牙科處置資源耗用相對價值表之研探

A Study on Resource Based Relative Value Scale of Dental Procedures in Taiwan

楊志良(Chih-Liang Yaung) ； 陳琇玲(Hsiu-Ling Chen) ； 溫信財(Hsyien-Chia Wen) ； 黃文駿(Wen-Jiun Huang) ； 黃意婷(I-Ting Huang)

《台灣公共衛生雜誌》 20卷6期 (2001/12) Pp. 475-484

https://doi.org/10.6288/TJPH2001-20-06-07

摘要

目標：本研究試圖建立本土牙科處置資源耗用之相對價值表。以發展醫療項目資源耗用的分析模式。方法：本研究結合「牙醫師工作量」、「藥衛材成本」、「操作時間」三種不同基準資料，透過牙科「成本結構」之各項成本占率以及單項處置之「服務量」，轉換為相同基準之相對值，建立牙科處置的資源耗用相對值，作為資源耗用分析模式。並請專家小組成員個別對研究結果進行評估，同時探討與健保支付標準的相關性，再將各項處置之相對值貨幣化後，與健保支付標準進行比較。結果：完成建立79項牙科處置之執業資源耗用為基準相對價值表。牙醫師全聯會推派之專家對研究結果的評估。與本研究所得相對值之間有顯著相關，本研究所得牙科各項處置耗用資源相對價值表與現行健保支付標準之間具有顯著相關，將研究結果相對值貨幣化後所得到牙醫師判定各項處置資源耗用金額，可獲得與健保支付標準之差異值。結論：本研究所得相對值整體為牙科專家認同，顯示健保支付標準大致反應牙科各項處置的資源耗用的相對性。但是部分項目牙醫師判定耗用的資源與健保支付標準之差異大，可作為未來調整支付標準之參考。

關鍵字

牙科 ； 資源耗用 ； 相對價值表 ； 支付標準

並列摘要

Objectives: The purpose of this study was to investigate the Resource Based Relative Value Scale of dental procedures (D-RBRVS) in Taiwan in order to establish a model of resource-input for medical services. Methods: The formula for our procedure cost was ”D-RBRYS = the RVS of dentists' Workload + the RVS of drug and material costs + the RVS of other operating costs”, We readjusted the three RVSs to a common scale and set up the D-RBRVS by dental cost structure and service volume. We then investigated the opinions of dental specialists and evaluated the correlation between our D-RBRVS and the dentistry payment scheme of the National Health Insurance (NHI). We also adjusted the D-RBRVS in a monetary base and compared with it the AA procedures were established. The views of dental specialists were significantly correlated with Our D-RBR VS. The results also correlated fairly well with the current dental payment schedule of the NHI. However, there were differences between the monetary-base D-RBRVS and the payment scheme of NHI for some services. Conclusions: The high acceptance of our D-RBRVS by dental specialists suggests that the parameters of dentists' workload, cost of medications and supplies, and time required for procedures establishes a reasonable basis for evaluating resources. The current NHI dental fee schedule also fairly well matched the D-RBRVS of the 79 procedures. The monetary-base D-RBR VS can be a reference for adjustment of the NHI dental payment system in the future.

並列關鍵字

dentist ； practice cost ； relative value scale ； payment system.