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http://140.128.103.80:8080/handle/310901/2797
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| Title: | 兩岸醫療制度分析與醫院護理人力之探討 |
| Other Titles: | A Study of Medical System and Hospital Nursing Human Resource in China and Taiwan-Comparison of Two Medical Centers |
| Authors: | 陳燕雪
Chen, Yen-Huseh |
| Contributors: | 陳潭
Chan, Tam
東海大學工業工程與經營資訊學系 |
| Keywords: | 醫療環境;醫療環境指標;醫療制度;人力資源;護理人力運用
medical environment;medical environment target;medical system;human resource;nursing resource employment |
| Date: | 2007 |
| Issue Date: | 2011-03-23T09:13:20Z (UTC)
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| Abstract: | 2000年大陸醫療產業市?為3510億元，到2005年醫療產業總市?額為6400億元，5年內增長1500億元成長42％，而醫療消費每人每年只有31美元，佔國民生產總值4％以下，與美國相比較，美國醫療消費每人每年為4090美元是大陸的130倍，佔美國國民生產總值的14％，可見中國大陸醫療市場的需求及發展空間之大。 台灣健保總額之後，各私立產業競相至對岸設立醫院外，台灣醫生也在無利可圖下紛紛出走，各醫療院所以人事緊縮來因應越來越嚴重的財務危機，此舉作法不僅影響醫療品質，更危害到病患之安全，本研究針對醫事人力資源之運用，探討兩岸醫療院所的人力運用情形。所以本文的研究目的： 1.探討兩岸醫療環境、醫療保險制度之差異。 2.探討兩岸醫院人力運用之差異。 3.探討兩岸醫療制度下對護理教育、醫院護理人力運用的影響。 結果發現台灣醫療環境擁有較高的民眾滿意度、較多的政府投入、及較佳的公共衛生成效之優勢，但相對的因經濟成長緩慢、醫療資源控管不良、及在總額下醫療院所間造成的激烈競爭之劣勢，並且處於大陸經濟成長快速、醫療需求量較大的威脅中。在護理人力資源上，大陸因護理教育停頓30年，造成護士普遍教育程度較低，社會地位低落，而台灣在學制改制下，學歷已漸漸提昇，但也因為如此，依目前的畢業人數看，將供過於求，僅約1/3畢業生得以順利就業。 兩岸的醫事人員一樣的面對複雜的照護環境，病人病情複雜度增高、民眾對醫療品質的需求增加、工作負荷量增加等因素，雖然兩岸政府皆有立法護理人員數比，但因大陸護士管理非完全由護理部門管理、在成本考量下緊縮人員，造成護理人員數比，遠不及公訂之比例，而台灣也因總額預算問題，緊縮護理人力、及人員培育上供過於求、離職率激增，一樣造成人力資源的不足。同時在國際各國醫事人員數比較上，可以見到兩岸護理人員數比,皆遠不如歐美其他先進國家。所以為提升醫療品質應有以下之改變。 所以筆者建議：1.政府應體驗醫療環境有越來越複雜趨勢，為避免醫療傷害、增加病患之安全，應立法增加護理人員數比。2.調整、控管各層級護理學校之招生，避免供過於求，影響護理人員之待遇及福利。3.鼓勵並增加在職進修，擬定完善的進修管道及環境，以提升護理素質。4.增加正職人員之聘用，避免以約聘方式進用，而增加離職率，造成年資偏低、臨床工作效益低。
From 2000 to 2005, the expense of medical care market in China had an increase of 42%, however, the total value was only 4% of its GDP, far lower than that of the USA (14%). Therefore, there is a great potential for the future development of medical business in China. On the other hand, many medical institutes and physicians in Taiwan went to China to search for further development because of the deteriorated financial situation, which occurred since the Bureau of National Health Insurance introduced a package compensation system. To cope with such stringent environment many hospitals in Taiwan were forced to decrease their staffs to save the management cost. However, such policy caused shortage of human resource in medical care and it would not only sacrifice the medical care quality but also affect patient safety. The current study is to investigate the problems of human resource in cross-strait hospitals. We try to delve into the following topics: 1. The cross-strait difference in medical environment and medical insurance system. 2. The cross-strait difference in hospital human resource employment. 3. The influence of cross-strait medical systems on the nursing education and nursing human resource. We found that people satisfaction to medical environment in Taiwan is higher than that in China. More government involvement and better public health care are also seen in Taiwan. However, stagnant economic growth, poor medical resource control, and keen competition in the medical care market are the problems. In addition, Taiwan is facing the rapid growth of economy and medical care market in china. As far as the nursing system is concerned, the quality of nursing education is inferior in China. On the other hand, the number of nurses in Taiwan will outstrip that in need. It is estimated that only about one-third of nurses who just graduate from school can find job. Both cross-strait medical personnel are confronted with the same problems in health care, such as more and more complicated medical environment, higher quality requirement in patient care, and over work loading. Imbalance in supplement and need of nursing staffs is seen in both cross-strait hospitals although the causes are different. At present, the nurse/patient ratio in cross-strait hospitals is far lower than that of the developed countries. We thus make the following suggestions: 1. Government should set a law to define a standard nurse/patient ratio. 2. The number of nursing student should be controlled and adjusted appropriately to avoid imbalance between supplement and need. 3. Provide suitable education opportunity for nursing staffs to promote nursing quality. 4. Increase formal positions for nursing staffs instead of short-term employment. |
| Appears in Collections: | [工業工程與經營資訊學系所] 碩博士論文
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