| Summary: | 碩士 === 國立中山大學 === 人力資源管理研究所 === 90 === Abstract
Due to the rapid rise in medical expenses and unanticipated accumulation of overdue premiums, Taiwan''s National Health Insurance has impacted the management of all-size hospitals. For the purpose of survival and maintaining good performance, the hospitals need to adopt suitable strategic management. Medical centers take the responsibilities of service, teaching, and research, it should be some hard thinking as to how to manage the hospital continuously and make every effort to achieve the goal of “health for all in the twenty-first century”.
This study was conducted in three stages: questionnaire development and testing, surveying, and data analysis. The 34-item questionnaire was self-made according to the definition and contents of community health nursing defined in United Kingdom Central Council (UKCC). Seven hundred and forty questionnaires were send to the community inhabitants with 679 were returned and valid, representing a response rate of 91.8%. Descriptive analysis, Chi-Square test, Pearson correlation analysis, factor analysis, and stepwise regression analysis were used for the statistical analysis.
The information about community health nursing was obtained from bureau of public health in the majority of inhabitants (57%). As for the satisfaction of service of community health nursing to the inhabitants, people who were satisfied is less than those who weren''t (21.4% vs 41.2%). Though fewer inhabitants who had a favorable impression on the medical center, more people prefer medical center to practice community health nursing. Community health nursing was classified into seven dimensions according to the factor analysis, "home health care" had a highest score (4.23), and "mental health care" got a lowest score (3.64). There was significant negative correlation between satisfaction and "supporting school health nursing", "home health care is of more humane care", "hospital gains profit from home health care", "willing to take home health care", and "hospital cooperates with community to care mental disabled". Significant positive correlation was noted between satisfaction and "accepting mental disabled in the community". In age 30-39 and 40-49, relating to the satisfaction of community health nursing, inhabitants who were unsatisfied are more than those who weren''t, significant difference was noted. People who had higher educational background felt unsatisfied to the service of community health nursing, and the higher the less. Through stepwise regression analysis, "establish referral system" had the best predictability in using facilities efficiently to economies of scale to reduce operating cost; "ability to provide better service" had the best predictability in confidence of practicing community health nursing in medical center; "medical center is a good neighbor" had the best predictability in increasing benefits from practicing community health nursing; and "public health nursing helping disease prevention" had the best predictability in government health policy.
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