台灣衛生所網路使用及資訊需求

The Internet Usage and Information Needs of Health Station in Taiwan

本研究執行於民國八十六年以及民國八十九年，針對全國369間衛生所主任共寄出兩次匿名之自填式問卷，調查衛生所主任有關網路使用需求，以及對於網路繼續教育的接受度及影響因素。各回收有效問卷總計157份與114份，回覆率分別佔42.5%與30.9%。研究結果顯示：使用網際網路的衛生所主任醫師比率三年之間已有明顯增加之情形，由29.3%上升至79.0%(x2=65.12, p<0.001)。使用網路的醫師於第一次調查有70%有固定上網的習慣，第二次調查增加為82%。使用網路的目的主要是為了獲得資訊，其次為與非醫療人員通訊，再次為執行醫療業務。經常利用的網路資源有全球資訊網，電子郵件、文獻或資料檢索等。認為目前工作型態需要使用網際網路的比率有增加之趨勢，兩次調查分別為40.9%與63.4%(x2=14.33, p=0.001)。而使用網路的主要障礙從不知如何學習入門轉變為連線費用。影響衛生所主任參加繼續教育課程的主要原因為時間及地點的方便性以及課程內容是否實用。有75%的衛生所主任願意利用網路通訊參加醫師繼續教育。近60%的衛生所主任願意利用網路通訊轉診或照會病人。影響使用網路通訊參加醫師繼續教育或轉診照會的主要因素：近60%的醫師認為可以節省時間、不用到很遠的地方，有約30%的醫師認為軟硬體是否容易學、方便使用，10%為費用。參加網路通訊教育的意願和目前有無使用網路、距離繼續教育課程場所遠近以及年齡均有相關，目前有使用網路者、距離愈偏遠的地區以及年齡層越年輕者願意參加網路通訊教育的意願愈高(P<0.05)。本研究認為，有愈來愈多的衛生所主任利用網際網路，而連線費用則為其是否經常上網之主要考量。多數醫師認為透過遠距通訊可以提高參加繼續教育課程與轉診病人的意願。網際網路服務應該更有效率與改進操作的方便性，以增加使用者付費的意願。因此，若要鼓勵衛生所主任上網接受繼續教育，或是辦理公務如：轉診照會以加強為民服務，可考慮給予部分補助，並於繼續教育課程中提供網路通訊學習的機會。 A structured anonymous questionnaire was sent to the physicians of 369 health stations in Taiwan in May 1997, and June 2000. 157 (42.5%) and 114 (30.9%)questionnaires were valid for analysis respectively. The results revealed the Internet users among health station physicians grow dramatically from 29.3% to 79.0%(x=65.12，p<0.001) in three years. Among the users, 70% in 1997, while 82% in 2000, hooked up Internet regularly. The major purposes of using Internet were: to obtain medical and non-medical information, to communicate with non-medical personnel, and to perform medical practice. The Web, E-mail, and Medline were the most popular services. The persons who believed it was necessary to access Internet in medical practice increased from 40.9% to 63.4% (x=14.33, p = 0.001). The major barrier of using Internet was lacking of instructions in 1997, while in 2000 became the high connecting fee. The major barrier of attending CME courses was the distance to travel. There were 75% respondents willing to obtain CME through Internet, while 60% would like to refer cases through telecommunication. The factors affecting the willingness of using Internet CME or tele-consultation were: time-saving (about 60%), user-friendly software and hardware (about 30%), and the cost (about 10%). The attitude of attending Internet CME was highly correlated with the distance to travel (p<0.01) in 1997's survey. The older the physicians were, the less willing to attend Internet courses (p<0.05). The results of this study suggest there are more and more health station physicians accessing to Internet and the high connecting fee becomes the major barrier. Most of the physicians believe it is beneficial to attend Internet CME or refer cases through telecommunication. Internet services should be efficient and user-friendly therefore the users are willing to pay the cost. To promote health care quality of rural areas, the government should assist the payment of connecting fee and encourage medical Internet services.

A structured anonymous questionnaire was sent to the physicians of 369 health stations in Taiwan in May 1997, and June 2000. 157 (42.5%) and 114 (30.9%)questionnaires were valid for analysis respectively. The results revealed the Internet users among health station physicians grow dramatically from 29.3% to 79.0%(x=65.12，p<0.001) in three years. Among the users, 70% in 1997, while 82% in 2000, hooked up Internet regularly. The major purposes of using Internet were: to obtain medical and non-medical information, to communicate with non-medical personnel, and to perform medical practice. The Web, E-mail, and Medline were the most popular services. The persons who believed it was necessary to access Internet in medical practice increased from 40.9% to 63.4% (x=14.33, p = 0.001). The major barrier of using Internet was lacking of instructions in 1997, while in 2000 became the high connecting fee. The major barrier of attending CME courses was the distance to travel. There were 75% respondents willing to obtain CME through Internet, while 60% would like to refer cases through telecommunication. The factors affecting the willingness of using Internet CME or tele-consultation were: time-saving (about 60%), user-friendly software and hardware (about 30%), and the cost (about 10%). The attitude of attending Internet CME was highly correlated with the distance to travel (p<0.01) in 1997's survey. The older the physicians were, the less willing to attend Internet courses (p<0.05). The results of this study suggest there are more and more health station physicians accessing to Internet and the high connecting fee becomes the major barrier. Most of the physicians believe it is beneficial to attend Internet CME or refer cases through telecommunication. Internet services should be efficient and user-friendly therefore the users are willing to pay the cost. To promote health care quality of rural areas, the government should assist the payment of connecting fee and encourage medical Internet services.