影響臺中海線地區診所醫師加入「家庭醫師整合性照護制度試辦計畫」意願之因素

Factors Associated with Clinic Physicians' Willingness to Participate in 'Family Physician Integration Network Project' of Taichung Coastal Areas

「家庭醫師整合性照護試辦計畫」是最近幾年來衛生署和健保局所推動 的重要衛生政策，也是SARS 以後重要的衛生改革。衛生主管機關希望藉由此 計畫能夠推廣家庭醫師制度，導正民眾就醫用藥行為，推行雙向轉診，使醫 療資源能夠有效的被利用。然而這樣的試辦計畫是否能成功，必須依賴基層 診所醫師的配合，以及地區醫院加入的意願。所以健保局使用了許多獎勵措 施，誘導診所醫師加入此試辦計畫。本研究主要的目的在於找出影響診所醫 師加入此試辦計畫意願之因素，盼能藉研究結果對衛生主管機關提出有效之 建議。 在以臺中海綠地區診所為例，以結構式問卷全面訪問該地區診所（開業）醫師對於家庭醫師試辦計畫的參與意願，結果發現於有效的90 份問卷中， 「家醫計畫政策相關因素」等三個因素和「診所特質」都與樣本診所的醫師加 入「家醫計畫」的意願有關。所以衛生主管機關應當要重視「家庭醫師」的 角色，在政策上更支持這樣的制度，並要扭轉診所醫師對家庭醫師的錯誤觀 念，這樣才可以使「家醫計畫」的推動成功。

Family physician integration network project is the most important health policy in recent years that the Department of Health and Bureau of National Health Insurance have tried to accomplish. This project is also an important improvement in health care after SARS. The DOH wishes that this project may promote the concept of family physicians, change care-seeking behaviors of Taiwanese and accomplish foreword/backward reference. For these purposes, the BNHI has installed many rewarding items for participating clinic physicians and hospitals. The BNHI want to encourage more clinic physicians to sign-in this project. The main purpose of this study is to find out factors which can influence the willingness of clinic physicians to participate in the project. Results of the study will suggest health policymakers useful information to correct shortcomings of the project. After surveying all the clinic physicians in coastal area of Taichung county by a structured questionnaire about their willingness to participate in the project, 'policy related factor' and other two factors and characteristics of clinics were found to have significant influence on physicans' willingness to participate in the project from 90 effective returned questionnaires. Therefore, the authors suggest that health policymakers should put more efforts to support this project and need to change mis-conception of clinic physicians about family physician so that the project may success.