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題名：醫療品質管理及門診服務品質定性指標
書刊名：中華公共衛生雜誌
作者：韓揆
出版日期：1994
卷期：13:1
頁次：頁35-53
主題關鍵詞：Medical care quality；Hospital administration；Ambulatory care
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(27) 博士論文(4) 專書(0) 專書論文(1)
  • 排除自我引用排除自我引用:27
  • 共同引用共同引用:0
  • 點閱點閱:56
　　　　　經濟愈發達，民眾愈重視醫療權益，全民健保實施後，就醫之經濟障礙排除，病人之注意力將轉向品質訴求。唯臺灣文化不同於歐美，臺灣醫師團體甚少從事品質建設或自律，民間不得不仰仗公權力執行權益保障，將來品質保證或提升工作不可避免要由醫療體系或醫院行政當局扮演重要角色。最近一項調查也顯示醫院有意推行品質管制活動，但缺乏對品質的了解及工作範例，因此加強醫院主管，包括醫師對品質之認識有其必要。醫療品質形式易懂，其實頭緒紛繁，醫師及行政工作者對其涵義及管理每多歧見，可能也是難以進行之原因。本文著者試圖從浩瀚文獻及實務資料中，以適當篇幅探索醫療品質之內容及管理問題，並藉在臺大醫院工作體驗及參酌全省其他醫院狀況，採用“專職團體腦力激盪研究法”開發了一套整體評估門診服務品質的定性指標，另將管理工作上慣用的表式作業概念化，成為一個模型，以容納這一指標，希望能幫助有志者對醫療品質之涵義及其管理問題快速進入精況或加深了解。關於門診評估指標模型，則可供醫院試用或供研究者進一步發掘。
　　　　　Medical quality is a term not clearly defined. According to a survey by the National Defence Medical Center, ROC, hospital administrators were enthusiastic for applying quality assurance programs, but had difficulties to implement them owing to the lack of knowledge pertaining both the reality of medical quality practice and the means to select proper indicators for implementation. This paper in one hand, after reviewing literatures and the nature of hospital care, abridged and explained the various aspect of medical care quality and management problems; on the other hand, after utilizing a large hospital's data and using the nominal group brainstorming technique, developed a set of qualitative indicators and a tabulation model for the sake of reviewing hospital OPD services. It is hoped that this exploration and the model indicators can help the health care administrators more accessible in embracing the concept of medical care quality and in conducting their management programs.
期刊論文
1.謝淑美(19810100)。醫療服務與醫療行為之研究。公共衛生，7(4)，373-391。  延伸查詢new window
2.Flanagan, E.(1985)。Indicators of quality in ambulatory care。QRB，11，136-137。  new window
3.Freeborn, D. K.、Greenlick, M. R.(1975)。Evaluation of the performance to ambulatory care system: Research requirement and opportunities Supplement。Medical Care，11，68-75。  new window
4.Dubois, R. W.、Brook, R. H.(1988)。Assessing clinical decision making: Is the ideal system feasible?。Inquiry，25，59-64。  new window
5.Winchester, D. P.(1990)。The assurance of quality care for the cancer patient。Cancer，65(3)，776-779。  new window
6.Lehmann, R.(1989)。Forum on clinical indicator development: A discussion of the use and development of indicators。Quality Review Bulletin，15(7)，223-227。  new window
7.Caper, P.(1988)。Defining quality in medical care。Health Affairs，7，46-61。  new window
8.Iglehart, J. K.(1987)。Congress moves to Bolster Peer Review: The health care quality improvement act of 1986。NEJM，316，960-964。  new window
9.Ikegami, N.、Goldsmityh, S. B.(1985)。Quality circles: the reality and myth of hospital management。HCMR，10(3)，45-53。  new window
10.Bradford, M.、Flynn, N. M.(1988)。Ambulatory care infection control quality assurance monitoring。American J. of Infection Control，16(1)，21-28。  new window
11.Bevsek, S. A.(1990)。Motivation and sustaining, commitment to quality assurance。J of Nursing Quality Assurance，4(2)，28-36。  new window
12.Burgner, M.(1981)。The sickness profile: Development and final revision of a health status measure。Med Care，14(8)，787-806。  new window
13.Omachonu, V. K.(1990)。Quality of care and the patients: New criteria for evaluation。Health Care Management Review，15(4)，43-50。  new window
14.Zeithaml, V. A.(1988)。Communication and control process in the delivery of service quality。Journal of Marketing，52(2)，35-48。  new window
15.JCAHO(1989)。Patient care quality defined。Joint Commission Perspectives，7-9。  new window
16.Moreu, F.(1989)。Implementation of a quality assurance program in a university hospital。Aust Clin Sev，9，65-70。  new window
17.Donabedian, A.(1987)。Commentary on some studies of the quality of care。Health care financing review，annual supplement，75-85。  new window
18.Palmer, R. H.、Nesson, H. R.(1982)。A review of methods for ambulatory medical care evaluations。Medical Care，10(8)，758-781。  new window
19.Casanova, J. E.(1990)。Status of quality assurance programs in American hospitals。Med Care，28(11)，1104-1109。  new window
20.Fifer, W.(1981)。Cost/Quality tradeoffs will be the next medical care crisis。Hospitals，55，56-59。  new window
21.Gleming, S. T.(1990)。The relationship between the cost and quality of hospital care: A review of the literature。Med Care Rev，47(4)，487-502。  new window
22.Dale, N.(1981)。Hospitals and PSROs: Can quality complete with cost?。Quality Review Bulletin，7(11)，2-3。  new window
23.Gonnela, J. S.(1990)。The problem of late hospitalization: A quality and cost issue。Academic Medicine，65(5)，314-319。  new window
24.Flood, A. B.(1984)。Does practice make perfect?。Med Care，22，98-114。  new window
25.Hughes, R. G.(1987)。Effects of surgeon volume and hospital volume on quality of care in hospitals。Med Care，25(6)，489-503。  new window
26.Sisk, J. E.(1990)。Assessing information for consumers on the quality of medical care。Inquiry，27(3)，263-272。  new window
27.Palmer, R. H.(1979)。Individual and institutional Variables which may serve as indicator of quality of medical care。Med Care，17(7)。  new window
28.Benson, D. S.(1986)。The QIP form: The one-page quality assurance tool。QRB，12(3)，87-89。  new window
29.石曜堂(19780800)。醫療品質評估。醫院，11(2)，106-109。  延伸查詢new window
30.Kane, R. L.(1981)。Utilization review in nursing homes: Making implicit level-of-care judgments explicit。Med Care，19，3-13。  new window
31.Billmeyer, D. K.(1986)。Quality of care。JAMA，256(8)，1032-1034。  new window
32.Bennett, W. G.(1989)。Quality assurance in ambulatory care。Academic Medicine，64(Supplement)，22-27。  new window
33.Hopkins, C. E.(1975)。Quality of medical care: A factor analysis approach using medical records。Health Serv. Research，10，119-208。  new window
34.Tarlov, A. R.(1989)。The medical outcome study: An application of methods for monitoring the results of medical care。JAMA，262(7)，925-930。  new window
會議論文
1.Bennett, I. L.(1982)。Quality assurance in hospitals。The International conference on quality assurance in medicine。Taipei。173-179。  new window
2.Pierson, R. N.(1982)。Quality assurance in medical practice。The International Conference on Quality Assurance in Medicine。Taipei。180-186。  new window
3.Cappiello, J. L.(1992)。Introduction to Continuous quality improvement。Symposium on Hospital quality assurance。Taipei：National Defence Medical Center。  new window
4.Palmer, R. H.(1991)。Considerations in defining quality of health care。Health Administration Press。3-58。  new window
5.陳維昭(1992)。臺大醫院門診醫療品質管理。醫院醫療品質保證研討會。國防醫學院。  延伸查詢new window
研究報告
1.國防醫學院(1991)。建立我國醫院醫療品質保證計劃模式之研究。  延伸查詢new window
2.行政院衛生署(1982)。公立醫院業務改革設計研究報告。臺北。  延伸查詢new window
3.韓揆(1992)。臺北市立醫院分科病人住院日之研究。  延伸查詢new window
4.City Government of Quebec(1970)。The health plan。  new window
5.行政院衛生署(1988)。省市（縣市）立醫院業務年報。  延伸查詢new window
圖書
1.Donabedian, A.(1980)。Explorations in quality assessment and monitoring。Health Administration Press：University of Michigan。  new window
2.Charns, M. P.、Schaeffer, M. J.(1983)。Health care organizations: A model for management。Prentice-Hall, Inc.。  new window
3.Somers, A. R.、Somers, H. M.(1977)。Health and health care: Policies in perspective。Germantown, MD：Aspen Systems Co.。  new window
4.Berwick, D. M.(1991)。Curing health care: New strategies for quality improvement。Jossey-Bass Publishers。  new window
5.Rowland, B. S.、Rowland, B. L.(1990)。Ambulatory care quality care assurance manual。Maryland：Aspen Publication。  new window
6.Plsck, P. E.(1989)。Quality improvement tools。Wilton, Conn.：Juran Institute, Inc.。  new window
7.Smith, L. K.(1992)。Overview of the ten process. Symposium on Hospital Quality Assurance。Taipei：National Defence Medical Center。  new window
8.Luke, R. D.(1983)。Organization and change in health care quality assurance。Maryland：Systems Corporation。  new window
9.DHEW(1966)。Hill-Burton Program (1944-1966): Two decades of partnership for better patient care。PHS Publication。  new window
10.Kasten, B. L.、Suleski, A. V.(1986)。Physicians and Medical Service DRG handbook。Stow, Ohio：Robinson Memorial Hospital, Lexi-Comp Inc.。  new window
11.James, E.(1984)。Assessing quality circles in health care settings: A guide for management。Chicago, Illinois：American Hospital Publishing Inc.。  new window
12.Crosby, P. B.(1979)。Quality is free。New American Library。  new window
13.Walton, M.(1986)。The Denning Management Method。NY：Putman。  new window
14.Demings, W. E.(1986)。Out of the crisis。Cambridge, Massachusetts：MITCAES。  new window
15.鄒濟勳、韓揆(1986)。建立我國醫院評鑑制度之研究（行政管理部分）。行政院衛生署。  延伸查詢new window
16.Starr, Paul(1982)。The Social Transformation of American Medicine。New York：Basic books。  new window
17.Imai, M. K.(1986)。The key to Japan's Competitive success。NY：Random House。  new window
18.Feigenbaum, Armand Vallin(1983)。Total quality control。McGraw-Hill。  new window
其他
1.謝炎堯(19930916)。電腦斷履描勞保使用率偏高有緣由。  延伸查詢new window
 
 
 
 
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