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牙醫診所醫療物價指數建立之研究

A Study on the Establishment of Dental Medical Economic Index

摘要


目標:本研究目的在建立兼顧成本控制及行政可行性的牙醫診所醫療經濟指數,以利總額支付制度之推行,並作為未來建構國內其他類型醫療經濟指數之參考。方法:本研究首先調查全民健保實施後牙醫診所之各項執業成本佔總成本之比率(包括人事費用、藥品費用、材料費用、建築物租金、設備折舊、其他費用及雜項支出),以作為指數計算之權重。其次,本研究利用牙醫診所各執業成本項目,就主計處公佈之各項物價指數中,選擇較能反映牙醫成本項目之指數,並參考主計處及相關政府機構86年至88年公告之相對物價指數進行加權平均,以建立牙醫診所醫療經濟指數。結果:醫師診察費(佔48.96%)為牙醫診所營運成本比重最大的項目,其次為人事費用(佔11.65%)及醫療材料(佔11.29%)。以民國85年為基期,台灣地區86及87年牙醫診所服務物價總指數分別為103.70%及108.93%,年增率分別為3.74%及5.00%。影響牙醫診所醫療經濟指數漲幅最大的成本項目為醫療器材及醫師費,影響率各為1.76%及1.44%。而影響最大的物價指數項目為躉售物價指數-醫療儀器類,影響率為2.59%,主要受到匯率波動之影響。在分類指數方面,若以執業地區分類,則以東部地區分類指數最高。結論:牙醫診所醫療經濟指數之建立及持續修正、改良對牙醫總額支付制度之推行至為重要。鑑於總額支付制度將逐漸推廣至中醫、西醫診所及醫院,衛生署應持續推動各種相關指數之建立。

並列摘要


”Objectives: The main purpose of this paper is to establish the Dental Medical Economic Index (OMEI) to facilitate the implementation of global budget payment system of the National Health Insurance. Methods: The paper first surveys the dental clinics to determine their cost structure, as measured by the percentage of personnel, medicine, materials, office rent, equipment depreciation, and other costs to total cost. Then, the cost structure is matched by appropriate price indexes to construct the Dental Medical Economic Index. Results: We found that dentists' consul-tation fee is the main cost item of dental clinics (48.96%), followed by personnel cost (11.65%) and material cost (11.29%). Using 1996 as the base year, the 1997 and 1998 Dental Medical Economic Indexes are 103.70% and 108.93%, representing an annual increase rate of 3.74% and 5.00%, respectively. In addition, the most significant influencing the DMEI are material and den-tists' consultation fee (1.76% and 1.44%, respectively), Among various price indexes, wholesale price index of medical equipment is the most significant influencing the DMEI (2.59%). Conclu-sions: The establishment and continuous refinement of DMEI is crucial to the implementation of global budget payment system for dental clinics. The methodology discussed in this paper can be used to establish similar indexes for other types of clinics and hospitals in the future.

被引用紀錄


陳琇玲(2006)。台灣牙科醫療服務資源耗用相對值(RBRVS)模式之建立及其適合性評估〔博士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2006.00244

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