| Summary: | 碩士 === 義守大學 === 管理科學研究所 === 92 === Abstract
Ever since March, 1, 1995 when National Health Insurance has started, in order to ensure the quality of medical service, promote professional autonomy and fair distribution of medical resource, reasonably budget medical service disbursement to control the growth of medical expense, and to reach the goal of balancing both income and outgoings, global budget payment system has been put to practice in multiple stages. It has been two years since the hospitals began the system in July, 2002.
Not very much research has been done on hospitals that carry out global budget payment system because the system was promoted separately in different regions and the time hospitals had carried it out was less than two years. Due to the fact that doctors’ satisfaction towards medical work has great influence on professional autonomy and medical quality, this research was conducted through structural questionnaires focusing on how doctors work in district teaching hospitals, understand the functioning of global budget payment system inside of the hospitals, how they feel about it, their degree of satisfaction and understanding of the system.
This research has released 180s copies of questionnaire and has recycled and selected 128 effective copies, recovery rate is up to 73.99%. After statistically analyzing the result, it is found that in terms of degree of satisfaction, 46.3% of doctors in district teaching hospitals are unsatisfied with global budget payment system and only 8.6% of them hold a positive attitude. And in terms of doctors’ recognition of the system, it shows high percentage in outpatient medical service value computation, gradual district allocation of budget and the calculation of present global budget system, the percentages go up to 75%, 83.6%, 68.8%. However, merely 36.7% of doctors have correct knowledge in establishment of payment standard unit and 14.1% in establishment of specialized examination unit. According to statistical analysis, a notable connection is found in doctors’ satisfaction and feeling towards global budget payment system.
Based on the study result, this research suggests the following: 1. related department in charge of practicing global budget payment system should convene conferences and state the difficulties in promotion and execution to help doctors understand the execution situation of the system. 2. Hospitals should actively provide information related to global budget payment system for their doctors, and it will help doctors understand the situation and difficulties in the execution situation of the system ,and hospitals will the effects on.3. Bureau of National Health should offer active and attentive assistance in processing administrative business. Through increasing doctors’ understanding of global budget payment system and improvement of administration efficiency to better doctor’s satisfaction and feeling towards the system and in all to upgrade the quality of medical service to benefit patients. This shall be the ultimate goal for hospitals to thrive and prosper continuously.
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