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中華民國泌尿科醫學會雜誌

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篇名 台灣泌尿科專科醫師人力資源之剖析
卷期 10:3
並列篇名 The Perspectives of Urological Manpower in Taiwan
作者 于大雄馬正平張聖原
頁次 99-102
關鍵字 台灣泌尿科專科醫師人力資源人力分配Taiwanurologycertified boardmanpowermanpower distributionTSCI
出刊日期 199909

中文摘要

台灣自1991年已步入老年化社會,老年泌尿疾病佔其健康疾病相當比例,如何維持一常態均衡且質量俱備之醫師群,達到病患與醫師「雙贏」之局努,即時(real-time)之人力成長代謝監測瞭解及培訓養成之規劃掌控儼然就成為一重要課題。隨著教學設備之完善與環境之變遷,台灣泌尿科專科醫師也在不斷成長之中,事先了解國內現有人力及分配,並與國外先進國家作比較,將是提供日後人力培養與發展速度的一重要指標。本文數據來源乃由中華民國泌尿科醫學會歷年登錄資料及中華民國行政院衛生署生命統計報告書所彙整加以分析。並以美國已開發先進國之網路統計資料與文獻蒐集結果作比較。在人數方面,近五年雖然新會員及通過甄審考試之專科醫師成長比例有逐漸微幅下降之趨勢,約在5 %,但每年仍有25至30位新增之專科醫師,現有專科醫師人數為484位,以1998年全國總人口數比,每十萬人口有2.21位泌尿專科醫師,換言之,每位泌尿專科醫師在我國需服務45,247人口,工作量仍是偏高。顯示專科醫師在我國目前將來幾年仍有成長空間。至於泌尿專科醫師分佈情形,依1997年10月註冊資料(共376人)所示,北部地區包括台北縣市96位(25.5 % ),宜蘭、基隆、桃園、新竹、苗栗等63位,共159 位,北部共佔了42.3 %。台中縣市53人,其它中部50人,共10人(27.4 %)。南部地區(高雄71人,其它地區41人)共112人(29.8 %)。其它金門一位,美國一位(0.5 %)。按各區人口數比例仍以台北縣市為最高,專科醫師佔1/4強。美國泌尿科專科醫師人口比由1978年之1: 32,416增至2,000年之l:24,972,與理想醫療品質人口比數l:35,000相較,美國已是專科醫師生產過多(overproduction)之窘境。臺灣的理想人。比泌尿專科醫師人數應為626人,1998年為484位,已達飽合度之77 %,以每年25-30人之成長率估算應在4.7-5.7年約五年左右(2003年)會到達飽合。故應未雨綢繆在「培訓」(人數與醫院)與「甄審」二個重要環節上適時調控。至於專科醫師之分佈是否恰當,則需從資訊提供與宣導二方面策略進行,以免過度密集所造成之惡性競爭與密度過低所導致之偏遠醫療地區服務品質降低或無法供應所需之遺憾。

英文摘要

Taiwan had stepped into a senile society since 1991 with which health care problem for old people is becoming a major issue. The quality and efficiency of any health care system depend on an appropriate level of manpower. The manpower issues of tomorrow will be influenced by the number of physicians and specialists trained today. A number of confounding variables can have impact and are almost impossible to predict at present. This study plans to evaluate the growth of urological manpower in Taiwan. The study was constructed using data obtained from the records of Urological Association of R.O.C. and annual survival statistics of National Health Bureau. These results were compared with that of USA and literature reports. Between 1995 and 1998 the number of board-certified urologists increased by 5.8-7.2% with 25-30 urologists practicing per year. In 1998 the ratio of board-certified urologists to population was 2.21:100,000 (45,247 people per urologist has to serve with total 484 urologist). It indicates still has some growing space for urologists in the near future. As concerning the distribution of urologists in Taiwan area, 42.3% urologists are practicing in Northern part (Taipei area 25.5%), 27.4% in Middle part, 29.8% in Southern part, and only 0.5% in King-Men and abroad. The predicted manpower ratio of urology in the United States will change from 1:32,416 in 1978 to 1:24,972 by year 2000. Overproduction of urologists will be a major issue since the ideal ratio is 1:35,000. We have reached 77% of the ideal urological manpower in Taiwan in 1999. According to the growth rate, the saturation will reach by year 2003. How to proper control the training program and board certification for urologist is a main problem we have to face in order to gain a balance for the best medical care.