為探讨牙醫師對全民健康保險實施後執業安排與支付制度的意见，本研究以中華民國牙醫師公會聯合之會之所有登記會員為研究對象，於1989年年底進行郵寄問卷調，共收集1303名有效樣本资料，回收率為24.9%。調查结果顯示：(1)九成以上牙醫師都願意接受全民健康保險特約，但祇有三分之一的牙醫師赞成须經評鑑合格才准特约；(2)大多数牙醫師赞成專診制度，但祇有半數同意限制牙醫師前往牙醫師人力過剩地區執業；(3)牙醫師大都赞成論量計酬制度，但對於支付標凖，则診所牙醫師倾向於主張同病／同項同酬，而醫院牙醫師则尚支持依评鑑等級與牙醫師資歷支付診療報酬；以及(4)近半數的牙醫師赞成差額负擔。根據上述發现，本研究進一步討論對全民健康保險政策的啓示與未来研究方向。

This study examines dentists' opinions on practice arrangement and payment system under national health insurance (NHI). The data for the analysis came from a mail survey of 1303 members from the China Dental Association in late 1989 (response rate of 24.9%). The results of this study showed that (1) more than 90% of dentists are in favor of making a contract with NHI to provide services, but less than one third agree with the requirement of accrediation for contract; (2) most dentists support the policy of referral system, but only half agree with the restriction of the number of dentists practicing in communities with an oversupply of dentists; (3) most dentists prefer to be paid on the basis of fee-for-service; in particular, office-based dentists like 'equal payment for equal diagnosis/service' while hospital-based dentists like being paid according to accrediation and professional merits; and (4) approximately half of dentists are in favor of balancing billing. Based on the findings, this study discussed the implications for national health insurance policy and future research.

牙醫師 ； 全民健康保險 ； 執業安排 ； 支付制度

dentist, national health insurance, practice arrangement, payment system