| Summary: | 碩士 === 義守大學 === 管理研究所碩士班 === 95 === With the development of society and the implementation of the Bureau of National Health Insurance, the general public in Taiwan has become more aware of the healthcare services they receive and the service quality of medical facilities. As such, most patients prefer to go to large hospitals for medical treatment. Hence, the roles and functions of medical facilities at varying levels are blurred. Compounded by the incomplete implementation of a referral system, medical resources are oftentimes abused. The Department of Health and Bureau of National Health Insurance consider that a thorough enforcement of a referral system is the most effective method to reduce waste and facilitate the development of a sound nation-wide medical-care network. On July 15, 2005, a referral system was put into force by the Department of Health and Bureau of National Health Insurance.
Since patient referral is an important part of medical care services, improving the quality of the referral service is crucial to a hospital’s management. This research, using simple tools, aims at determining how satisfied the physicians were after they received referral requests from public medical center and whether the referral services have lived up to the physicians’ expectations and met their needs; in addition, this research hopes to act as a reference for hospitals that plan to improve their referral service quality.
Considering the requirements of the Bureau of National Health Insurance, the need of hospital assessments, and the active promotion by the Bureau of National Health Insurance of the referral system, the researcher therefore chose this issue as the subject. The researcher worked with family physicians at public medical center and collected and compiled available literature related to the subject to design the questionnaire used for this research. Some medical center staff mailed and collected the questionnaires. The researcher was responsible for the analysis of the questionnaire survey and research report. The findings of the survey were discussed and its conclusions and suggestions are presented in the final part of the research.
A total of 275 questionnaires were received (survey response rate: 41.7%) with most of the respondents being male physicians, aged between 40 and 49. A majority of the respondents worked in clinics and most were in the Department of Internal Medicine. Most of them have been in the medical profession for at least 10 to 19 years. Among the responding physicians, not many had participated in the “Family Physician Healthcare Team Pilot Program.”
The primary purpose of this project is to delve into the satisfaction level of the physicians in the receiving units and understand how satisfied they are with the referral services provided by medical center Physicians in different departments were found to have varied satisfaction levels with medical center A significant variance was observed. Whether or not the physicians considered cooperating with medical center in the referral process impacted on the level of satisfaction. Other factors that were found to result in a significant variance in satisfaction level with the referral service include: (1) whether or not medical center sent referral letters to the physicians in the receiving units; (2) whether o not the physicians in the receiving units provided medical center with information on the patient’s treatment; and (3) whether or not medical center received notices from the physicians if the physicians determined that the patients should go back to medical center for follow-up treatments. The satisfaction level of the physicians in the receiving units with the medical center referral system was graded in the questionnaire. The average satisfaction rating was 80.87, implying that most of the respondents were rather satisfied with Kaohsiung Veterans General Hospital.
As the result of the research indicates a lack of consistency in the questionnaire (lower reliability), the researcher suggested that consistency should be taken into consideration in further questionnaire design. Secondly, considering that the questionnaires used in the research had to be mailed due to limitations in time and manpower and in order to get better results, we suggest future researchers working on relevant subjects should use other methods for sending questionnaires.
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