- 學位論文
醫院層級對醫療費用及住院天數之影響
The Influence Of Different Hospital Levels On The Length Of Stays And The Medical Expense For Hospitalizations
摘要
為了探討不同的醫院層級對住院天數及醫療費用的影響，本研究利用在醫學中心、區域醫院、地區醫院三種層級都十分常見的住院疾病，分別為心肌梗塞、心臟衰竭、中風、肺炎、氣喘。使用2007至2009年的住院醫療費用清單明細檔資料，利用最小平方法進行迴歸分析，比較不同層級的醫院在住院天數及醫療費用上的差異。並進一步控制有使用慢性病床的樣本進行分析，觀察結果是否不同。 研究結果發現，分析整體樣本時，五種病的結果大致相同，醫院層級越高，住院天數越高，醫療費用也越高。在控制慢性病床的樣本後，醫學中心的醫療費用仍比其他層級來得高，區域醫院在心臟衰竭及肺炎的醫療費用上低於地區醫院，其他病仍高於地區醫院。在住院天數部分，醫學中心的住院天數除了在氣喘上高於地區醫院外，其他病的住院天數皆少於地區醫院，區域醫院的住院天數則皆少於地區醫院。當病情較為嚴重時，到大醫院可以使用較好的設備，也可以受到較完善的照顧；當病情比較穩定，到小醫院可以休養比較久，且醫療費用較低，比較不會造成醫療資源的浪費。
並列摘要
The purpose of this thesis is to investigate the influence of different hospital levels on the length of stays and the medical expense for hospitalizations. Inpatient data including myocardial infarction, heart failure, stroke, pneumonia and asthma that are extremely common hospitalization in medicine center, regional hospital and local hospital between 2007 and 2009 are used. This study analyzes the influence by applying the ordinary least squares regression model. The results show that both length of stays and medical expense increase with higher hospital level. After controlled the chronic hospital bed samples, the medical expense in medicine center is still higher than the other levels. However, the medical expense for heart failure and pneumonia in the region hospital is lower than the local hospital. On the other hand, the length of stays in the medicine center is shorter than the local hospital for all disease except the asthma. The length of stays in the region hospital is shorter than the local hospital. When the condition is serious, a patient can visit a big hospital with better medical equipment. When the condition is stable, a patient can transfer to a small hospital with longer length of stays. Therefore, the medical resources will be used more efficient.