| Summary: | 碩士 === 淡江大學 === 管理科學研究所 === 92 === Title of Thesis：Effects of the financial incentives on the medical Total pages:85
behaviors under the system of the national
health insurance：A medical system in Taoyuan
Key Words：National Health Insurance, Payment System, Physician Payment Arragement, Medical Behavior, Financial Incentive
Name of Institute：Tamkang University, Graduate Institute of Management Sciences
Graduate Date：June, 2004 Degree Conferred：Master’s degree
Name of Student：Kun-Chang Jeng Advisor：Dr. Hai-Ming Chen
Abstract：
The objective of this research is to discuss the effects of financial factors caused by policies and payment systems of Taiwan’s National Health Insurance System on doctors’ salary system in hospitals, hospital management strategies and medical behaviors.
In accordance with the research objective, literature review and case study methods are used to develop five fundamental research aspects, including characteristics of hospitals, the national health insurance system, doctors’ salary system, hospital management strategies and medical behaviors.
In terms of characteristics of hospitals, the national health insurance system and doctors’ salary system, data of case are conducted to establish medical systems and management processes, and also to analyze internal and external environment factors that lead to their impacts on the medical behaviors.
The results of the study are hoped to serve as references in practical business management for future managers of medical institutions.
The research results are as follows:
1.The impact of the health insurance policy on medical behaviors is far greater than the involvement of hospital’s internal management system; the payment system also affects the intensity of medical care, medical behaviors, medical quality, organization efficiency and hospital’s management.
2.In response to the impact of the health insurance system on their operations, medical institutions put into practice the physician fee (PF) system in view of gaining monetary benefits; however, the expansion of the management system interferes with medical behaviors, and at the same time causes conflicts between doctors and hospitals.
3.In order to survive in the environment, medical institutions formulate many responsive strategies so the health insurance system’s regulatory measures and norms cannot achieve the expected results.
4.Since the payment system of the health insurance regime fails to consider time and risk incurred by doctors in discharging their medical duties, the system is viewed as not achieving fair and reasonable payment standards. Moreover, when hospitals formulated the PF system, the emphasis is put on labor, and as a result, doctors have doubts as to the reasonableness of the design of the PF system.
5.Under the profit-seeking mentality, doctors would choose to practice in areas with high-effectiveness and low risk. Owing to this, the payment systems would also have an impact on the choices of doctors’ areas of practice.
6.Due to the financial incentive, the PF system does promote productivity. Nevertheless, those doctors who are devoted to teachings and researches cannot receive a certain degree of rewards, which would lead to the lack of interest in teaching and research work, deterioration of quality and even distortion of values.
7.The payments made under the health insurance payment system vary in accordance with the levels of hospitals. Since the missions and business motives of public hospitals differ from their private counterparts, the doctors’ salary systems and business management strategies of public and private hospitals demonstrate significant differences.
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