以Rasch評量模式探討老人福利機構評鑑指標與制度之研究

南華大學機構典藏系統 > 管理學院 > 企業管理學系(管理科學碩/博士班,非營利事業管理碩士班) > 博碩士論文-非營利事業管理碩士班 > Item 987654321/22355

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题名:	以Rasch評量模式探討老人福利機構評鑑指標與制度之研究
其它题名:	Indicators and Policies in the Evaluation of Welfare Institutions for the Elderly: A Rasch Analysis
作者:	甘士照 Kan, Shih-chao
貢獻者:	非營利事業管理研究所鄭讚源 Tsan-yuang Cheng
关键词:	機構評鑑;老人福利;Rasch測量;長期照護 long term healthcare;Rasch measurement;institute accreditation;elderly welfare
日期:	2006
上传时间:	2015-08-04 11:05:07 (UTC+8)
摘要:	老人福利法第13條規定：「主管機關對老人福利機構應予輔導、監督及評鑑。」為增加對長期照護機構的瞭解，政府依法辦理評鑑作業，評鑑的輔導與建議對機構的營運有重大意義，也對改革中的機構評鑑制度提供改善意見的參佐。　　　本研究利用Rasch(1960)測量的客觀等距的特性，分析2004年內政部老人福利機構評鑑的複評131機構之評鑑資料，將各項指標的0至100計分，轉換為5點計分，數值愈大表示愈滿意。並將財團法人養護機構、財團法人安養機構及小型福利機構等三類型受評機構的評分表，合併為一個統一評分標準，進行(1)評鑑指標的單一向度(unidimensionality)；(2)排名各機構的能力水準；(3)各類型機構在五大評鑑項目及各評鑑指標上的反應情形；(4)對個別受評機構異常指標的評鑑報表呈現。　　　利用Winsteps (Linacre,1999)軟體進行等級量尺模式的檢測分析，結果顯示118個指標中，醫療距離指標得分皆同不予列計外，刪除收容個案符合機構服務能力水準、外展服務努力及貢獻度的二指標不合Rasch模式(Infit超過0.6及1.4)，當指標問項的Outfit 或Infit MNSQ 超出0.6及1.4之外者，即予刪列，而期以符合單一向度及部份獨立性的試題反應理論假設。結果顯示118個指標經效度分析後剩下115題符合其單一向度的Rasch模式，相似於其Cronbach’s α(Cronbach,1951)。　　　結論分析中，小型福利機構在設備添購及參與社區上呈現困難，財團法人安養機構在個案研討、失禁如廁處理上呈現困難，財團法人養護機構在SARS量體溫表現優異，財團法人安養機構在指標廚師、寢室人數上表現傑出。整體上以小型福利機構表現最佳，而財團法人養護機構及財團法人安養機構沒有統計上顯著的差異。　　　因此，運用Rasch分析評鑑資料，可以在評鑑結果分析方面提供更多的訊息。不單只是關心受評機構間的排名，而更能關切各受評機構在不同能力水準下的「應表現好而未表現好、或不應表現好卻是表現好」的砥勵功效。也更能客觀對歷次評鑑分數上做縱斷面及長期分析與比較。　　Taiwan’s elderly welfare law stipulated that authorities should be supervised and accreditedperiodically. The accreditation standards for institutes also emphasize relevant long-term healthcare institutes on mutual communications and collaborations in communities.　　　In order to pay more understanding on long-term healthcare institutes and improving instituteaccreditation, we used the characteristics of the Rasch model’s objectiveness, interval and sufficiency and analyzed the data from a total of 131 institutes in 2004. This study was conductednot only to combine separated scoring sheets into a single one, but to transfer the 100-point scale toa Likert type 1-5 scoring scale. The goal of this study was set at (1) examining indications fitting a unidimensionality, (2)ranking institutes on ability strata, (3)responding changes across items on theinstitute hierarchy, and (4) reporting unexpected strings for the institute.　　　After examining and analyzing the data through the Rasch rating scale model by the Winsteps computer software, we have found some results indicating that the distance from hospitals was dropped due to the scores being identical. Two items which were related to residential treatment and outside services were deleted due to misfit in the Rasch model’s expectation ( infit statistics beyondthe range of 0.6 and 1.4). The remaining 115 items were deemed to construct a unidimensionality.Persons reliability (similar to Cronbach’s α) was reached to 0.91.　　　Small institutes suffered difficulties in equipment acquirement and community participation which differentiated those of elder care institutes in the case study and Urinary Incontinencetreatment. Body temperature examination in SARS period was excellently performed by elderhealthcare institutes. Chef performance and dormitory allocation in elder care institutes weresuperior. Small institutes surpassed the other two types of institutes in overall analysis, statisticallythere was no significant difference between the other two.　　　Rasch analysis provides the institute accreditation with much more information.. We suggest that the researchers could use it for their further studies in the future.
显示于类别:	[Department of Business Administration, Master/Ph.D Program in Management Sciences] Disserations and Theses(M. A. Program in Nonprofit Organization Management)

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