消費者使用品質報告卡之探討－－以美國經驗為例

Exploring Consumers' Use of Report Cards: US Experience as an Example

品質報告卡被歐美健康照護體系所採用己有10年以上的歷史，發行品質報告卡的目的是希望提供民眾選擇醫療服務提供者的參考資訊，同時促進醫療服務提供者改善其醫療服務品質，因此，藉由探討嚴眾使用品質報告卡的情形，即可衡量品質報告卡的推行成效。但至目前為止，品質報告卡對消每陼就醫行為的影響還未定論。在品質報告卡上的品質指標方面，消費者普遍認為病人滿意度為品質報告卡之重要指標。造成消費者不願使用品質報告卡之原因包括品質報告卡中所提供的資訊並非消費者所需的及品質報告卡缺乏標準化的製定標準等八項。消費者最信任由州政府或如消費者團體之非營利性機構來主導品質報告卡的發行。在台灣，全民健康保險已全面實施總額預算制度，如何確保醫療機構提供的醫療品質更是刻不容緩的工作。本文的主要目的在介紹美國消費者使用品質報告卡的經驗。希望藉由介紹品質報告卡，思考可能適合台灣健康照護體系的醫療品質確保方式。

Report cards have been adopted by the US health care system for more than 10 years. The publication of report cards is intended to inform consumers' choice on providers and to improve quality of medical care delivered by providers. Therefore, the performance of report cards can be evaluated by the level of use of report cards by consumers. The performance of report cards is still controversial. As to quality indicators of report cards, consumers generally considered patient satisfaction as one of the important indicators. The barriers to using report cards include indicators not needed by consumers, lack of standardized measurement, etc. The organizations issuing report cards that consumers trust most are state governments and non-profit consumer organizations. It is imperative to assure the quality of medical care under the large-scale implementation of global budgets in Taiwan. The purpose of this article is to introduce consumers' experience with the use of report cards in the US. This can help in developing the most appropriate methods of quality assurance in Taiwan.