| Summary: | 碩士 === 台北醫學院 === 醫務管理學研究所碩士班 === 90 === Since the Bureau of the National Health Insurance (BNHI) initiated the case payment system, the medical institutions have been cutting off the medical services in order to control the cost, which could resulted in downscales of the quality of medical care. To date, the BNHI has no means to monitor the quality of medical care. Neither has established any open, fair, and justice review systems. As a result, more and more disputes have occurred between the BNHI and hospitals. The need of establishing a organization similar to the peer review organization (PRO) in the United States to monitor and to ensure the quality of medical care provided to the public has been proposed in many studies conducted in the past. The purpose of this research is to explore hospitals’ opinions about the establishment of such review organization. The result will be useful to the Department of Health (DOH) in making policies.
A self-administered, anonymous questionnaire was mailed to the 507 hospitals accredited by the DOH in 2001 as medical centers, regional hospitals, and district hospitals nationwide. In addition, five hospital administrators and managerial-level physicians were interviewed afterward to verify the results. The investigation period was between the February and May 2002. A total of 174 (34.3%) questionnaires were returned.
The study revealed that 86.3% of hospitals considered the establishment of the quality review organization to be feasible and 94.1% suggested that such organization should be operated and managed by the Taiwan Joint Commission on Hospital Accreditation or the Department of Health. Additionally, more than 93.5% of respondents suggested that not only doctors, but also the nursing staff should be included in the review group. Among the review areas, the “Process Phase” got the highest score and the “Structural Phase” got the lowest. This showed that there was a significant difference in review areas between the “Process Phase” and the “Structural Phase” (p<0.05). Via the Scheffe’s post-history testing, a significant difference in review areas also exists between the medical centers and the regional hospitals. Finally, this research suggests that the DOH establish the review organization as soon as possible to assure the quality of medical care in hospitals in Taiwan.
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