| Summary: | 碩士 === 臺北醫學大學 === 醫務管理學系 === 92 === Foreign studies show that patient dumping situation occur often in the emergence rooms in the hospitals. Since the hospital emergence rooms are the very first front line to save the life of patients , for both the patients and the family, it is desired that the medication service providers offer the best timing and proper cares needed to the patients. However, due to the instability of domestic referral system practice and lacking of management and supervising from the legal enforcement unit, would the patient dumping situation happens when a patient expected with less means arrives at the emergence room for help and then is dumped by the hospital to another because of the business competition nature between hospitals? This dumping situation also leads to the readmitted emergence room phenomena to occur. Because the phenomena not only lowdown the accessibility of medication and affects the medication rights of the patient, all the medication service providers are also affected for the wasting of both medication resources and administration cost because the above readmitted phenomena , worst of all ,it severely damages the all medication service system.
This research tries to understand northern Taiwan area in year 2001the readmitting phenomena, by suing the “2001 national health insurance research database” year 2001section as secondary data for the analysis base, to see how it is associated with the factors of hospital’s specialization, doctors’ specialty and the characters of the patients. And this research may come to the conclusion of existing of patient dumping situation.
This study reveals that the characters of the patients and of the hospitals indeed cause the act of the same patients to re-admitted to different hospitals for emergency department for medication service even under the same diagnoses in the same day. Both the medical centers and public hospitals accept more such patients who have been to other hospitals for the first treatment, and the hospitals preferred choices for such patients for the secondary treatment are Taipei and Taoyuan medic medical area . However, due to the data-base analysis methodology used in this study, it cannot be identified whether the repeated medication phenomena is activated by the hospital’s “patient dumping” or caused by the special chrematistics─doctor shopping, rooted in our culture.
Because of the exiting large gray area in medication field and the information gap between the patients and the hospitals, also added the fact that patient dumping is still an unfamiliar vocabulary to the people here, in terns of medication accessibility due to the nation-wide insurance system for the less-resourced weaks, the patient dumping phenomena here is not as obvious as in medication markets in the States. Nevertheless, surrounded by the unsettle of referral system and under the ill-functioned medication rating system, the Medication Bureau should re-exam all the aspect and the when designing the healthy policy and the coordination of concerning packages in order to benefit all our people fairly in full aspect medication service and also to promote well-quality medication culture.
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