| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 90 === The National Health Insurance（NHI） has adopted the Diagnosis Related Groups（DRGs）to control increasing Healthcare Care expenditures efficiently and planed to phase-in in2004. The purpose of this study is DRG90, which is “simple pneumonia and pleurisy （age＞17 w/o CC）”, as an example to examine appropriateness of DRGs .In addition, the differences in prescription patterns in different specialty have also evaluated.
Samples included in the study were abstracted from " simple pneumonia and pleurisy （age＞17 w/o CC）" of a medical center locating in Taipei. The data were abstracted from inpatients expenses claim data and inpatient order claim data（from 2000 to 2001）.Statistical methods, such as t-test, Chi-square(χ2)test ,ANOVA, and MANOVA were applied to analyze differences in prescription patterns among various patient characteristics (sex, age)and medical specialities.
Results of the study indicate that there are significant differences among patient characteristics（sex, age）and prescription patterns, even in the same DRG90.
Policy implication of the study include：（1）NHI Taiwan DRGs system should weight more on patient characteristics, severity of illness and recorder levels of payment.（2）The hospital should establish practice guidelines （or Clinical pathway ）emphasizing pharmacoeconamics for hospital inpatient service in order to control cost and quality of medical care.
|
|---|
