| Summary: | 碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 94 === Objectives: To Study the Association between Utilization Management in Hospital, Medical Autonomy, and Job-Career Satisfaction among Attending Staff
Material and Methods: The study is a secondary data analysis from the survey of Prof. Duan-Rung Chen on medical managements. The survey was conducted between late 2004 and early 2005 with structured questionnaires. A total of 674 attending staffs practiced in 50 hospitals acrreditated as district teaching hospitals or higher was included for analysis. SPSS 12.0 was used for descriptive statistics as well as bivariate analysis and multivariate logistic regression.
Results: The overall questionnaire response rate was 17.05%. Most respondents were male physicians aged between 30 to 49 years old (84.7%). Few respondents had bachelor of management (9.4%). About 30% of attending staffs felt satisfaction for current practice work and medical career. Among them, only 1.6% of physicians reported very satisfied. Older physician (over 50 years old) were more satisfied in job and career than their younger colleagues. Positive statistically significant correlation was also noted between physicians’ status of professionalism and job-career satisfaction (β=0.141, p<0.01). Multivariate logistic regression revealed that the non-compulsive utilization management of prescription cost and patient number per outpatient clinic were related negatively to job-career satisfaction. The results were statistically significant (β=-0.133 and -0.121 respectively, p<0.5). Besides, medical autonomy was proved to be one of the most important positive predictors for job-career satisfaction (β=0.163, p<0.001).
Conclusions: Low job-career satisfaction of attending staffs was noted in Taiwan. Two factors including utilization management and medical autonomy posed such results. Detailed considerations and planning should be made by Bureau of National Health Insurance before policy revision. In front of financial crisis, hospital managers needed more wisdom to perform adequate utilization management.
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