| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 90 === Beginning from November of, the Nation Health Insurance(NHI) has implemented a Tuberculosis medical payment program, based upon quality of medical services. This program aimes at pursuring “health” instead of “illness” in paying health care institutions.The purpose of this study is to assess the potential effects of this program on medical care resource utilization.7,351 TB patients, treated by 108 institutions in NHI North Bureau, and their claim data were collected and analyzed.
The result of this study indicate that accredited level of hospitals affect TB patients’ medical resources utilization; besides age and sex can also be factors which associate with TB patients’ resource utilization, due to it needs longer timing of hospital attention.
Results of this suggest:
I. NHIB should include patients’ gender and ages as adjustment factors to TB re-imbursement so the NHIB can maintain its equal payment to equal workload principle.
II. Under NHI’s “Pay-by-quality” system and “Global budget” system, health care institutions should be more aggressive and positive in promoting higher quality of care so that they can receive more payment and/or contain unnecessary costs. In other words, health care institution can be more profitable if they could treat patients with better quality of care.
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