目的：
實施全民健保雖提升民眾就醫的可近性，也提供選擇醫療照護自由，卻會造成民眾逛醫師、逛醫院及片段式醫療照護等問題。照護連續性差不僅影響病人的醫療照護結果，亦會造成醫療資源浪費和健保財務上一大負擔，因此如何使照護連續性提升實為刻不容緩的議題之一。本研究旨在瞭解民眾對於照護連續性之知識、態度、行為，及影響照護連續性的因素，並探討知識、態度、行為之間的關係。
方法：
本研究為橫斷面研究，以台灣地區20歲以上民眾為研究對象，採線上問卷之方式進行收案，調查期間為2020年4月21日至5月7日，共回收492份問卷，排除填答IP重複及無效問卷後，有效問卷共計484份。採用獨立樣本T檢定、單因子變異數分析、皮爾森相關分析、多元線性迴歸分析、階層迴歸分析。
結果：
經階層迴歸分析發現年齡、婚姻狀況、有無罹患慢性疾病、照護連續性之知識及態度對其行為具有影響力，其中照護連續性之態度影響最大且亦為預測其照護連續性之行為最重要之因子。而民眾對於照護連續性之知識、態度、行為之間有顯著正相關，表示民眾對照護連續性的認知程度越高，對照護連續性的態度越正向，其照護連續性的行為越積極。
結論：
在片段式醫療照護的情況下，希望本研究結果可作為政府推動相關政策之基礎，引導醫師改變過去以單一疾病為導向之照護模式，重視整合性門診，並透過政策介入，加強醫療院所之間的合作及資訊流通，增進照護協調性並改善民眾的照護連續性。建議未來研究可從照護協調性之角度，探討其與醫療照護結果及成本花費之間的關係，透過整合初級照護提升照護連續性。

Objective:
The implementation of national health insurance in Taiwan has increased the accessibility of medical care and provided freedom of choice, yet it also results in the problems of doctor-shopping, hospital-shopping, and fragmented care. The problems of poor continuity of care not only affect the outcome of sick care but also result in medical resource waste and a significant financial burden on health insurance. Thus, one of the most pressing issues is how to improve care continuity. The purpose of this study is to understand people's knowledge, attitudes, and behaviors regarding continuity of care, and the factors that affect the continuity of care, and to investigate the relationship among knowledge, attitudes, and behaviors.
Methods:
This is a cross-sectional study using Taiwan citizens aged 20 or older as of the target population, and an online questionnaire is used to collect cases. A total of 492 questionnaires were collected during the period from April 21 to May 7, 2020, after excluding duplicate and invalid IP addresses. The total number of valid questionnaires was 484. Independent sample T-test, single-factor variance analysis, Pearson's correlation analysis, multiple linear regression analysis, and hierarchical regression analysis were used.
Result:
Regression analyses revealed that age, marital status, presence of chronic diseases, and knowledge, as well as attitudes about the continuity of care, were important factors in people's behaviors. In particular, the attitude toward care continuity is the most influential and predictive factor. There was a significant positive correlation between people's health knowledge, attitude, and behavior towards continuity of care, reflecting patients’ awareness of the continuity of care. The higher the level of awareness, the more positive the attitude towards continuity of care, and the more positive the behavior towards continuity of care.
Conclusion:
In the context of fragmented care, we hope that the results of this study could urge the government to promote policies to lead physicians to change their custom approach of single-disease-oriented care and to emphasize on integrated outpatient care and through appropriate policy intervention to strengthen cooperation and information exchange between medical institutions for better care coordination and care continuity. It is proposed that future research can examine the relationship between care coordination and health care outcomes as well as medical costs and hopefully through the whole-person integration of primary care to create a space of continuity of care.

論文審定書 i
摘要 ii
Abstract iii
圖次 vii
表次 viii
第一章、緒論 1
第一節、研究背景與動機 1
第二節、研究目的 2
第三節、研究流程 3
第二章、文獻探討 4
第一節、照護連續性定義 4
第二節、照護連續性現況 8
第三節、照護連續性之重要性 9
第四節、知識態度行為模型 11
第五節、文獻小結 13
第三章、研究方法 14
第一節、研究架構與假設 14
第二節、研究對象與資料來源 15
第三節、研究工具 16
第四節、研究變項定義與屬性 22
第五節、資料處理與分析 24
第四章、研究結果 25
第一節、個人基本資料分佈情形 25
第二節、描述性統計分析 31
第三節、照護連續性知識、態度、行為之差異性 35
第四節、照護連續性知識、態度、行為之相關性 41
第五節、照護連續性知識、態度、行為之多元線性迴歸分析 42
第五章、討論 51
第一節、個人基本資料與照護連續性之關係 51
第二節、影響照護連續性之相關因素 53
第六章、結論與建議 55
第一節、研究假設驗證 55
第二節、結論與建議 56
第三節、研究限制 57
第四節、研究貢獻 58
參考文獻 59
附錄一、研究問卷 66
附錄二、專家效度名單及審查意見 71
附錄三、人體試驗委員會通過證明 78

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