電子期刊
台灣家庭醫學雜誌
陳澤元1 施至遠1,2 曾家琳1 洪德仁3,4,5 邱泰源1,2,5 詹其峰1,2*
方法:本研究為無記名結構式問卷調查,於2022年8月至2022年10月之間進行,針對執業登記會籍為臺北市醫師之意見調查,內容包括:基本資料、參加居家醫療照護整合計畫與居家失能個案家庭醫師照護方案現況與障礙誘因等,問卷經專家效度檢視修正後以電子式表單請醫師回答。針對醫師參與居家照護相關計畫(居家醫療照護整合計畫、居家失能個案家庭醫師照護方案)進行單變量分析與多元邏輯斯迴歸分析。
結果:本研究共計回收410份,發現到門診數較少的醫師,較願意參與居家醫療照護整合計畫,女性醫師較願意參與居家失能個案家庭醫師照護方案;而越瞭解計畫/方案內容的醫師,越願意參與居家醫療照護整合計畫、居家失能個案家庭醫師照護方案。醫師對於推動居家醫療照護整合計畫之障礙前三名依序為提供24小時電話諮詢服務有困難(76%)、往返案家交通耗時(75%)、給付不足(74%);而居家失能個案家庭醫師照護方案前三名影響的因素為往返案家交通耗時(71%)、給付不足(69%)、個管師人力不易安排(69%)。
結論:對台北市醫師參與居家醫療照護整合計畫、居家失能個案家庭醫師照護方案之政策建議,包括給付需考量向上調整並納入交通成本與提供24小時緊急電話諮詢服務,以及建立更有效率之個案媒合溝通機制。
(台灣家醫誌2024; 34: 195-208) DOI: 10.53106/168232812024123404002
關鍵詞:居家照護、居家整合照護計畫、居家失能個案家庭醫師照護方案
1臺大醫院家庭醫學部
2臺灣大學醫學院家庭醫學科
3台北醫學大學醫學系
4洪耳鼻喉科診所
5台北市醫師公會
受理日期:112年2月26日 修改日期:113年5月7日 同意刊登:113年6月18日
*通訊作者:詹其峰 通訊地址:台北市中山南路7號 臺大醫院家庭醫學部 E-mail: jcf036@ntu.edu.tw
Perspectives of Physicians in Taipei on the HomeHealthcare Programs
Tse-Yuan Chen1, Chih-Yuan Shih1,2, Chia-Lin Tseng1, Te-Jen Hung3,4,5,Tai-Yuan Chiu1,2,5 and Chyi-Feng Jan1,2*
Purpose: With the advent of an aging society, the demand for home medical care services in Taiwanhas increased. However, the current participation rate of physicians in home medical care remainslow. The study accordingly conducted a questionnaire survey to help understand the operationalchallenges and barriers facing physicians in Taipei regarding the promotion of home healthcareprograms.
Methods: This study as an anonymous structured questionnaire survey was conducted betweenAugust 2022 and October 2022 to solicit the opinions of physicians registered for practice in TaipeiCity. The questionnaire covers basic information, participation in home medical care integrationprograms, the current status, and challenges and incentives of home care for disabled cases by familyphysicians. After expert validity review and revisions, the questionnaire was administered tophysicians through in an electronic form. Univariate and linear regression analyses were performedon the results obtained from physicians participating in home healthcare programs (home medicalcare integration program, home care for disabled cases by family doctors).
Results: According to the 410 responses collected, physicians with less clinic sessions are morewilling to participate in home medical care integration programs, and female physicians tend to bemore willing to participate in home care for disabled cases by family physicians. Physiciansequipped with a better understanding of the programs are also more willing to participate. The topthree obstacles for physicians to promote home medical care integration programs were respectivelydifficulty in providing 24-hour telephone consultation services, time-consuming transportation, andinsufficient reimbursement. For home care for disabled cases by family physicians, the top threechallenges were time-consuming travel to patients at home, insufficient reimbursement, anddifficulty in arranging case managers.
Conclusion: To promote the participation of Taipei physicians in home medical care integrationprogram and home care for disabled cases by family physicians, the study recommends the followingthree measures: increasing the reimbursement considering transportation costs, providing 24-houremergency telephone consultation services, and establishing a more efficient communicationmechanism for case matching.
(Taiwan J Fam Med 2024; 34: 195-208) DOI: 10.53106/168232812024123404002
Key words: home health care, home integration care program, home long-term medical careservices for disabilities
1Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
2Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
3Clinical Associate Professor, Department of Medicine, Taipei Medical University
4Dr. Hung’s E.N.T. Clinic, Taipei, Taiwan
5Taipei Medical Association, Taipei, Taiwan
Received: February 26, 2024; Revised: May 7, 2024; Accepted: June 18, 2024.
*Corresponding author