醫院結核病個案管理模式之探討

Objectives: The purpose of this study was to investigate the current management of tuberculosis patients in Taiwan's hospitals and to analyze the impact of hospital characteristics on the inclusion of various components of the model for tuberculosis case management. Methods: Using the 2001-2004 hospital accreditation data, the study population comprised more than 462 district hospitals in Taiwan. The survey was conducted in early March 2006 by mailing self-administered questionnaires to the individuals in charge of managing tuberculosis patients in those hospitals. The final effective sample size was 234. Results: The results showed that, except for the referral management aspect, hospitals that were participating in the pay-for-quality demonstration program performed better in terms of manpower allocation, admission management, and the like. Conclusions: This study demonstrated that the pay-for-quality demonstration program did exert a positive influence on management of tuberculosis patients in these hospitals. Six policy recommendations, such as increasing the training of tuberculosis case managers, were proposed on the basis of these research findings.