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題名：醫療品質評估的發展--從專業評鑑到報告卡系統
書刊名：臺灣公共衛生雜誌
作者：魏玉容／鍾國彪／鄭守夏
作者(外文)：Wei, Yu-jung／Chung, Ku-piao／Cheng, Shou-hsia
出版日期：2005
卷期：24:4
頁次：頁275-283
主題關鍵詞：醫療品質；評鑑；評估；報告卡；Quality of care；Accreditation；Assessment；Report card
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(5) 博士論文(4) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:5
  • 共同引用共同引用:29
  • 點閱點閱:69
　　　　　醫療品質向來是醫療服務體系中的核心價值之一，品質的評估、確保與持續改進也是各國政府十分重視的工作。本文主要在整理與比較美國與台灣在醫療品質的確保與品質測量的各種努力。從過去發展的演進來看，醫療品質的確保是由醫院評鑑制度開始，其間持續不斷的發展測量指標，來評估、監測醫療品質。接著是醫療專業在成本控制壓力下的自我提升，包括引進企業管理的制度與技術，並訂定以實證為基礎的臨床作業準則，進一步提升醫療品質。最近則發展到讓醫療消費者參與品質的評估以及醫療品質資訊的公開，希望透過資訊提供讓消費者能做明智的選擇，促使醫療專業可以加速品質改善，更符合病人的期望。最後本文亦提出建議供政策參考。
　　　　　Quality of health care is one of the core values in the healthcare delivery system. Many nations have made essential efforts in the assessment, assurance, and improvement of healthcare quality. The purpose of this article is to describe the evolution in healthcare quality improvement and assessment in the United States and in Taiwan. Evidence shows that quality assurance was initially established by implementing a hospital accreditation mechanism; accompanied by continuous development of quality indicators to monitor the quality of healthcare. As the cost-containment pressure increased, health professionals began to adapt industrial management tools and create evidence-based practice guidelines to improve the quality of healthcare. Recent developments include consumer involvement in quality assessment and public disclosure of quality information. It is hoped that the quality information provision will facilitate consumers' choice among providers and accelerate the process of professional quality improvement. Finally, the article provides several recommendations for policy consideration.
期刊論文
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17.Fraser, I.、Mcnamara, P.、Lehman, G. O.(1999)。The pursuit of quality by business coalitions: a national survey。Health Aff，18，158-165。  new window
18.Crofton, C.、Lubalin, J. S.、Darby, C.(1999)。Consumer Assessment of Health Plans Study (CAHPS)。Med Care，37，MS1-MS9。  new window
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24.Farley, D. O.、Short, P. F.、Elliott, M. N.(2002)。Effects of CAHPS health plan performance information on plan choices by New Jersey Medicaid beneficiaries。Health Serv Res，37，985-1007。  new window
25.Schneider, E. C.、Epstein, A. M.(1998)。Use of public performance reports: a survey of patients undergoing cardiac surgery。The Journal of the American Medical Association，279(20)，1638-1642。  new window
26.Baker, D. W.、Einstadter, D.、Thomas, C.(2003)。The effect of publicly reporting hospital performance on market share and risk-adjusted mortality at high-mortality hospitals。Med Care，41，729-740。  new window
27.Hibbard, J. H.、Stockard, J.、Tusler, M.(2003)。Does publicizing hospital performance stimulate quality improvement efforts?。Health Aff，22，84-94。  new window
28.Hannan, E. L.、Kilburn, H. Jr.、Racz, M.(1994)。Improving the outcomes of coronary artery bypass surgery in New York State。JAMA，271，761-766。  new window
29.Huang, P.(1996)。Quality assurance in Taiwan, the Republic of China。Int J Qual Health Care，8，75-82。  new window
30.邱瓊萱、魏中仁、楊志良、鍾國彪(20000400)。醫療產業品質保證與品質管理思潮演進--以美國與臺灣為例。醫院，33(2)，1-12。  延伸查詢new window
31.楊哲銘、王鳳君、洪啟宗、邱文達(20001200)。區域醫院推動馬里蘭醫療品質指標計劃之實證經驗。醫院，33(6)，17-25。  延伸查詢new window
32.Cheng, S. H.、Song, H. Y.(2004)。Physician performance information and consumers' choice: A survey of subjects with the freedom to choose between doctors。Qual Saf Health Care，13，98-101。  new window
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37.Cheng, S. H.、Ho, Y. C.、Chung, K. P.(2002)。Hospital quality information for patients in Taiwan: can they understand it?。Int J Qual Health Care，14，155-160。  new window
38.謝慧欣、鄭守夏、丁志音(20001200)。住院病患對就醫選擇資訊之需求：初步調查發現。中華公共衛生雜誌，19(6)，437-445。new window  延伸查詢new window
39.Epstein, A. M.(1998)。Rolling down the runway: the challenges ahead for quality report cards。JAMA，279(21)，1691-1696。  new window
40.Sangl, J. A.、Wolf, L. F.(1996)。Role of consumer information in today's health care system。Health Care Financing Review，18(1)，1-8。  new window
41.Marshall, M. N.、Shekelle, P. G.、Leatherman, S.、Brook, R. H.(2000)。The public release of performance data: what do we expect to gain? A review of the evidence。The Journal of the American Medical Association，283(14)，1866-1874。  new window
42.Chassin, M. R.、Hannan, E. L.、Debuono, B. A.(1996)。Benefits and hazards of reporting medical outcomes publicly。N Engl J Med，334，394-398。  new window
43.陳琇玲、鍾國彪、洪幼珊(19991200)。臨床品質指標簡介。醫院，32(6)，37-45。  延伸查詢new window
44.陳佩妮、鄭守夏、鍾國彪、林王美園(19970400)。臺灣地區醫療品質指標適用性之探討。中華公共衛生雜誌，16(2)，133-142。new window  延伸查詢new window
45.Cleary, Paul D.、Edgman-Levitan, Susan(1997)。Health Care Quality: Incorporating Consumer Perspectives。Journal of the American Medical Association，278(19)，1608-1612。  new window
46.Hibbard, Judith H.、Jewett, Jacquelyn J.(199705)。Will Quality Report Cards Help Consumers?。Health Affairs (Millwood)，16(3)，218-228。  new window
47.徐慧娟、薛亞聖(20010200)。醫院管理指標的性質與應用。醫院，34(1)，29-41。  延伸查詢new window
48.藍忠孚、熊惠英、胡澤芷、葉佳禧(20000300)。臺灣地區醫療機構品質管理現況分析。醫療品質，2(1)，5-12。new window  延伸查詢new window
49.Donabedian, Avedis(1988)。The quality of care: How can it be assessed?。Journal of the American Medical Association，260(12)，1743-1748。  new window
學位論文
1.林淑琴(2001)。消費者特定求醫途徑之探討--以台北市某地區醫院全膝關節置換消費者為例-(碩士論文)。國立陽明大學。  延伸查詢new window
2.宋欣怡(2001)。民眾就醫選擇資訊的潛在需求研究(碩士論文)。國立臺灣大學。  延伸查詢new window
3.謝慧欣(1999)。民眾對健康資訊需要之初探(碩士論文)。國立臺灣大學。  延伸查詢new window
4.邱培源(2002)。病患健康資訊需求與尋求行為之研究(碩士論文)。淡江大學。  延伸查詢new window
5.張淳茜(2000)。病患健康資訊來源及其相關因素之研究(碩士論文)。中國醫藥學院。  延伸查詢new window
圖書
1.鍾國彪(1997)。全民健康保險的整體醫療品質之評估。台北：中央健康保險局。  延伸查詢new window
2.江東亮(2003)。醫療保險政策--台灣經驗。臺北：巨流出版社。  延伸查詢new window
3.吳肖琪(1999)。評估醫院醫療品質指標。台北：行政院研究發展考核委員會。  延伸查詢new window
其他
1.Joint Commission on Accreditation of Healthcare Organizations。Facts about the JCAHO，http://www.jcaho.org/， 2004/05/31。  new window
2.Agency for Healthcare Research and Quality。About AHRQ，http://www.ahrq.gov/， 2004/05/31。  new window
3.National Committee for Quality Assurance。The Health Plan Employer Data and Information Set (HEDISR)，http://www.ncqa.org/Programs/HEDIS/， 2004/05/31。  new window
4.National Committee for Quality Assurance。Accreditation Programs，http://www.ncqa.org/Programs/Accreditation/accreditation.htm， 2004/05/31。  new window
5.台灣醫務管理學會。THIS簡介，http://www.tche.org.tw/this_data/this.htm， 2004/05/31。  new window
6.衛生署中央健康保險局。醫療品質指標資訊，http://www.nhi.gov.tw/02hospital/hospitaL8.htm， 2004/05/31。  延伸查詢new window
7.財團法人醫院評鑑暨醫療品質策進會。醫療品質指標計畫，http://www.tjcha.org.tw/quality/quality.asp， 2004/05/31。  延伸查詢new window
 
 
 
 
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