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來源文獻資料
摘要
外文摘要
引文資料
題名:
外科醫師學習效果之分析--兼論工作地點移轉對於醫師學習之影響
書刊名:
農業與經濟
作者:
簡毓寧
/
陸怡蕙
作者(外文):
Chien, Yu-ning
/
Luh, Yir-hueih
出版日期:
2014
卷期:
52
頁次:
頁81-112
主題關鍵詞:
外科醫師
;
學習效果
;
全子宮切除手術
;
工作地點移轉
;
Surgeons
;
Learning effect
;
Hysterectomy
;
Workplace switching
原始連結:
連回原系統網址
相關次數:
被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
排除自我引用:0
共同引用:0
點閱:9
本研究使用1997-2008年之全民健保資料,以罹患子宮肌瘤並進行剖腹式子宮全切除手術之台灣婦女作為研究對象,探討外科醫師手術量與手術績效之關聯,並著眼於轉院醫師與非轉院醫師的差異性探討,以及層級別與移轉前後之學習速度變化。研究結果顯示轉院醫師與非轉院醫師皆呈現顯著之正向學習,且兩類醫師之學習速度在移轉之前並無顯著差異。此外,不僅外科醫師之學習速度會因醫院層級不同而有所差異,轉院醫師在進行層級間的移轉時,層級變化對於醫師的學習速度亦產生增強的效果;不過,移轉之後呈現顯著學習效果差異者,僅侷限於向上層級移轉(區域醫院轉至醫學中心,抑或是地區醫院轉至區域醫院或醫學中心)的醫師。
以文找文
Drawn from Taiwan's National Health Insurance Database (NHID), data with inpatients underwent the uterine-leiomyoma-causing hysterectomy surgery during 1997-2008 are used to evaluate the association between surgical volume and outcome. We focus on examining the volume-outcome relationship from two distinct perspectives. The first involves the learning differences between switching and non-switching surgeons. The second concerns switching surgeons' mean differences in learning rate during the pre- and post-switching periods. Our result confirms the persistence of performance improvement as surgeons' trials accumulate, but find no significant learning differences between the non-switching and switching surgeons evaluated at the pre-switching period. Furthermore, in addition to hospital accreditation, an upward switching such as from the regional hospitals into the medical centers and from the district hospitals into the regional hospitals or medical centers, are found to explain the variations in learning rates among hysterectomy surgeons.
以文找文
期刊論文
1.
Contreras, J. M.、Kim, B.、Tristao, I. M.(2011)。Does Doctors' Experience Matter in Lasik Surgeries?。Health Economics,20,699-722。
2.
David, G.、Brachet, T.(2009)。Retention, Learning by Doing, and Performance in Emergency Medical Services。Health Services Research,44,902-925。
3.
Finlay, K.、Magnusson, M. L.(2009)。Implementing Weak-Instrument Robust Tests for a General Class of Instrumental-Variables Models。The Stata Journal,9,398-421。
4.
Gowrisankaran, G.、Town, R. J.(1999)。Estimating the Quality of Care in Hospitals Using Instrumental Variables。Journal of Health Economics,18,747-767。
5.
Groysberg, B.、Lee, L. E.、Nanda, A.(2008)。Can They Take It With Them? The Portability of Star Knowledge Workers' Performance。Management Science,54(7),1213-1230。
6.
Hockenberry, J.、Lien, H. M.、Chou, S. Y.(2008)。The Impacts of Task Repetition and Temporal Breaks in Production on Human Capital and Productivity。Journal of Human Capital,2,303-335。
7.
Huesch, M. D.(2009)。Learning by Doing, Scale Effects, or Neither? Cardiac Surgeons after Residency。Health Services Research,44,1960-1982。
8.
Kc, D. S.、Staats, B. R.(2012)。Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon Performance。Manufacturing & Service Operations Management,14,618-633。
9.
Luh, Y. H.、Huang, F. M.、Chien, Y. N.、Lo, C. C.。Organizational Learning Differences in Healthcare Services: The Case of Medical Centres in Taiwan。Applied Economics,44,695-706。
10.
Sfekas, A.(2009)。Learning, Forgetting, and Hospital Quality: An Empirical Analysis of Cardiac Procedures in Maryland and Arizona。Health Economics,18,697-711。
11.
Tsai, A. C.、Votruba, M.、Bridges, J. F.、Cebul, R. D.(2006)。Overcoming Bias in Estimating the Volume-Outcome Relationship。Health Services Research,41,252-264。
12.
Wang, J.、Hockenberry, J.、Chou, S. Y.、Ya, M.(2011)。Do Bad Report Cards Have Consequences? Impacts of Publicly Reported Provider Quality Information on the Cabg Market in Pennsylvania。Journal of Health Economics,30,392-407。
13.
Whiteman, M. K.、Hillis, S. D.、Jamieson, D. J.、Morrow, B.、Podgomik, M. N.、Brett, K. M.、Marchbanks, P. A.(2008)。Inpatient Hysterectomy Surveillance in the United States, 2000-2004。American Journal of Obstetrics and Gynecology,198,34.el-34.e7。
14.
Luft, H. S.、Hunt, S. S.、Maerki, S. C.(1987)。The Volume-outcome Relationship: Practice-Makes-Perfect or Selective-Referral Patterns?。Health Services Research,22,157-182。
15.
Lien, H.-M.、Chou, S.-Y.、Liu, J.-T.(2008)。Hospital Ownership and Performance: Evidence from Stroke and Cardiac Treatment in Taiwan。Journal of Health Economics,27(5),1208-1223。
16.
Halm, E. A.、Lee, C.、Chassin, M. R.(2002)。Is Volume Related to Outcome in Health Care? A Systematic Review and Methodologic Critique of the Literature。Annals of Internal Medicine,137(6),511-520。
17.
Huckman, R. S.、Pisano, G. P.(2006)。The Firm Specificity of Individual Performance: Evidence from Cardiac Surgery。Management Science,52,473-488。
18.
Pisano, G. P.、Bohmer, R. M.、Edmondson, A. C.(2001)。Organizational differences in rates of learning: Evidence from the adoption of minimally invasive cardiac surgery。Management Science,47(6),752-768。
19.
Begg, C. B.、Cramer, L. D.、William, J. H.、Brennan, M. F.(1998)。Impact of hospital volume on operative mortality for major cancer surgery。JAMA,280,1747-51。
20.
Farley, D. E.、Ozminkowski, R. J.(1992)。Volume-outcome relationships and in-hospital mortality: the effect of changes in volume over time。Medical Care,30,77-94。
21.
Luft, H. S.、Bunker, J. P.、Enthoven, A. C.(1979)。Should Operations Be Regionalized? The Empirical Relation between Surgical Volume and Mortality。The New England Journal of Medicine,301,1364-1369。
22.
Dokko, G.、Wilk, S. L.、Rothbard, N. P.(2009)。Unpacking prior experience: How career history affects job performance。Organization Science,20,51-68。
會議論文
1.
蔡偉德、李淑芬(2009)。總額支付制度降低醫療服務品質?。第十屆全國實證經濟學論文研討會。嘉義:國立中正大學。
延伸查詢
研究報告
1.
Ramanarayanan, S.(2006)。Does Practice Make Perfect: An Empirical Analysis of Learning-By-Doing in Cardiac Surgery?。
學位論文
1.
江尚峰(2010)。服務量對醫療結果的影響--以台灣的肝癌病患為例(碩士論文)。國立中央大學。
延伸查詢
圖書
1.
Greene, William H.(2012)。Econometric Analysis。Essex, UK:Pearson Education Limited。
2.
Gujarati, D. N.、Porter, D. C.(2009)。Basic econometrics。New York:McGraw-Hill。
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外科醫師學習效果再探討─工作地點移轉、先前經驗與醫師學習適應期之研究
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外科醫師學習效果再探討─工作地點移轉、先前經驗與醫師學習適應期之研究
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