The Initial Exploration of Diagnosis Related Groups Performance on Administration Efficiency and Medical Behavior ：The Case of A Hospital

• Main Authors: Li-meng Kang, 康立盟
• Other Authors: Ting-lin Lee
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/64339985507953312238

碩士 === 國立高雄大學 === 高階法律暨管理碩士在職專班(EMLBA) === 98 === This study aimed to compare the difference of selected community hospital on service volume, fecundity, quality indicator, financial performance, patients’ satisfaction between the first half of year 2000 and the second half of year 2000 when the Drug Related Groups (DRG) payment system came to effect. Further analyses were conduced in order to evaluate the hospital’s performance. With understanding of DRG payment system, we could try to anticipate how and what DRG payment system affects the hospital, healthcare staff, administrative staff, and patients. The adapted method in this study was case study. Through reviewing literature and questionnaire survey, more delicate data were collected for analysis. Our results indicated that the service volume of each department or the total service volume of the hospital, the average hospitalized day, 3-day ER revisit rate, 14-day rehospitalized day, CMI value of each department, and adjusted CMI value for average medical cost were not significant difference. However, the number of people receiving operation decreased dramatically. The accuracy of the case diagnosis rose obviously. The paid amount of DRG 155 items was higher than practical medical payment. Later half-year impact brought by implementation of DRG payment system was not as big as anticipated, the main reason was that the case payment, the former of DRG 155 items, has come to effect for a long time and the result has been far better. Herein we would like to suggest that hospital manager should strictly request physicians to use the correct diagnosis code and record chart accurately, those will bring the benefit for hospital to save the cost, reduce the hospitalized day, complete the preparation for discharge of patients. Those efforts will help to fully prepare hospitals to face the impact from overall implementation of DRG payment system in the upcoming four years.