| 中文摘要 |
隨著醫療科技的轉變及新興疾病的不斷增加，International Classification of Diseases, Ninth Revision, Clinical Modification（ICD-9-CM）編碼系統已無法符合現今醫療照護資料分類需求。因此，中央健康保險署於2016年元旦起，門、住、急診、診斷及處置代碼全面實施International Statistical Classification of Disease and Related Health Problems Tenth Revision Clinical Modification／Procedure Coding System（ICD-10-CM／PCS）。國內各家醫院為能精確進行疾病分類編碼及及時申報，紛紛導入ICD-10-CM／PCS編碼資訊系統。但回顧過去文獻對於ICD-10-CM／PCS編碼資訊系統使用行為之研究相當缺乏，回顧過去研究主要以ICD-10-CM／PCS編碼之規則介紹或是醫院對ICD-10-CM／PCS的策略觀點為主要考量。有鑑於此，本研究以資訊系統接受後持續使用模型及任務－科技適配理論為理論基礎，建立並驗證疾病分類人員對ICD-10-CM／PCS編碼資訊系統之使用行為。因此，本研究採問卷調查法，針對有導入ICD-10-CM／PCS編碼資訊系統的醫院疾病分類人員為研究對象進行問卷調查，再以結構方程模式來驗證假說。研究結果顯示任務―科技適配度及資訊品質對確認有顯著影響，任務－科技適配度及確認對知覺有用性有顯著影響，系統品質及服務品質對確認無顯著影響，確認及知覺有用性對滿意度有顯著影響，知覺有用性及滿意度對持續使用意圖有顯著影響。期望本研究成果能作為政府機關、醫院與資訊業對ICD-10-CM／PCS編碼資訊系統執行與管理策略之參考，並增益學術界對ICD-10-CM／PCS編碼資訊系統使用行為之相關研究。
In order to make our clinical disease classification catch up with the world trend, the National Health Insurance Administration under Ministry of Health and Welfare announced that International Classification of Disease, 10th Revision, Clinical Modification/Procedure (ICD-10-CM/PCS) coding system was to be implemented thoroughly starting from January 1, 2016 for its routine calculation of medical expenses. ICD-10-CM/PCS is vastly different from ICD-9-CM which had been used in current healthcare systems. Therefore, such implementation would cause heavy impact on the information system and coders at the hospital alike. The purpose of this study is to look into the post-acceptance model of information system continuance and the theory of task-technology fit (TTF) to evaluate a behavioral model of intention to use the new coding system. Questionnaires were systematically distributed to the coding staff with experiences of using ICD-10-CM/PCS coding information system at hospitals. The result showed that the task-technology fit and information quality had strong predictive powers in explaining confirmation. The data showed that task-technology fit and confirmation were keys to perceived usefulness. Both confirmation and perceived usefulness were found to have a significant impact on satisfaction. The end results showed that continuance usage was positively influenced by perceived usefulness and satisfaction, and integration of the post-acceptance model of information system continuance with the theory of TTF was helpful in understanding the continual usage behavior of the coding staff. The implications of these findings are discussed, and relevant managerial guidelines are presented. |
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