目標：本研究旨在探討澎湖地區急診重症醫療品質整合醫療服務經營模式計畫實施後，澎湖地區民眾在急診醫療利用情形與滿意度是否有改變。方法：本研究從健保申報資料進行相關比較，並以隨機選樣方式對澎湖本島居民進行計畫前後滿意度調查，回收率均在9成以上。以SPSS 10.0 for Windows軟體進行分析，並以描述性統計、T檢定呈現研究結果。結果：IDS計畫實施後平均每月門診急診次數由760.3次增至1117.3次（P＜0.05），而平均每月費用則約增加35.7萬元（P＜0.05）；平均急診住院次數從91.0次增為145.7次（P＜0.05），而由急診轉送住院之費用平均每月約增加127.3萬元（P＜0.05）。另外從兩次滿意度調查結果發現，受訪民眾對急診醫療的滿意度相對提高。結論：澎湖地區離島醫療及急診重症醫療品質整合醫療服務經營模式計畫實施後有助於提升急診效益及民眾滿意度，且增加當地民眾對澎湖急診醫療的信心，並減少遠送台灣本島就醫的社會成本，故持續於澎湖地區推展此計畫是有其價值的。

Objectives: The study evaluated the changes in health services utilization and patient satisfaction following the implementation of an Integrated Delivery System (IDS) in the Peng-Hu area, starting on July 1, 2001. Methods: Using data collected from benefit claims of the Kaohsiung-Pinton Branch of National Health Insurance Bureau and community surveys conducted by the investigator, the researcher employed inferential statistics, such as Student T-test, as well as descriptive statistics in fulfilling the goals of the study. Two surveys were conducted before and after the program with a response rate＞90%. Results: Following the IDS program, the average number of ambulatory emergency care incidents increased from 760.3 per month to 1117.3 per month (P＜0.05) and the average cost rose to NT$357,000 (P＜0.05). Similarly, the average number of hospitalized emergency care incidents increased from 91.0 per month to 145.7 per month (P＜0.05) and the average cost rose to NT$1,273,000 (P＜0.05). Besides, the second time the satisfaction of residents was measured, it was relatively higher than in the first survey. Conclusions: The increase in health services utilization and satisfaction levels among residents showed that the IDS program was successful. Thus, we suggest a continuance of this program is suggested.

整合式醫療服務經營模式計畫 ； 醫療保險計畫 ； 急診 ； 醫療照顧

Integrated delivery system (IDS), health insurance program, emergency, health care