2012年醫院層級間護理人員缺額補充之比較

Comparison of nursing shortfall and supplement between hierarchical hospitals in 2012

目的：瞭解2012年國內層級醫院間護理人員的缺額補充率是否相同？其缺額補充是否受醫院平均每床護理人數多寡的影響而不同？方法：利用衛生署網路上公佈的各家醫院兩年（2011及2012年底）的護理人員執業登記人數，(1) 探討一年來醫院護理人員的增加率、(2) 單因子變異數分析比較層級醫院間護理人員的年度缺額補充率、(3) 共變數分析檢定層級醫院組內迴歸係數的同質性（即平均每床護理人數與缺額補充率之直線關係，是否隨層級醫院的改變而不同）。結果：層級醫院間護理人員的年度缺額補充率，沒有統計顯著性的差異，平均每床護理人數與層級醫院間呈現交互作用，說明層級醫院間對護理人員的缺額補充，受醫院平均每床護理人數多寡的干擾影響而不同。結論：本研究2012年醫院執登護理人員增加率為0.76%，小於衛生署公佈的增幅。說明衛生署編列專款增加護理師薪水的貢獻與效果之不足，宜更以改善護理師的工作環境及落實合理的醫病照護人床比。

Objectives: To understand whether there is a similar rate of nursing shortfall-and-thensupplement (SATS) between hierarchical hospitals in 2012, and to examine whether the rate is influenced along with the ratio of nurse supply number to hospital eligible beds (NTB). Methods: Data of the registered nurses in hospitals were retrieved from the website of Taiwan government Health Department (DOH) at the end of December in 2011 and 2012, respectively. We computed the increasing rates of nurses in past one year, compare whether any difference in those rates exists between hierarchical hospitals by using one-way ANOVA, and verify the regression slop coefficients of nurse shortfall to predict the SATS rates between hierarchical hospitals are equal by using ANCOVA. Results: No any difference in those SATS rates is found between hierarchical hospitals. The interaction effect between hierarchical hospitals and the NTB ratios was significantly present. Conclusions: The overall SATS rate in 2012 is 0.76% much less than the report released by the DOH. Although the NTB ratios predicting the SATS rates are different between hierarchical hospitals, the results of this study can be further inferred to that the greater SATS rate influenced by the NTB ratios is present in local hospitals when the NTB ratio is in a range of 0.4 and 1.0.