牙醫師對全民健康保險實施後執業安排舆支付制度的意見調查

An Opinon Survey of Dentists on Practice Arrangement and Payment System under National Health Insurance

江東亮(Tung-Liang Chiang) ； 李彩萍(Tsai-Ping Lee) ； 林芸芸(Yun-Yun Lin)

《中華公共衛生雜誌》 13卷3期 (1994/06) Pp. 223-228

https://doi.org/10.6288/CJPH1994-13-03-03

摘要

為探讨牙醫師對全民健康保險實施後執業安排與支付制度的意见，本研究以中華民國牙醫師公會聯合之會之所有登記會員為研究對象，於1989年年底進行郵寄問卷調，共收集1303名有效樣本资料，回收率為24.9%。調查结果顯示：(1)九成以上牙醫師都願意接受全民健康保險特約，但祇有三分之一的牙醫師赞成须經評鑑合格才准特约；(2)大多数牙醫師赞成專診制度，但祇有半數同意限制牙醫師前往牙醫師人力過剩地區執業；(3)牙醫師大都赞成論量計酬制度，但對於支付標凖，则診所牙醫師倾向於主張同病／同項同酬，而醫院牙醫師则尚支持依评鑑等級與牙醫師資歷支付診療報酬；以及(4)近半數的牙醫師赞成差額负擔。根據上述發现，本研究進一步討論對全民健康保險政策的啓示與未来研究方向。

關鍵字

牙醫師 ； 全民健康保險 ； 執業安排 ； 支付制度

並列摘要

This study examines dentists' opinions on practice arrangement and payment system under national health insurance (NHI). The data for the analysis came from a mail survey of 1303 members from the China Dental Association in late 1989 (response rate of 24.9%). The results of this study showed that (1) more than 90% of dentists are in favor of making a contract with NHI to provide services, but less than one third agree with the requirement of accrediation for contract; (2) most dentists support the policy of referral system, but only half agree with the restriction of the number of dentists practicing in communities with an oversupply of dentists; (3) most dentists prefer to be paid on the basis of fee-for-service; in particular, office-based dentists like 'equal payment for equal diagnosis/service' while hospital-based dentists like being paid according to accrediation and professional merits; and (4) approximately half of dentists are in favor of balancing billing. Based on the findings, this study discussed the implications for national health insurance policy and future research.

並列關鍵字

dentist ； national health insurance ； practice arrangement ； payment system