病人分類系統與護理費用

Patient Classification Systems and Nursing Fees

徐南麗(N. L. Hsu)

《護理雜誌》 43卷4期 (1996/12) Pp. 23-33

https://doi.org/10.6224/JN.43.4.23

摘要

本研究係國科會補助五年計劃之第四年研究，目的在依已建立之因素型病人分類量表鉤選每日護理項目，以下列幾種不同方式計算護理費用：(1)以研究工時來計算各類病人之每日平均護理費用。(2)依專家建議之理想護理工時、理想護理收費，分別計算各類病人之每日平均護理費用。(3)以各種醫療保險給付與全民健保所付之每日病房護理費用，并比較收費在病人分類上之差异。調查時間自84年3月14日起至6月24日止。調查杳對象以臺北某醫學中心之一般外科四個專科病房1028信病人及26位護理專家為樣本。研究工具採用因素型病人分類量表。信度採觀察員信度，效度採專家效度。調查結果顯示第一、二、三、四類病人的護理收費，根據因素型病人分類量表鉤選之每日護理項目，(1)以護理工時來計算，得到：314，649，895及1214元。(2)以每分鍾專家建議工時乘以5元計算，得到：377、786、1076及1463元；以專家建議單項護理技術收費計算，得到：438、1028、1507及2109元。(3)以勞保收費標準為351、767、1235及1780元。(4)以建保收費標準計算為:378、915、1390及1960元。上述四種收費之間有差异存在。本文研究結果可供保險機構做為未來以病人分類給付護理費用及病人收費標準之參考。

關鍵字

病人分類 ； 病人分類系統 ； 護理成本 ； 護理費用

並列摘要

This is the fourth year of five-year research plan sponsored by the National Science Council. The purpose of this study was to use VGH-T Factor Patient Classification Systems to calculate the following nursing Fees: (1) by using time study for each nursing activity, (2) by experts’ opinion for ideal nursing activity time and ideal nursing charge to calculate nursing Fees, (3) by using different insurance payments and National Health Insurance payments to compare nursing Fees for four types of patients. The investigation period started on March 14, 1995, and ended on June 30, 1995. Patient Classification Tool was used in four general surgical units. There were 1,028 patients’ data for patients’ needs used. Reliability and validity were based on inter-rater reliability and experts’ opinion. The results showed: (1) based on nursing time, the nursing Fees for Types 1, 2, 3, 4 were NT$314. 649, 895 and 1214; (2) according to experts’ opinion, the nursing Fees for Types 1, 2, 3, 4 were NT$377, 786, 1076 and 1463; (3) according to labor insurance payments, the nursing Fees for Types 1, 2, 3, 4 were NT$351, 767, 1235 and 1780; (4) according to National Health Insurance payments, the Fees for the four types were NT$378, 915, 1390 and 1960. There were significant differences between the four types of patients. There were significant differences between the different calculations of nursing Fees. The results help not only in patient classification, but also help insurance companies with reference to payment for nursing fees.

並列關鍵字

patient classification ； patient classification system ； nursing cost ； nyrsing fees