| Summary: | 碩士 === 元智大學 === 經營管理碩士班(國際企業學程) === 95 === In 1995, Taiwan government began to implement National Health Insurance system for improving medical quality and welfare in society. However, because Bureau of National Health Insurance has faced adversity for long time, it started to draft global budgeting system to improve the adversity. To resolve the problem of wasting medical resources under global budgeting system, Bureau of National Health Insurance adopted Case Payment system instead of Fee for Services. It began to draft TW-DRG stemming from AP-DRG version in the United States. And it first used Case Payment 54 items to be buffer for all of DRG items which will be implemented in future.
Due to “patients with serious illness tends to go to big hospitals, the other patients will go to small hospitals”, academic medical centers would benefit less than regional and district hospitals do. Therefore, this study would like to prove whether variation of balance of reimbursement minus cost exists among different levels of hospitals. This study will use data from National Health Research Database, and choose patients with DRG codes which appear in academic medical centers, regional hospitals, and district hospitals. This study adopts average of medical cost and of balance to avoid the difference of scale among different levels of hospitals. This study uses Post-Hoc test and Independent-Sample T test to analyze the variation of medical cost and of balance in each DRG and at large among different levels of hospitals.
The result shows that there is significant variation of medical cost and of balance among different levels of hospitals at large. The phenomenon results from slight variation of medical cost and of balance in each DRG item among different levels of hospitals. This study also deduces four propositions to explain the implication of the phenomenon.
|
|---|
