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  • 學位論文

健保總額支付制度對署立地區醫院之影響 ---以署立某地區醫院為例

The Influence resulted from Global Budget System in Public Regional Hospitals ---for example by a public regional hospital

指導教授 : 古思明

摘要


本研究探討健保局實施總額支付制之A級審查方案(即醫院個別總額,屬於健保局給予個別醫院支付目標制,俗稱醫院小總額)對於署立地區醫院的影響。我們針對個案醫院加入A級審查方案的前後兩年之服務量及醫療收入做一比較和統計是否有所改變?統計結果發現在健保局要求的醫療品質之下,個案醫院的門診人次及住院人日數有明顯差異且醫療收入有明顯減少。公立地區醫院面對環境以及健保制度的改變,不但心態要調整,其策略以及定位均要有所改變,才不致於走向被淘汰的命運。 關鍵字: 總額支付制、A級審查方案、地區醫院。

並列摘要


Bureau of National Health Insurance administers the A level examination plan of Global budgets (namely, Health Insurance Bureau give a limit amount payment to individual hospital each season ) which affects regional hospital very much ! The research, the case hospital joined the A level examination plan around two years, compares and counts the service quantity and the medical income whether has the changes? The statistical result discovery in under the Health Insurance Bureau request medical quality, the case hospital outpatient service people and the is-hospitalized person-date number to have the obvious difference, also the medical income has obviously reduces. Public regional hospital facing environment and health insurance system change, not only the point of view needs to adjust, its strategy and character must have changes, only then does not send to the eliminates destiny ! Key words: global budgets, A level examination plan, regional Hospital.

參考文獻


4. 衛生署(2004),全民健保改革宗論。
14. 財團法人醫院評鑑暨醫療品質策進會:http://www.tjcha.org.tw.
1. 凌嘉華 譯(2000),「用Excel 做商用統計學」,臺灣西書出版社。
2. 陳國團(2004),「經營之道—醫院企業化管理」,新文京。
3. 邱文達(2003),「醫院品質實務管理」,合記圖書。

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