影響醫院導入全民健保「電子化醫療影像專業審查系統」之相關因素

The Influential Factors to Hospital's Implementation in Digitized Medical Image Claim System in National Health Insurance

背景：中央健康保險局為因應電子化政府時代來臨，以增進審查效率，降低行政作業成本並提升整體服務品質，規劃以「電子化醫療影像專業審查系統」（含資料及影像）替代繁複的人工作業流程，本研究目的欲瞭解醫院使用該電子化審查作業之意願及現況，並進一步探討影響醫院導入之相關因素。方法：本研究為一橫斷性研究，研究對象為453家評鑑等級為地區醫院（含）級以上醫院，研究工具採自填式結構性問卷，問卷內容在經過效度及信度檢定後進行測試，調查期間為96年4月20日至96年6月15日，共計回收152份有效問卷，回收率33.55％。結果：「醫院組織」因素與(p< 0.05)「科技認知」因素(p< 0.01)會影響醫院「電子化醫療影像專業審查系統」導入意願，其中高階主管支持(p< 0.001)、使用者參與(p< 0.001)、知覺有用性(p< 0.01)、易用相容性(P< 0.01)、成本負擔(p< 0.01)等均為重要變項。結論：醫院導入系統之意願(Odds Radio = 6.475)以及醫院有無PACS設備(Odds Radio = 14.695)，為醫院實際採用「電子化醫療影像專業審查系統」之顯著變項，此一結果值得中央健康保險局加以重視。

Background: The electronic government era already approached, the bureau of National Health Insurance has implemented and promoted the 'Digitized Medical Image Claim System' in order to reduce the administrative cost and improve medical quality and efficiency. This research purposes includes understanding the intention, system adoption situation, and influential factors to hospital. Methods: This research adopts cross-sectional approach. The research subjects are 453 contracted medical care institutions with the evaluated level as district hospital and above. The research tool is structured questionnaire. The questionnaire was put to test in the period of April 20, 2007 to June 15, 2007, after verifying validity and reliability. Total of 152 valid questionnaires were retrieved and the response rate was 33.55%. Results: The result showed that 'medical institution' (p< 0.05) and 'technological cognition' (p< 0.01) would affect the hospital's will in implementing the 'Digitized Medical Image Claim System.' Top and middle management's support (p< 0.001, users' participation (p<0.001), perceived usefulness (p< 0.01), ease-of-use compatibility (p< 0.01), and cost (p< 0.01) were crucial variables in these factors. Conclusions: What's noticeable was that system implement intention (Odds radio= 6.475) and hospital possession of PACS facility (Odds Radio= 14.695) were the significant variables regarding hospital's actual adoption of the 'Digitized Medical Image Claim System.' This result is worthy of the attention from the bureau of National Health Insurance.