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題名:健保總額預算影響醫療工作感受量表之設計及信效度評估
書刊名:醫務管理期刊
作者:史麗珠劉孟茹張薰榕鄭秀貴沈昱名
作者(外文):See, Lai-chuLiu, Meng-juChang, Hsun-jongCheng, Hsiu-kueiShen, Yu-ming
出版日期:2009
卷期:10:1
頁次:頁36-47
主題關鍵詞:健保總額預算工作感受醫療人員信效度Global budgetWork perceptionMedical workersValidity and reliability
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(2) 博士論文(1) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:0
  • 共同引用共同引用:128
  • 點閱點閱:46
目的:自2000年健保施行總額預算後,少有探討醫療人員對健保總額預算影響醫療工作感受,也沒有這方面的量表。因此,本研究設計一份「健保總額預算影響醫療工作感受量表(WPGB)」,並進行信效度的評估,以利後續研究。 方法:WPGB題目的訂定是參考相關文獻、訪談及觀察,包括9個問題(健保施行總額預算前後的工作量、工作時間、人力調整、文書處理量、薪水、醫藥物品的運用、工作流程、醫療品質、與病人關係)。之後採專家效度、建構效度之假說驗證、內在一致性、再測信度評估WPGB的信效度。 結果:13位專家對WPGB的內容效度指標(CVI)平均值爲83%,在55-100%間。邀請北部某醫院的醫療人員填寫問卷,有效問卷348份,回收率爲48.3%。以工作滿意度(中文版職業壓力指標第二版(OSI-2))來評估建構效度之假說驗證,結果相關係數r爲-0.35,達顯著意義。24位醫療人員兩週內填寫WPGB兩次,再測信度ICC=0.78。 結論:我們設計的WPGB具良好的內容效度、建構效度的假說驗證及兩週的再測信度。期望WPGB廣泛被採用,共同探討健保總額預算對醫療工作影響的課題,研究結果也能互相比較。
Objectives: Since 2000, the payment system of global budget (GB) has been included in Taiwan National Health Insurance, but no study has been conducted to investigate work perception about global budget for medical employees (WPGB), and no questionnaire to measure WPBG has been available. Therefore, we aimed to design a questionnaire to measure medical employees' perceptions of their work tasks before and after implementation of GB so that further study of WPGB could subsequently be conducted. The validity and reliability of the WPGB questionnaire were evaluated. Methods: The WPGB questionnaire was based on literature review, interviews, and observation and consisted of nine questions on the following topics: workload, working hours, manpower, paperwork, salary, medical resources, working procedure, treatment quality, and relationship with patients before and after GB. Expert validity, hypothesis testing of construct validity, internal consistency, and test-retest reliability of the WPGB questionnaire were evaluated. Results: The mean content validity index of the WPGB questionnaire for 13 experts was 83%, with a range of 55% to 100%. A total of 384 medical employees (response rate, 48.3%) at one hospital in northern Taiwan participated in the study. Regarding hypothesis testing of construct validity, the correlation coefficient between WPGB and job satisfaction in the second version of the occupational stress index (OSI-2) was -0.35 and reached statistical significance. Another 24 people from the same hospital completed the WPGB questionnaire twice in 2 weeks, and the reliability intraclass correlation coefficient was 0.78. Conclusion: The content and hypothesis testing of construct validity and test-retest reliability of the WPGB questionnaire are acceptable. We welcome other researchers to use the WPGB questionnaire and evaluate the findings on the same basis.
期刊論文
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8.張育嘉、黎伊帆、汪芳國、鄭守夏(20060400)。全民健保實施總額預算制度之初步影響評估:以牙醫與西醫基層為例。臺灣公共衛生雜誌,25(2),152-162。new window  延伸查詢new window
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10.陸洛、李惠美、謝天渝(20050900)。牙醫師職業壓力與身心健康及職業倦怠之關係:以高雄市牙醫師為例。應用心理研究,27,59-80。new window  延伸查詢new window
11.張益誠、廖宏恩(20021000)。西醫基層診所實施總額預算前後之價量變化--以臺灣北部地區西醫基層診所為例。臺灣公共衛生雜誌,21(5),363-372。new window  延伸查詢new window
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圖書
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2.Polit, D. F.、Hungler, B. P.(1995)。Nursing research: Principles and methods。Philadephia:J. B. Lippincott。  new window
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3.楊思標(2004)。對台灣現行醫療體制及生態之反思--全民健保時代的醫療倫理。  延伸查詢new window
4.梁亞文、洪錦墩(2005)。歐洲各國總額預算支付制度之跨國比較--以德國、英國與荷蘭爲例。  延伸查詢new window
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7.李逸(2004)。公衛科護理科人員工作壓力感受因應策略與壓力結果之探討--以互動型工作壓力模式爲架構。new window  延伸查詢new window
8.Santos JRA.(1999)。Cronbach's Alpha: A Tool for Assessing the Reliability of Scales。  new window
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