實施DRGs對醫院財務之影響－以南部某區域醫院消化系統主診斷為例

Influence of DRGs on Hospital Finance of Inpatient Services: An Analysis on the Diseases of the Digestive System at a Regional Hospital in South Taiwan

嚴玉華(Yu-Hua Yan) ； 吳重慶(Chung-Chieng Wu) ； 周腎榮(Shyan-Rong Chou) ； 牟聯瑞(Lein Ray Mo)

《秀傳醫學雜誌》 8卷1&2期 (2008/06) Pp. 1-8

摘要

The TNHI (Taiwan National Health Insurance) has been phasing in the Global Budget System step-by-step, and will soon launch the Diagnosis Related Groups payment system (DRGs) for inpatient services in the near future. In this study we utilized the TNHI claims data provided by a regional teaching hospital in the southern Taiwan, based on the medical information from digestive system diseases. To assess the financial risk, die hospitals running using the TNHI should be facing soon after the implementation of that DRGs, we intended to analyze those differences yield by various physician performances in the treatment of the same MDC (major diagnostic category) patients, for example: those variation in the treatment of the DRGs-15802 and DRGs-18402 (see Text) from different physician handling cases text, as well as the different influences on hospital management. Through this study we could conclude that there are some financial risks that exist in certain MDC treatments, though not all, and that the duration of hospital days could be one of the major influencing factors for the financial risks.

關鍵字

診斷關聯群 ； 財務風險 ； 主要疾病類型

並列摘要

The TNHI (Taiwan National Health Insurance) has been phasing in the Global Budget System step-by-step, and will soon launch the Diagnosis Related Groups payment system (DRGs) for inpatient services in the near future. In this study we utilized the TNHI claims data provided by a regional teaching hospital in the southern Taiwan, based on the medical information from digestive system diseases. To assess the financial risk, die hospitals running using the TNHI should be facing soon after the implementation of that DRGs, we intended to analyze those differences yield by various physician performances in the treatment of the same MDC (major diagnostic category) patients, for example: those variation in the treatment of the DRGs-15802 and DRGs-18402 (see Text) from different physician handling cases text, as well as the different influences on hospital management. Through this study we could conclude that there are some financial risks that exist in certain MDC treatments, though not all, and that the duration of hospital days could be one of the major influencing factors for the financial risks.

並列關鍵字

diagnosis related groups ； financial risk ； major diagnostic category