Effects of Doctor’s Individual Global Budget on Physicians’ Practice

• Main Authors: Wei-Chun Chang, 張維淳
• Other Authors: 林耀欽
• Format: Others
• Language: zh-TW
• Published: 2006
• Online Access: http://ndltd.ncl.edu.tw/handle/28166511902915452977

碩士 === 元智大學 === 資訊管理學系 === 94 === In the year of 2005 ,this study’s case hospital participated hospital global budget , the strategy of NHI Research .For the effective management, case hospital divided fee between senior physician and physician. This research wants to probe into under the circumstances that the case hospital implement the doctor’s individual global budget, the doctor take one''s own interests into account only, the constant serving amount of increase and medical resource are consumed, ignore the whole policy of the hospital? Or it is limited to consider medical resources, reduce the light disease patient''s service amount? Does the patient more serious to the disease exert an influence? This study use " influenza " to represent light disease,and " tumour " to represent serious disease. And we use “the number of patients” ,” average every person hospitalization cost”, “every person expenses for medicine on average”, “every person write a prescription day on average”, “every person expenses for treatment on average”,this 5 indicator to find out the difference between the implement of the doctor’s individual global budget. The contrast group were in the year of 2004, experiment groups were in the year of 2005 after being implemented of the doctor’s individual global budget. Length of service and training of doctor also probe among this research. This research materials source is from the case hospital file , that for NHI.The file record to EXCEL file and put in order to carry on statistical analysis with SPSS10.0. No matter " influenza " or " tumour ", after implementation of the doctor’s individual global budget , doctor''s serving amount has not obviously dropped. " influenza " every person hospitalization cost, expenses for medicine, give medicine day, treatment fee obviously drop after the implementation of the doctor’s individual global budget. The doctor, through reducing the method that every person uses medicine, checking, handling, achieve the goal of in charge of accusing of the expensesing. " Tumour " every person hospitalization cost, expenses for medicine, give medicine day, treatment fee have not too many changes after implementation of the doctor’s individual global budget, so the implementation of the doctor’s individual global budget, had no influence of the serious patients'' rights and interests. Disease serious degree, doctor length of service, doctor department can influence medical behavior of doctor. Propose the competent authority and hospital administrator, while carrying on the distribution of global budget , need to consider the serious degree of disease accepted for medical treatment, if hospital need to pratice the doctor’s individual global budget, propose advance gradually way . Finally , use the doctors’ bonus and consider the degree of disease.