遠距醫療實施之關鍵成效因素初探

Exploring the Key Factors that Affect Patient Willingness to Use Telemedicine

目的：衛福部立臺東醫院與高雄長庚紀念醫院於2018年11月首度合作開辦「遠距醫療門診」，以成功分院作為施作地點。但遠距醫療試辦計畫施行至今尚未有進一步的學術研究，因此，本研究以此全國首例之「遠距醫療門診」為研究對象，以問卷發放分析病患願意接受「遠距醫療門診」的關鍵因素及影響因子。方法：本研究為一橫斷式研究，發放問卷回收資料後，以工具變數與最大概似估計法來解決病患內生性選擇的問題，進而探討影響遠距醫療次數之因子與接受遠距醫療的病患其相對一般門診差異的感受程度為何。結果：迴歸分析結果顯示，會診醫師對病患的解釋易懂時，病患會有更高的意願在下一次繼續嘗試遠距醫療。另外，性別為男性且年齡大於60歲以上，對遠距醫療的重複接受意願會更高。而接受遠距門診次數愈多的病患，其愈覺得遠距醫療與一般門診無差異。結論：遠距醫療開辦後對偏鄉地區的醫療資源補充具有正面影響。另一方面，老年人對遠距醫療的需求也相對年輕人來得高，在看診的過程中，若能讓病患覺得遠距與一般門診無差異，就能讓病患更願意接受遠距門診。

Purposes: The Ministry of Health and Welfare Taitung Hospital and Kaohsiung Chang Gung Memorial Hospital jointly launched the first telemedicine outpatient service in November 2018, using the Chenggong branch as the operating site. However, no further academic research has been conducted since the telemedicine pilot program. Therefore, this study took the first telemedicine outpatient service in Taiwan as the research object and used questionnaires to analyze the key factors that affect patients' willingness to use telemedicine outpatient services. Methods: After the questionnaire data were collected, instrumental variables and maximum likelihood estimation methods were used to determine the patient's endogenous choices. The study further investigated the factors that affect the frequency of using telemedicine and whether telemedicine and general outpatient services were perceived by patients as different. Results: Regression analysis results showed that when the consulting doctor's explanations to the patient were easy to understand, the patient had a higher willingness to use telemedicine next time. In addition, if the patient was male or more than 60 years old, the willingness to use telemedicine next time was higher. The more telemedicine patients received, the more they felt that there was no difference between telemedicine and general outpatient services. Conclusions: The implementation of telemedicine services improves the medical resources in rural areas. In addition, the demand for telemedicine is higher in older adults compared with younger people. If patients feel that there is no difference between telemedicine and general outpatient services during the diagnosis process, they will be more willing to accept the former.