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題名:醫師人力配置評比量表的建立:效度、信度與均等度分析
書刊名:醫務管理期刊
作者:錢才瑋王文中周偉倪 引用關係
作者(外文):Chien, Tsair-weiWang, Wen-chungChou, Willy
出版日期:2009
卷期:10:3
頁次:頁183-200
主題關鍵詞:Rasch分析探索性因素分析醫師人力醫學中心區域醫院Rasch analysisExploratory factor analysisClinical manpowerMedical centerRegional hospital
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(0) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:37
  • 點閱點閱:121
目的:對於醫院間醫師人力之評估與比較,建立一個常模參照的評估平台,以迎合醫院評鑑第8.1.2.2項確保院內必要職系人力配置之足量評估與說明。 方法:本研究擷取衛生署網站的醫事機構開業登記查詢資料,分析全國19家醫學中心及60家區域醫院的醫師人力,利用探索性因素分析及試題反應理論的Rasch模式,分析24個專科醫師的人力供給,建構成一個單向度的測量。 結果:研究發現:(1)國內19家醫學中心及60家區域醫院的內、外、婦、兒科醫師人力佔醫師總數的50%;(2)醫師人力評估量表鑑別醫院相異性的均等度達0.97;(3)有三分之一的區域醫院在醫師人力配置上的表現,達到表現達醫學中心的水準。 結論:醫師人力的評比量表,藉由各醫院登錄在衛生主管機關的資料,轉換成測量值而可以比較醫院間人力的供給水準、配適度Fit統計及均等度指標可以瞭解各項醫事人力供給的形態及趨勢、各醫院在各專科醫師人力供給下的標準化殘差Z分數,可以得知該醫院在該專科醫師供給上的足與不足。
Objectives: To set up a reference norm that compares physician manpower among hospitals, so that each hospital can keep accreditation and maintain sufficient professionals. Methods: We downloaded data from a government website of the physician supply at 79 Taiwanese medical centers and regional hospitals. Then, we used exploratory factor analysis and the Rasch model to examine the underlying unidimensionality of physician manpower characteristics and whether we can establish an appropriate scale that measures individual hospital performance and physician supply. Results: We found that: (1) four classes of physicians (internal, surgery, obstetrics and gynecology, and pediatrics) accounted for 50% of the total number of physicians; (2) the Ferguson discrimination delta for physician supply was 0.97; (3) more than one third of Taiwanese regional hospitals met the criterion of medical centers in terms of physician supply. Conclusions: The 16-item Rasch model can be used to: (1) determine the physician supply among hospitals; (2) determine the distribution and changes of different classes of physicians over time by use of Rasch residual fit statistics and the Ferguson delta coefficient; and (3) investigate the number of specified professionals in each hospital, to determine whether the supply is sufficient, by use of Z-residual score analysis.
Other
1.Recjase MD.(1979)。Unifactor latent trait models applied to multifactor tests results and implications。  new window
期刊論文
1.Likert, Rensis(2001)。A Technique for the Measurement of Attitudes。Archives of Psychology,140(5),1-55。  new window
2.Andrich, D.(1978)。A rating scale formulation for ordered response categories。Psychometrika,43,561-573。  new window
3.Zweig, M. H.、Campbell, G.(1993)。Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine。Clin Chem,39,561-577。  new window
4.林云云(1999)。全民健康保險對醫師專科分布的衝擊。醫院雜誌,32(1),1-16。  延伸查詢new window
5.江東亮(19951000)。臺灣地區的醫師人力政策:1945-1994。中華公共衛生雜誌,14(5),383-391。new window  延伸查詢new window
6.王文中(19970400)。測驗的建構:因素分析還是Rasch分析?。調查研究,3,129-166。new window  延伸查詢new window
7.Schumacker, R. E.、Linacre, J. M.(1996)。Factor analysis and Rasch analysis。Rasch Measurement Transactions,9(4),470。  new window
研究報告
1.台灣醫師公會全國聯合會(2000)。八十八年中華民國台灣地區執業醫師、醫療機構統計。台北:中華民國醫師公會全國聯合會。  延伸查詢new window
圖書
1.Rasch, G.(1960)。Probabilistic models for some intelligence and attainment tests。Copenhagen:The Danish Institute of Educational Research。  new window
2.Wright, B. D.、Masters, G. N.(1982)。Rating scale analysis: Rasch measurement。Chicago:MESA Press。  new window
3.Wright, B. D.、Stone, M. H.(1979)。Best Test Design: Rasch Measurement。Chicago, IL:Mesa Press。  new window
4.Hair, Joseph F. Jr.、Black, William C.、Babin, Barry J.、Anderson, Rolph E.、Tatham, Ronald L.(2006)。Multivariate data analysis。Pearson Prentice Hall。  new window
其他
1.Cooper RA.(2009)。States with more physicians have better-quality health care。  new window
2.Baker TD, Perlman M.(1968)。Health Manpower in a Developing Economy: Taiwan, A Case Study in Planning。  new window
3.江東亮、張媚(1996)。公元2021年台灣地區醫師人力的供給之推計:模型建立與初步結果。  延伸查詢new window
4.何明宗(2009)。台灣地區未來醫師人力供需研究--灰色預測模式之應用。new window  延伸查詢new window
5.醫療品質曁人力監督聯盟(2007)。拜會署長r新制醫院評鑑基準曁評分說明」會議紀錄。  延伸查詢new window
6.楊漢淥、林佩萩(2008)。醫院評鑑作業應簡化了。  延伸查詢new window
7.石美春(2007)。醫學中心任務指標試評。  延伸查詢new window
8.Hankins M.(2007)。Questionnaire discrimination:(re)-introducing coefficient Delta。  new window
9.Hankins M.(2008)。How discriminating are discriminative instruments?。  new window
10.Hankins M.(2008)。Discrimination and reliability: equal partners? Understanding the role of discriminative instruments in HRQoL research: can Ferguson's Delta help? A response。  new window
11.Ferguson GA.(1949)。On the theory of test discrimination。  new window
12.Smith RM.(2000)。Fit analysis in latent trait measurement models。  new window
13.Metz CE(1978)。Basic principles of ROC analysis。  new window
14.Griner PF, Mayewski RJ, Mushlin AI, Greenland P.(1981)。Selection and interpretation of diagnostic tests and procedures。  new window
15.Linacre JM.(2008)。WINSTEPS [computer program]。  new window
16.Lin D, Ruth C, Bruce S, Beichner B.(2006)。Evaluating an electricity and magnetism assessment tool: Brief electricity and magnetism assessment。  new window
17.姚漢禱(2002)。負Alpha信度係數指標在運動技能測驗之研究。new window  延伸查詢new window
 
 
 
 
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