| 摘要註: |
護理人力資源短缺是一個世界性長期存在的問題,台灣隨著出生率的下降,逐漸走向高齡化社會,加上健保總額預算制度實施後,醫院為了降低成本進而精簡護理人力,造成長期護理人力的短缺,讓護理人員的工作量及時間不斷的增加,造成護理人員的離職或是不願意投入護理工作。近年來,有關單位提出相關政策,以解決護理人員短缺問題,但都無有效的成果,而護理人員供需為一複雜且動態的過程。本研究以系統動態學來探討台灣護理供需結構危機,以及透過模型建構找出其影響護理人員供需的主要因素。並藉由政策模擬結果來給與政府建議與修改政策方向。根據模擬與分析,本研究得出結果為護理人員執業率與護病基準為影響護理人員供需的關鍵因素,護病基準影響一家醫院可以承擔多少病人;執業率則影響有多少人投入護理產業,若執業率過低,導致護理人員需延長工時工作,負擔加重,影響護理人員流動,而每年學校培育出的護理學人數是足夠的,但因為工作環境問題,造成護理人員離職或轉職,產生護理人為供需結構危機,本研究建議應從護理學生教育著手,增加護理學生就業意願,並改善護理人員工作負擔。 The shortage of nursing human resources is a long-term problem in world. With the decline birth rate, Taiwan will be an aging society. And in order to control and reduce the cost, the government implementation the total health care budget. Hence hospitals cut the most ratios in hospital operation are human budget. And number of nursing is the most in the hospital. It leads to nursing manpower shortage, and their workload and work time continue to increase. And nursing will not stay in hospital or turnover and the graduated of nursing school will not to be a nursing. It leads to the supply and demand crisis of nursing.In recent years, the relevant section proposed some policies to improve the nursing shortage problem. But it still has no effective results. And nursing supply and demand is a complex and dynamic process. This study, we used system dynamics to discuss the supply and demand crisis of nursing in Taiwan and find the main factors which influence the model of nursing supply and demand. Then try to amend the policy direction in Taiwan.According to the simulation and analysis, the key factors affecting supply and demand are employment rate and standard between nursing and patients in this study. The standard between nursing and patients influence how many patients that the hospital can afford them. And employment rate will influence how many nursing join to the industry. If the employment rate is too low, nursing will extend their work time and have heavy burden. It will influence nursing turnover. And number of nursing school graduate is enough. But the environment of nursing work influence nursing to turnover and be the crisis of nursing supply and demand. Hence, this study suggests that it should improve the situation from student in nursing school. To increase nursing students employment rate and improve the environment of nursing work. |