法的應用對於臨床路徑(Clinical Pathway)的影響較少被重視。臨床路徑是病人從入院到出院的流程，除了基本辦理的入院手續外，還包括療程時間的安排、療程內容以及最終醫療效果。有效的臨床路徑規劃不僅能夠避免醫療費用的浪費，更能提升病人照護之滿意度，以提升醫療院所知整體醫療品質。過去許多研究在探討不同部門的臨床路徑，本研究旨在建構一臨床路徑規劃機制，並比較改善前與改善後臨床路徑對於住院天數、醫療費用、內、外部顧客滿意度之影響。本研究首先訂定出影響臨床路徑規劃的關鍵因子，接著運用灰關聯分析(Grey Relation Analysis) 探討影響臨床路徑的因子間之相互關聯，評估這些因子對於外部顧客付出之醫療成本以及內外部顧客滿意度之影響，研究結果將可提供給醫療體系與醫護理人員制訂臨床路徑決策之用，本研究之研究目的有： 1. 探討影響臨床路徑變異之因素與這些因素對住院天數與醫療費用之關係。 2. 提出臨床路徑規劃機制，並比較改善前後各項醫療品質指標的差異，驗證改善臨床路徑的成效。 3. 分析內部顧客(醫護人員)與外部顧客(病患)對改善前後臨床路徑之滿意度。 4. 提供醫療院所與醫護人員相關的管理意涵。 There are several management tools and methods are applied in health care industry. Clinical Pathway is a critical factor for high health care quality; however, few studies were found on the relationship between clinical pathway and health care quality. Effective and efficient clinical pathway planning can prevent resource wasting, enhance customers’ satisfaction and improve the entire quality of health care. This study proposes the mechanism for clinical pathway improvement and emphasizes on comparison between the satisfaction before and after clinical pathway improved. Critical factors influencing clinical pathway planning will be identified first and Grey Relation Analysis is then applied to determine the relationships among these factors and their impacts on operational cost and patients’satisfaction. Management implications will be provided for health care institute and managers to make related decisions. The objectives of this study are as follows. (1) Identify the factors causing pathway variation and investigate the relationship between these factors and the day number of hospitalization and the expense of hospitalization, (2) Propose a mechanism for clinic pathway improvement and compare the performance index before and after improvement, (3) Investigate the satisfaction of internal customers and external customers, and (4) Provide managerial implication to related managers.
