總額預算支付制度對西醫師執業行為之影響──以六所區域級以上醫院為例

The Impact of Global Budget System on Pysicians' Behavior - An Example of Six Hospitals in Taiwan

本研究目的在於探討實施總額預算支付制度後西醫師執業行為之影響情 形。研究對象為2002 年台灣六所區域級以上醫院八個專科的西醫主治醫師， 依醫院別、科別進行分層隨機抽樣，共抽出240 位西醫師為樣本。 本研究採自行設計之結構式問卷，以訪視方式進行資料之蒐集：結果顯 示如下：西醫師在看診績效層面之執業行為，多數之西醫師皆沒有改變；而 在看診態度層面之執業行為，多數之西醫師皆有正面的影響。另外；年齡、 執業場所、每週平均看診人數、與每週看診診次等變項與看診績效之關像有 顯著差異。年齡、執業場所、執業總年資、每週平均看診人數、與每週看診 診次等變項與看診態度之關僻、則有顯著差異。

The purpose of the study is to probe the impact of implementing Global Budget System (GBS) on physicians' behavior in Taiwan. The population in this study consisted of all physicians at two academic hospitals and four regional hospitals in Taiwan. The total sample size was 240 medical doctors from eight clinical departments at six hospitals. The data was collected from February 2003 to March 2003. The research instrument was a self-developed constructive questionnaire. Important findings of the study included that most physicians did not change their clinical care performance after the implementation of GBS and that most felt GBS had positive effects on clinical care attitude. However, the study did find the physicians' behavior after the introduction of GBS was affected by the variables of age, type of hospital, years in practice, average weekly number of outpatients and weekly number of clinical care patients.