軍人納入健保對國軍醫院住院部醫療資源使用之影響

The Impacts of Military Personnel Enrolled in the National Health Insurance on Medical Utilization in the Department of Admission of Military Teaching Hospital

莊世杰(Shih-Chieh Chuan)

《東港安泰醫護雜誌》 11卷3期 (2005/09) Pp. 139-145

https://doi.org/10.7078/TSMHMNJ.200509.0139

摘要

背景：我國全民健保自1995年實施後，幾乎所有國民均被納為全民健保的對象，而且絕大多數醫療院所，包括軍醫院均成為全民健康保險的特約機構。然而，大約四十萬國軍官兵的實際醫療需求，加上整體社會及醫療團體的共識，乃於2001年2月將所有軍人納入全民健保體系。本研究欲探討分析在軍人納入健保體系後，對國軍醫院而言，醫療資源的使用是否發生變化並了解對醫院財務管理的影響。
方法：本研究取樣軍人納入健保前後各兩年的時間，針對現役軍人身分的病患，於南部某一國軍地區教學醫院住院部門的醫療統計資料，分析並比較軍人納入健保前後的差別。
結果：經由統計分析結果發現，平均每人每天藥費，在軍人納入健保前後並無明顯改變，而其他項目如總住院人次、總住院藥費、總住院天數、平均每人次費用、平均住院天數、平均每人藥費、平均每人每天費用、平均每人每天藥費及總醫療費用則均具有顯著變化。
結論：軍人納入健保後，國軍醫院對醫療資源的使用確實發生了相當的變化。如何掌控整體醫療費用，在有限的資源中，作更有效率的分配利用，使軍醫院在醫療市場的劇烈競爭下仍能穩健的經營，當為經營管理者的重要課題。

關鍵字

軍人 ； 醫療資源利用 ； 全民健保 ； 國軍醫院

並列摘要

Background: Since 1995 the National Health Insurance (NHI) was implemented in Taiwan, the system of military hospital has been incorporate into the system of NHI. However, about four hundred thousand military personnel should subsume the scheme because of the practical medical needs, social requests and inner hope of military personnel. The government has admitted military personnel in 2001 as insurants under NHI scheme allowing medical service and life dignity. This study is to investigated the impacts of military personnel enrolled in the National Health Insurance on medical utilization in the in-patient department of a military teaching hospital.
Methods: Researcher had collected the 4 years data of in-patient department of the military teaching hospital which in is south area of Taiwan. Data are obtained between Feb. 1999 and Jan. 2003, the analyzed data included total amount of patients, total cost of admission, average cost of admission per patient, cost of drugs per patient, average of hospitalization (days), total hospitalization, cost of total admission per patient per day, cost of total drugs per patient per day, and total cost of admission. Results: After military personnel enrolled the NHI, the cost of drugs per patient per day had no significant change. The other items showed significant changes.
Conclusions: We concluded the significant impacts of military personnel enrolled the NHI on medical utilization. It also has an obvious influence on the military hospital. Hence, it suggests that the military hospital would be more competitive if it is more accessible to military personnel and its quality of service is enhanced as well as its facility must be improved.

並列關鍵字

Military personnel ； Medical utilization ； National Health Insurance ； Military teaching hospital