第六章 結論與建議
第二節 建議
一、對衛生主管機關之建議
本研究參考國內外急性心肌梗塞指標，發現台灣並無針對降血脂藥物進行監 測，建議未來醫療品質公開網可以針對住院中、出院後 3/6/9 個月降血脂藥物的使 用進行監測，能夠全面的監測急性心肌梗塞病人的醫療品質。急性心肌梗塞的住 院死亡率逐年下降，但是在醫療費用仍高，且醫療費用集中在出院後的復健與治 療。台灣政府近年來致力於提升急性照護品質，如急診品質提升方案，醫院也執 行各項策略來改善急性心肌梗塞病人的照護品質，但是照護結果在各醫院仍有差 異。本研究也指出台灣醫院策略的執行現況仍有進步的空間，因此建議主管機關 可以加強急性心肌梗塞病人到院前的治療、住院臨床指引治療即出院後的持續追 蹤治病，做為未來政策擬定或相關給付的方向，鼓勵醫院提供急性心肌梗塞病人 即時且完整的醫療照護，增加病人照護的連續性並撙節急性醫療資源。
本研究結果發現，執行醫院策略能有效提升病人照護過程及結果的品質，且 執行的策略的數量與病人照護品質呈現正相關。建議衛生主管機關未來可以參考 將本研究選出的 7 項策略，優先提升醫院策略的執行比率，改善急性心肌梗塞的 照護過程及結果，進一步改善病人預後情形，藉此樽節龐大的醫療花費。
二、對醫療服務提供者之建議
執行醫院策略能改善急性心肌梗塞的照護過程及結果，然而台灣醫院目前執 行策略的狀況仍有進步的空間。在資源有限的情況下，醫院所能執行的策略有限，
因此建議醫院管理者參考本研究選出的醫院策略優先執行，也可逐步提升醫院策 略執行的數量以持續性提升性心肌梗塞病人的照護過程及結果。
三、對未來研究者之建議
本研究找出急性心肌梗病人的醫院策略，但是無法得知各醫院執行的狀況，
亦無法瞭解醫院是否執行其他醫院策略來提升急性心肌梗塞照護過程與結果，因 此建議後續研究可以針對醫院策略執行的深度與廣度，以質性研究進行進一步的 探討。本研究所使用的照護過程與指標觀察時間較短，建議後續研究者可以將觀 察的時間拉長，如 30 天死亡率、再入院率，能夠更進一步瞭解醫院策略對於急性 心肌梗塞病人照護過程指標的相關性。
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附件一、問卷 (14) 其他_________________________________
2. 請問 貴院近兩年(104 年 1 月至 105 年 12 月)是否有以下定期會議，檢討 AMI/
(4) 其他____________________________________
附件二、IRB 證明
附件二、IRB 證明