全民健保實施後住院病患復健治療利用分析

The Utilization Analysis of Rehabilitative Therapies in Inpatients under the National Health Insurance Scheme

吳肖琪(Shiao-Chi Wu) ； 吳義勇(Yee-Yung Ng) ； 熊嘉玲(Chia-Ling Hsiung) ； 藍忠孚(Chung-Fu Lan)

《中華公共衛生雜誌》 17卷1期 (1998/02) Pp. 19-27

https://doi.org/10.6288/CJPH1998-17-01-03

摘要

全民健保開放骨科、神經科、神經外科、整型外科四個急性醫療專科可直接施行復健治療，與全民健保依醫院評鑑層級給付復健治療部分費用後，各科復健治療利用的情形是本研究之目的。本研究利用民國84年7至12月全民健保住院申報資料進行分析，結果顯示健保實施後，復健治療使用率為6.2%，復健科的復健治療使用率最高(90.7%)，但骨科由於病忠多，其復健治療使用次數最多（佔總復健使用人次25.1%），其次是神經科（佔6.4%），再其次才是復健科（佔6.3%），以醫院層級區分，醫院層級愈高則復健治療使用率愈高，各醫療專科絕大部份的復健治療利用，是在醫學中心及區域醫院；開放的四個醫療專科，其復健治療利用共佔總復健治療利用40.3%。隨著人口之老化，建議在實施第三期醫療網計畫時，在加強復健醫療及長期照護部份，要強化提供急性醫療專科復健治療之功能，並考慮地區醫院之定位。

關鍵字

健康保險 ； 復健醫療 ； 住院醫療 ； 復健治療

並列摘要

The National Health Insurance implemented in 1995 opened the direct access of rehabilitative therapies to four specialties including orthopedic, Nneurology, Nneurological surgery, and plastic surgery, and revised the payment method of rehabilitative therapies according to the levels of hospitals. The purpose of the study concerns the utilization of rehabilitative therapies in inpatients under the National Health Insurance Scheme. We made descriptive analysis for the computerized data of the Inpatient reimbursement claim of the National Health Insurance during July and December in 1995. The result showed that the total utilization rate of inpatient rehabilitative therapies was 6.2%. The highest utilization rate of inpatient rehabilitative therapies was in department of rehabilitation(90.7%). The most utilization frequency of inpatient rehabilitative therapies was orthopedic (25.1% of the total utilization rate), followed by neurology(6.4%) and rehabilitation medicine (6.3%). The upper level of hospitals, the higher of utilization rate of inpatient rehabilitative therapies. The use of inpatient rehabilitative therapies occurred mostly in medical centers and area hospitals among these specialties. The use of inpatient rehabilitative therapies among these four specialties was 40.3% of the total use. Therefore, we suggested to enforce providing rehabilitative therapies of specialties for improving the rehabilitation medicine and long term care system in the third planning of Medical Care Network and to reevaluate the role of community hospitals for the rehabilitative therapies especially for the growing population of aging.

並列關鍵字

Health Insurance ； Rehabilitation Medicine ； Inpatient Care ； Rehabilitative Therapy