「醫院總額支付制度實施前後各級醫院醫療服務之研究」-以桃竹苗地區之醫院為對象

Before and after practicing Global Budget Payment System the research of different levels of hospitals are mainly in Taoyuan ,Hsinchu and Miaoli.

馮玉女(Yuh-Neu Ferng)

指導教授 ： 羅 新 興 ； 徐 學 忍

元智大學/管理學院/管理研究所/碩士(2004年)

摘要

本研究收集北區分局服務地區四十三家醫院，實施總額支付制度前後各一年半健保資料庫之申報資料進行比較，含醫療費用申報資料醫事人力資料、醫療設備資料及病床數資料。
資料分析結果彙整後，邀請各層級醫院之專家代表至北區分局進行專家焦點團體座談會，並將相關專家意見彙整後，依照會議決議建議事項將九十二年四月至六月SARS期間之資料刪除後，重新分析資料。
經由上述定量與定性研究過程，本研究獲得下列幾點結論：
一、醫院總額支付制度實施以後，各層級醫院之部分醫療費用申報具有差異性，一般而言，住院申報件數呈現減少情形，而住院申報總金額及住院每件平均金額呈現增加情形；而門診申報件數、門診申報金額及門診每件平均金額呈現減少現象。
二、醫院總額支付制度實施以後，醫學中心各類醫事人力均呈現減少之情形，其他層級醫院之醫事人力除復健治療人員及其他人員呈現增加之情形外，其他醫事人力呈現減少之情形。
三、醫院總額支付制度實施以後，各層級醫院之醫療設備普遍呈現增加之情形。
四、醫院總額支付制度實施以後，各層級醫院之病床數呈現增加之情形。

關鍵字

總額支付制度

並列摘要

The research collects Bureau of National Health Insurance Northern Branch the services of 43 hospitals. The researcher compares the application data of insurance informations between the earlier one and half years and later one and half years. The informations include the fee of medical application, the data of medical man, the medical equipments, and the number of sickbeds.
After the analysis, the researcher invites the expert representatives to Bureau of National Health Insurance Northern Branch to work on Focus Group. The researcher also combines the opinious from virious experts. According to the result of the meeting, we dicide to erase the data during（from April to June,2003）and renew the information.
Based on the analysis of fixed quantity and quality, we come to the following conclusions：
1、 After practcing Global Budget Payment System of hospital, there are differences among parts of medical fee from different levels of hospitals. Generally speaking, we find the decrease of applications for hospitaizing cases, the total and single amount of hospitalization has increased; the clinical cases, money applications cases, and the amount of average cases have decreased.
2、 Since Global Budget Payment System of hospital is put in practice, different kinds of medical man in Academic Medical Centers appeare decrased. Medical members show decrased except the medical man of rehabilition and the other man show incrased.
3、 After practcing Global Budget Payment System of hospital the medical equipment of different levels of hospital shows incrased.
4、 Global Budget Payment System of hospital the sickbeds’ number from different levels of hospital have incrased.

並列關鍵字

Global Budget Payment System

參考文獻

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