The adoption rate of QCC is 73 percent where 52.8 percent of hospitals are limited in specific department and 36 percent of hospitals are implemented hospital-wide. The length of implemen -tation for QCC is 25.5 months. There are average 33 QCC teams in imple-mented hospitals in which most of them come from nursing department. It is about 610,000 NT dollars for education and training and about 880,000 NT dollars for overall expenses each year. The incremental cost is negatively related with average education and training cost, average other expenses and average overall expenses each year. There is marginally significant relation between the length of implementation of QCC and subjective realized total effects(p<.10).

D.16 完成檢誤日期:2004-02-13
D.17 預定釋出日期:2004-03-05
D.18 初次釋出日期:2004-03-05
D.19_1 最新版釋出日期:2004-03-05
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10.6141/TW-SRDA-E87172-1
https://efenci.srda.sinica.edu.tw/webview/index.jsp?object=https://efenci.srda.sinica.edu.tw:80/obj/fStudy/E87172
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