| Summary: | 碩士 === 國立台北護理學院 === 長期照護研究所 === 92 === The purposes of this study are to examine the costs of home health care agencies in order to understand major factors of cost in a home health care agency and to determine the cost of each service item within each resource-utilization group, using the technique of activity based costing, and to compare the results with the corresponding reimbursements by the Bureau of National Health Insurance. In addition, a comparison is made to see whether there are differences between public agencies and agencies that are nonprofit corporations.
Of the 60 agencies accredited with high scores of 2000-2002 by the Department of Health, 33 agreed to participate.Among them nine agencies completed and returned the questionnaire. The response rate is 15%. The nine agencies are all hospital based: 5 are from the 25 that are public agencies and 4 from the 35 that are nonprofit corporations.
This study used a structured questionnaire to collect data. The questionnaire includes two parts that one is “resource costs of agency” the other one is “resource costs of nursign activities”. The questionnaire was developed by the researcher of this study and the validity of the contents was examined by five home care professionals and experts,using the content validity index for each part. 1.
Based on the descriptive analysis, the public agencies have been in business longer, and have fewer staff, than the agencies that are nonprofit corporations. The seniority level of the staff as well as the average salary per minute is also higher. However, agencies that are nonprofit corporations have higher visit frequency with respect to all resource utilization groups except group #4, longer working hours with respect to each resource utilization group, and more square meters of office area, than the public agencies.
The calculation of the cost of each service item within the resource-utilization groups using the technique of activity-based costing results in the following: (1) Public agencies have higher average cost with respect to resource utilization groups # 1 and # 3 than agencies that are nonprofit corporations. On the other hand, agencies that are nonprofit corporations have higher average cost with respect to resource utilization groups #2 and # 4 than public agencies. (2) The costs for resource utilization groups # 1 and #3 are higher, and those for #2 and #4 are lower than the amounts reimbursed by the BNHI.
Use the independent t-test to examin the differences between public agencies and agencies that are nonprofit corporations in numbers of staff, the average salary per minute, workign hour, square meters of office,and the cost of each service item within the resource-utilization groups and total costs All the results indicate that the differences are statistatical non-significance ( p value > 0.05).
Due to the small samle size, results of this research may be considered as preliminary. Hoping that in the future more home health care agencies will join the research like this and provide more information to assist in the findings of costs difference in running an agency and the reimbursement provided by BNHI.By doing so we may hare a better picture concerning cost differences between home health care agency and BNHI reimbursement.
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