| Summary: | 碩士 === 國立虎尾科技大學 === 資訊管理研究所在職專班 === 102 === Reimbursement charges for dialysis had been a significant drain in Taiwan’s health care spending. In fact, costs associated with dialysis are found to be in the top five health care spending. Researches of dialysis services have shown the quality of hemodialysis may affect patients’ long-term survival, morbidity, and life quality. Several researchers have proposed key factors influencing the quality of hemodialysis. However, most studies focused on single quality indicator and few efforts have been made to systematically search the key quality indicators in the hemodialysis process. The appropriateness of the classification and ranking is verified by focused group interview and Delphi consensus methods. The collected indicators are further hierarchically weighted by analytical hierarchy process in three levels: dimension, class, and individual indicator, and thereby establishes an instrument to summarize the most important quality indicators for hemodialysis. In the managerial application dimension, results of this study provide the managers with important tools for examining the current dialysis nursing care process. The healthcare providers themselves can use the instrument developed by this study to verify the quality of hemodialysis stepwise. Patients can also use this instrument to examine whether self-care follow the best quality procedure. In the managerial mechanism dimension, the managers can establish rewarding or punishing system based on the quality indicators. Healthcare providers can establish a standard operation procedure based on the available time and resources. The managers can also help establish the work attitude. In the managerial decision dimension, the government can establish a tool for evaluation or accreditation of various dialysis institutions, which in turn will guide the allocation of the resources from the funding source. The management team can also link these indicators to the payment system and build a pay-by-performance system. We hope results of this study can improve the quality dialysis therapy and in turn improve the overall health of patients and reduce the related complications.
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