臺灣博碩士論文加值系統

由於台灣開始試辦遠距健康照護以來，推動不如預期理想，以往的遠距健康照護模式屬於定點式的服務，民眾需定時定點量測生理資訊後上傳，其收集資料及推廣方式有限，大多以服務行動不便、老年人及慢性病患為主，且健保署目前將遠距健康照護列為自費項目，為發展一大阻礙。數位時代的來臨，人手一支智慧手機已成常態，帶動物聯網(Internet of Things, IoT)應用的興起，以穿戴式裝置應用於遠距健康照護而言，可隨時隨地進行生理量測並即時上傳資料，希望藉由兩者的結合應用推廣給一般健康民眾使用，使其更普及。
本研究主要在探討穿戴式裝置應用於遠距健康照護之重要指標，以文獻探討及專家訪談建立層級架構，透過問卷調查方式，蒐集民眾之意見，再以模糊層級分析法進行權重計算。研究結果顯示，「營運模式」為最重要的構面，其中又以「願付價格」為最重要的考量指標，因此，除了民眾對此服務認知不足導致需求較低外，我國尚缺乏一個能夠讓消費者願意付費使用遠距健康照護的商業營運模式。最後，本研究經由歸納擬訂兩套遠距健康照護發展策略，經由權重評選後，應以市場策略優先考量，其中差異化定價將市場區分為長期照護、輔助診斷及健康管理三種並分別訂價；執照制度則是採用換軌制，使醫護人員通過認證後即可從事遠距健康照護工作；設立個資瀏覽權限，不得無故洩漏；遠距健康照護設備應通過認證；依民眾願付價格定價，本研究建議2,600元/月；推動私人保險企業遠距健康照護服務保單；政府應積極介入再教育，增加民眾認知；結合穿戴式裝置實現「行動式」遠距健康照護。期望以此策略使遠距健康照護服務順利進入消費者市場。由於我國於2015年5月三讀通過長期照顧服務法，並將仿照健保制度規劃長期照護保險法，將會影響未來遠距健康照護的給付，因此，本研究之可行性增高。

Since 2007, Taiwan's Ministry of Health and Welfare started to conduct the pilot telehealth, but the promotion doesn’t work better as expected. Conventional telehealth models include home-based, community-based and institution-based three patterns and the service type belongs to fixed position service. People need to regularly target for measuring and uploading their physiological information. Because its way to collect information and promotion is limited, therefore it’s usually serve for the disabled, elderly and chronic patients. The National Health Insurance Administration Ministry of Health and Welfare currenly classify the telehealth into own expense item, and it’s the obstacle for development. Because of the era of the digital is coming, everyone has a smart phone become normal, and it bring up the rise of Internet of Things (IoT) applications. The smart wearable device apply to telehealth, can be realized its physiological measurements to upload data at anytime and anywhere, and become more popular.
This research focuses on important indicators of the application of smart wearable devices on telehealth. A hierarchical framework was built through literature reviews and interviews with experts. The public’s opinion was collected with surveys and fuzzy analytic hierarchy process was used in weight computing calculations. The research results show that “business model” as the most important aspect and “willingness to pay” as the most important indicator of consideration. Therefore apart from the low demand resulted from the public’s lack of understanding about the service, Taiwan is also lacking a commercial business model that prompts consumers’ willingness to pay and use telehealth. Lastly, this research drafted two sets of telehealth development strategies, after weight selection, marketing strategies should be a priority consideration, set prices should be differentiated to divide the market into three components, namely, long-term care, aided diagnosis, and health management; an alternation system should be adopted in licensing, allowing medical personnel to assume telehealth work as soon as they have been approved; access to personal information should be limited and any leaks without legitimate reasons should be prohibited; all telehealth equipment should be required to be approve; prices should be set in accordance to the public’s willingness to pay and this research’s suggestion is $2,600 per month; encourage private insurance companies to provide coverage for telehealth services; the government should actively participate in reeducation to increase the public’s knowledge about the service, integrating smart wearable devices to realize telehealth. We hope this strategy could help telehealth enter into the consumer market successfully. Since May 2015, Taiwan has third Reading of long-term care services, and planning long-term care insurance, it will affect the telehealth payments, therefore, the feasibility of this study increased.

摘要i
ABSTRACTii
誌謝iv
目錄v
表目錄vii
圖目錄ix
第一章 緒論1
1.1 研究背景與動機1
1.2 研究目的4
1.3 研究範圍與限制4
1.4 研究流程5
第二章 文獻探討7
2.1 文獻架構7
2.2 遠距健康照護8
2.2.1 遠距健康照護定義8
2.2.2 遠距健康照護服務8
2.2.3 我國遠距健康照護發展困難與政策現況9
2.2.4 小結11
2.3 物聯網12
2.3.1 物聯網定義12
2.3.2 物聯網發展歷程13
2.3.3 物聯網架構16
2.3.4 物聯網的應用18
2.4 預防醫學23
2.5 營運模式25
2.5.1 長期照護型態25
2.6 台灣長期照護現況28
2.6.1 長期照護服務法28
2.6.2 長期照護保險28
2.7 模糊層級分析法29
2.7.1隸屬函數與模糊數32
2.7.2語意變數33
第三章 研究方法34
3.1 研究架構34
3.2 研究樣本36
3.3 研究方法36
3.3.1 層級架構建立37
3.3.2 問卷前測39
3.3.3 問卷設計41
3.4 資料分析方法42
3.4.1 建立三角模糊數42
3.4.2 建立模糊正倒值矩陣44
3.4.3 FAHP之效度檢定44
3.4.4 群體整合46
3.4.5 模糊權重之計算46
3.4.6 解模糊化46
3.4.7 正規化47
3.4.8 層級串聯47
3.4.9 解模糊數之排序47
第四章 研究結果與分析48
4.1建構遠距健康照護之層級架構48
4.2層級架構一致性檢定49
4.3研究樣本分析49
4.4 FAHP權重計算61
4.4.1 建立模糊正倒矩陣61
4.4.2 群體意見整合63
4.4.3 模糊權重計算63
4.4.4 解模糊化65
4.4.5 正規化65
4.4.6 層級串聯69
4.4.7 權重結果分析70
4.5策略選擇71
4.5.1策略介紹73
4.5.2策略評選81
4.6小結86
第五章 結論與建議88
5.1結論88
5.2研究建議89
參考文獻90
附錄一 遠距健康照護服務重要指標評估之問卷95

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