全民健保支付制度改變前後公立醫院與財團法人醫院服務量及醫療利益之比較

Translated title of the contribution: A Comparative Analysis of Medical Services and Financial Performances between Public and Non-profit Proprietary Hospitals before and after Introduction of the Case Payment System

Research output: Contribution to journalArticle

Abstract

In order to curb the rapid growth in medical expenditures, the administration of National Health Insurance (NHI) is gradually changing its payment system from the fee-for-service (FFS) payment system to the case payment one. This study explored the impacts of this policy on public and non-profit proprietary hospitals' medical services and financial performances, by comparing the before and after results of eight DRG codes incepted on October 1, 1997. The results show that, after the introduction of the case payment system, the average length of stay has decreased significantly, but no apparent evidence to conclude the average reimbursement has decreased. Nevertheless, both case volume and medical revenues have significantly increased after the inception of the case payment system. Further, we also found that nonprofit proprietary hospitals seem to outperform their public-sector counterparts in the selected financial indicators.
Original languageTraditional Chinese
Pages (from-to)169-193
Number of pages25
Journal當代會計
Volume2
Issue number2
DOIs
Publication statusPublished - 2001

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Financial performance
Payment system
Service performance
Comparative analysis
Medical services
Length of stay
Public sector
Payment
National health insurance
Medical expenditures
Financial indicators
Reimbursement
Fees
Revenue

Keywords

  • National Health Insurance
  • Payment system
  • Public hospital
  • Nonprofit proprietary hospital
  • Financial performance

Cite this

全民健保支付制度改變前後公立醫院與財團法人醫院服務量及醫療利益之比較. / Chen, Ming-Chin; 黃崇謙(Chung-Chien Huang).

In: 當代會計, Vol. 2, No. 2, 2001, p. 169-193.

Research output: Contribution to journalArticle

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title = "全民健保支付制度改變前後公立醫院與財團法人醫院服務量及醫療利益之比較",
abstract = "本文探討全民健保支付制度由論量計酬支付制改變為論病例計酬支付制對公立醫院與財團法人醫院服務量及醫療利益影響之比較,以民國86年10月1日開始實施論病例計酬支付制的八項病別進行實證分析。研究結果顯示,在健保支付方式改變為論病例計酬支付制下,醫院的平均住院日數普遍有明顯的減少,但病例的平均醫療費用則沒有顯著的減少;然而實施論病例計酬支付制後,醫院病例的服務量及收入總額卻明顯地增加,顯示論病例計酬支付制對於醫院增加服務量及收入的財務誘因有較大的影響。因此政府如果僅以支付制度作為抑制醫療資源浪費的做法,其成效可能有限。此外,本文的研究結果也顯示,實施論病計酬支付制後,財團法人醫院在控制醫療費用、增加服務量收入以及淨利率的績效表現均優於公立醫院,這些差異說明公立醫院與財團法人對於支付制度改變反應的效率並不相同,可供政府作為釐訂醫療管理政策之參考。",
keywords = "全民健保, 支付制度, 公立醫院, 財團法人醫院, 績效指標, National Health Insurance, Payment system, Public hospital, Nonprofit proprietary hospital, Financial performance",
author = "Ming-Chin Chen and 黃, {崇謙(Chung-Chien Huang)}",
year = "2001",
doi = "10.6675/JCA.2001.2.2.03",
language = "繁體中文",
volume = "2",
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AU - 黃, 崇謙(Chung-Chien Huang)

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N2 - 本文探討全民健保支付制度由論量計酬支付制改變為論病例計酬支付制對公立醫院與財團法人醫院服務量及醫療利益影響之比較,以民國86年10月1日開始實施論病例計酬支付制的八項病別進行實證分析。研究結果顯示,在健保支付方式改變為論病例計酬支付制下,醫院的平均住院日數普遍有明顯的減少,但病例的平均醫療費用則沒有顯著的減少;然而實施論病例計酬支付制後,醫院病例的服務量及收入總額卻明顯地增加,顯示論病例計酬支付制對於醫院增加服務量及收入的財務誘因有較大的影響。因此政府如果僅以支付制度作為抑制醫療資源浪費的做法,其成效可能有限。此外,本文的研究結果也顯示,實施論病計酬支付制後,財團法人醫院在控制醫療費用、增加服務量收入以及淨利率的績效表現均優於公立醫院,這些差異說明公立醫院與財團法人對於支付制度改變反應的效率並不相同,可供政府作為釐訂醫療管理政策之參考。

AB - 本文探討全民健保支付制度由論量計酬支付制改變為論病例計酬支付制對公立醫院與財團法人醫院服務量及醫療利益影響之比較,以民國86年10月1日開始實施論病例計酬支付制的八項病別進行實證分析。研究結果顯示,在健保支付方式改變為論病例計酬支付制下,醫院的平均住院日數普遍有明顯的減少,但病例的平均醫療費用則沒有顯著的減少;然而實施論病例計酬支付制後,醫院病例的服務量及收入總額卻明顯地增加,顯示論病例計酬支付制對於醫院增加服務量及收入的財務誘因有較大的影響。因此政府如果僅以支付制度作為抑制醫療資源浪費的做法,其成效可能有限。此外,本文的研究結果也顯示,實施論病計酬支付制後,財團法人醫院在控制醫療費用、增加服務量收入以及淨利率的績效表現均優於公立醫院,這些差異說明公立醫院與財團法人對於支付制度改變反應的效率並不相同,可供政府作為釐訂醫療管理政策之參考。

KW - 全民健保

KW - 支付制度

KW - 公立醫院

KW - 財團法人醫院

KW - 績效指標

KW - National Health Insurance

KW - Payment system

KW - Public hospital

KW - Nonprofit proprietary hospital

KW - Financial performance

U2 - 10.6675/JCA.2001.2.2.03

DO - 10.6675/JCA.2001.2.2.03

M3 - 文章

VL - 2

SP - 169

EP - 193

JO - 當代會計

JF - 當代會計

SN - 1609-3895

IS - 2

ER -