實施醫院門診合理量對醫師勞動供給之影響

The Effect of Hospital Adequate Outpatient Volume on Physician Labor Supply

陳欽賢(Chin-Shyan Chen)

《醫務管理期刊》 2卷3期 (2001/09) Pp. 60-71

https://doi.org/10.6174/JHM2001.2(3).60

摘要

醫院門診合理量已於民國九十年一月正式推行，中央健康保險局意圖利用此一措施，來抑制持續成長的醫院門診量，減緩快速膨脹的醫療費用，同時亦全求醫院門診的看診品質能相對提昇。本文將從經濟學勞動供給的角度，嘗試分析醫院門診合理量實施後，醫師的服務量會產生何種變化。由理論模型的推估結果發現，當休閒被視為正常財，而醫師診察費因醫院門診合理量的實施而下降時，此政策對於醫師實際門診工作時問的影響是不確定的。換言之，若政策對醫師所產生之替代效果大於所得效果，其門診工作時問會相對下降，上述目的或許可達成。但若所得效果大於替代效果，在病人的大量需求下，醫師會進而擴大其門診工作時間，則上述醫院門診合理量的預設效果，可能會大打折和而適得其反。如此，不僅無法降低醫院門診量，反倒有助於門診量的進一步擴張。

關鍵字

門診合理量 ； 全民健保制度 ； 醫師勞動供給

並列摘要

The policy of Hospital Adequate Outpatient Volume was implemented by the Bureau of National Health Insurance in January 2001. The goal is to contain the rapidly rising hospital outpatient volume as well as to maintain the quality of outpatient services. This paper analyzes the effect of Hospital Adequate Outpatient Volume on a physician's working hours based on the theory of labor supply, Results of the theoretical model show that as the policy leads to a decrease in physician fees, the effect of this policy is ambiguous given that leisure is a normal good. In other words, there may be two outcomes resulted from this policy. When the substitution effect is greater than the income effect, a physician will reduce his (her) working hours (outpatient volume). Conversely, if the income effect is greater than the substitution effect, he (she) may increase working hours to compensate his (her) potential losses, Therefore, if the policy results in the latter outcome, hospital outpatient volume will continue to grow rather than to shrink after the new regulation.

並列關鍵字

Adequate Outpatient Volume ； National Health Insurance ； physician labor supply