醫院精神病患轉床醫療決策制定之研究

A Study on the Medical Decision Making of Transferring Patients in Psychiatric Wards

一般大型醫院的病床資源有限，當面對眾多須住院的病患時，普遍存在著病床分配的問題，例如不該佔床的病患佔用寶貴的病床資源，但對於應該立即接受治療的病患卻無法立刻分配到病床。而病床的周轉率與醫院轉床醫療決策有著密不可分的關係，對決策者而言，病床的分配實為一複雜的問題，本研究擬運用決策分析技術，透過層級分析法，建立醫院轉床醫療決策評估量表，輔助醫師進行醫療決策，以縮短病患待床時間，達到提昇醫院經營管理效率且強化服務品質的目的，同時提供爾後醫院在轉床醫療決策上之參考依據。本研究以雲嘉南地區衛生福利部精神治療專責病院為驗證個案，期透過所建立醫院轉床醫療決策評估模式，協助負責轉床決策制定的管理者更有效的管理病床資源，也讓醫院的醫療服務品質獲得提升。

Since the number of beds in large-scale hospitals is often limited, the allocation of the beds becomes a critical issue when numerous patients are required to be hospitalized. For example, a high proportion of patients with less serious conditions may occupy beds and waste valuable medical resources, and as a result, patients with more serious conditions who need to be treated and hospitalized may have no chance to obtain an assigned bed instantly. The bed turnover rate is highly correlated to medical decision making of transferring patients which is a complicated problem for hospital management. This study uses the analytic hierarchy process to propose a medical decision assessment procedure for transferring patients which can assist psychiatrists in making appropriate medical decisions to shorten patients' waiting time for beds and thus enhance efficiency and service quality for hospital management. This study selects a mental hospital in the southern area of Taiwan as a subject and uses the proposed medical decision assessment procedure to effectively manage bed resource and thus enhance medical service quality for the hospital.