以跨文化觀點探討兩岸抗生素監控系統對醫師開藥行為之影響;The Impact of Cultural on Taiwan and China Physicians’ Antibiotic Prescribing Behavior Using Antibiotic Stewardship System

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Title:	以跨文化觀點探討兩岸抗生素監控系統對醫師開藥行為之影響;The Impact of Cultural on Taiwan and China Physicians’ Antibiotic Prescribing Behavior Using Antibiotic Stewardship System
Authors:	吳昕穎;WU, HSIN-YING
Contributors:	資訊管理系醫療資訊管理研究所
Keywords:	開藥行為;抗生素監控系統;跨文化;計畫行為理論;prescribing behavior;antibiotic stewardship system;cross-culture;planned behavior theory (TPB)
Date:	2017
Issue Date:	2019-07-17
Publisher:	資訊管理系醫療資訊管理研究所
Abstract:	大陸「中外合資、合作醫療機構管理暫行辦法」施行後，台資醫院陸續進駐大陸。兩岸人民雖同文同種，但工作文化截然不同。因此台資醫院需要面臨諸多的跨文化的適應與管理的難題。台灣數位政府排名屢佔世界前茅，醫療資訊系統亦為他國學習之對象，然而台資醫院能否以優勢之醫療系統輔助其醫院的管理？尚待研究。在醫院管理中，抗生素的管理為病人安全及醫療品質之重要基礎。近幾年抗生素濫用在世界各國已受到高度關注，世界衛生組織在 2011年將世界健康日的主題，訂定為全球降低抗生素的濫用以抑止抗藥性。各國遂紛紛擬定相關措施以減少抗生素濫用，研究指出管理方法中以事前審核及電腦輔助系統較有效果。因此本研究將運用抗生素監控系統，針對兩俺醫師探討跨文化對其開立抗生素行為的影響。理論基礎將採被應用於探討歐洲七國之醫師開藥行為的計畫行為理論，再根據文獻探討進行研究模式之修正。本研究結果可加強計畫行為理論解釋跨文化醫師開藥行為之完整性，並提供台資醫院認識文化變數的重要內涵，提高醫生應用資訊系統遵循開立抗生素規範，作為醫院管理之基礎並提升病人的安全與醫療品質。研究結果指出，醫師在使用抗生素監控系統時，所感受的壓力越大，其使用抗生素監控系統的意願會越高；在文化調節方面，結果顯示兩岸文化差異不會影響醫師使用抗生素監控系統開藥之行為。 After the execution of the Interim Measures for the Administration of Sino-foreign Equity Joint and Cooperative Joint Medical Institutions, many Taiwan hospitals went to mainland China to open hospitals. Although, people from both sides have same language and origin, their working cultures are very different. In other words, the Taiwan hospitals may face many adaptions and management obstacles. Taiwan e-government has been ranked top worldwide for many years. Many countries came to Taiwan to learn the hospital information systems. However, can Taiwan hospitals use this advantage to run the hospitals in China is still an issue to be explored. In hospital management, antibiotic stewardship is the most important foundation for patient safety and medical care quality. Recently, misuse of antibiotics has become a world wild issue. The WHO even chose antimicrobial resistance and its global spread as the theme for the world health day in 2011.Many countries established policies and mechanism to control the spread of antimicrobial resistance. Studies showed that auditing prescription beforehand with computer-aided systems is a more effective method. Therefore, this study will explore the culture effects on physicians’ prescribing behavior while using the antibiotic steward information system. The theoretic foundation of the research model is planned behavior theory (TPB) which has been used to explore the physicians prescribing behavior in Europe. The research model will be modified by adding other variables through related literature reviews. The results of this study can be used to increase the completeness of TPB in explaining the subject area and as reference for Taiwan hospitals to understand the influence of working culture on physicians’ obedience of prescribing antibiotics using an antibiotic steward information system to further prevent antimicrobial resistance and enhance patients’ safety. The results show that, physicians in the use of antibiotic monitoring system, the greater the pressure, its use of the system will be higher. In terms of cultural regulation, the results show that the cultueal differences between the two sides will not affect the physician use antibiotic monitoring system to prescribe the behavior.
Appears in Collections:	[Graduate Institute of Healthcare Information Management] thesis

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