收容人納入健保後醫療滿意度之研究——以矯正署雲林第二監獄為例

A study of NHI Satisfaction for the Inmates－ Taking Yunlin Second Prison, Agency of Corrections, Ministry of Justice as an Example

二代健保在2013年1月1日終於上路，符合四類三目收容人一律納入健保，保費由矯正署編列預算支出，收容人不用繳納健保費，但就醫時須自己負擔掛號費、部分負擔及非健保局給付的藥品及材料費用。本研究的對象以矯正署雲林第二監獄收容人為對象，針對其整體醫療服務內容、看診醫療品質、看診需付掛號費、給藥速度、藥效、不用繳納健保費及醫療浪費等問題進行問卷調查。在納入健保初期的整體醫療服務滿意度，其中非常滿意及滿意為41.4%、沒意見者有48.7%、不滿意及非常不滿意為9.9%。而在健保實施6個月後的整體醫療服務滿意度，其中非常滿意及滿意為44.9%、沒意見者有39.1%、不滿意及非常不滿意為16.0%。在監內看診除了醫療品質有提升外，其他的項目皆朝向負面反應。其原因可能為收容人對健保政策的期待不如預期，健保署引進的醫療資源非醫院自願規劃的，導致醫療資源的量及質皆沒有預期的品質。本研究的對象及提供的醫療服務模式皆侷限於一個矯正機關的模式，時程為6個月的前後變化，有鑑以健保署、醫療院所及矯正機關皆處於磨合期，隨時採取適切的調整，其他矯正機關的醫療服務模式是否也有相同的結果值得更進一步的探討。最後希望藉由此議題能達到拋磚引玉的目標。未來能有更完整性及更全面性的調查。 Second-generation NHI finally hit the road in January 1, 2013, in line with four inmates all three head into health insurance, premiums Correction Department budgeted expenditure, the inmates do not pay health insurance premiums, but the doctor must own the burden of registration fees, part of the burden NHI benefits and non-drug and materials costs. Object of this study was to rectify the Department of Human Subjects Yunlin second prison capacity for its services, quality of care, visits to pay, do not pay health insurance premiums, the rate of administration, efficacy and medical waste and other issues questionnaire. Overall satisfaction with medical services into the initial health insurance, which is very satisfied and satisfied with 41.4%, 48.7% had no opinion were dissatisfied and very dissatisfied 9.9%. In the implementation of the overall health care satisfaction six months later, one of the very satisfied and satisfied with 44.9%, and 39.1% had no opinion were dissatisfied and very dissatisfied 16.0%. In addition to the prison to see the doctor there to enhance the quality of care, other projects are facing a negative reaction. The reason may be as accommodating people looking for health insurance policies as expected, the introduction of the National Health Insurance Agency voluntary non-hospital medical resources planning, resulting in the amount and quality of health care resources are not anticipated quality. The object of this study and medical services provided are limited to model a corrective mode organs, schedule changes before and after six months, in order to have a view of the Department of National Health Insurance, hospitals and correctional institutions in the run-in period are ready to take appropriate adjustment model for other correctional facilities medical services are also worth the same resultsfurther discussion. Lastly, I hope that thisissue can be achieved by better ideas goals. In the future to have more integrity and more comprehensive investigation.