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中醫門診品質確保方案—中醫門診品質指標之發展、建立與監測 郭乃文台北醫學大 |
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| 全民健康保險自民國八十九年七月於中醫門診實施總額支付制度，並依據費協會、監理會及中央健保局對中醫門診總額支付制定品質確保方案之要求，該方案應由中華民國中醫師公會全國聯合會應負責監測中醫門診總額支付制定品質確保方案以保障醫療服務品質。另，基於監測全民健保中醫門診總額支付制度醫療服務品質需要，應研訂中醫「服務品質」與「品質照護保證」之中長期指標。本計劃基於上述政策依據，擬自今年度（民國九十二年）進行中醫「服務品質」之指標研究。歐美臨床品質指標系統發展非常完整，特別是其中與評鑑相結合的做法，值得國內學習與借鏡。國內目前所施行之指標系統包括：醫院評鑑暨醫療品質策進會發展之台灣醫療品質指標系統(Taiwan Quality Indicator Project, TQIP)，及臺灣醫務管理學會研擬之台灣醫療品質指標系統(Taiwan Healthcare Indicator Series, THIS)。但上述這兩套指標系統皆以測量西醫醫療品質為主；而中醫為我國醫療之特色，民眾選擇中醫就醫情形亦相當普遍，但中醫醫療品質方面至今並無相關指標系統之建立，對於中醫醫療品質亦無標準可供參考使用，因此本計劃期參照美國醫療機構評鑑聯合委員會（JCAHO）研發之「門診醫療臨床指標發展格式(Clinical Indicator Development Form0)，首先搜集並彙整相關文獻，擬定指標清單及指標選擇標準；接下來進行專家深度訪談，並將訪談結果彙整後，以德菲法進行專家意見之彙整及凝聚共識，最後，邀集衛生署、健保局專家、公衛醫管學者、中醫師公會全聯會，討論並擬定中醫門診品質指標初稿，以利後續計劃進行中醫門診品質指標之試行及指標信、效度測試。期望在本三年計劃發展、建立及監測中醫門診品質指標及通報系統後，可監測中醫門診醫療品質，對於中醫門診醫療服務品質有所助益，保障民眾中醫就醫品質及權益。 | |
| 關鍵字：中醫門診、中醫醫療品質、品質指標發展 |
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Development and Monitoring of Quality Indicators for Chinese Medicine Outpatient Care Nai Wen KuoTaipei medical university |
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| The global budget payment system of the Chinese medicine outpatient care in the National Health Insurance was implemented in July, 2000. According to requests by the Bureau of National Health Insurance, the NHI Supervisory Committee, and the NHI Committee for the Arbitration of Medical Costs, for assuring quality of Chinese medicine outpatient care after implementing global budget payment system, the National Association of Chinese Medical Doctors must propose a proposal to monitor quality of Chinese medicine outpatient care. Therefore, it is important to develop the quality indicators of Chinese medicine outpatient care.Currently, there are two major quality indicator systems in Taiwan: THIS (Taiwan Health Indicators Series) by the Taiwan College of Healthcare Executives and TQIP (Taiwan Quality Indicator Project) by the Taiwan Joint Commission on Hospital Accreditation. However, these two indicators systems are both for Western Medicine. Thus, it is necessary to develop a quality ind | |
| 關鍵字：Quality in Chinese medicine, Chinese medicine outpatient care, Development of quality indicators |
