| Summary: | 碩士 === 南台科技大學 === 企業管理系 === 99 === Based on the criteria of hospitalization quality scrutinized by Bureau of National Health Insurance since 2004, the rate of the long-stay-patient over 30 days remains high. According to the annual statistics report of 2009, 3.71 percent of the discharged patients were those who were hospitalized over 30 days, and spent 17.18% of the cost of hospital admission. It is evident that long-stay-patient expenditure consumes a huge amount of health and medical resources. The study aims to explore how the population variables, disease factors and doctor characteristics factors linked with acute inpatients influence the long-stay-patient and medical utilization.
The study retrieved data from the Details of Inpatient Expenditures by Admissions (DD), the Details of Inpatient orders (DO) and the Hospital Information System (HIS). The sample of the study was composed of 590 acute inpatients hospitalized over 30 days between 2008 and 2010 in X Veterans Hospital. In order to establish a regression prediction model, the study employed SPSS to compute the Pearson Correlation Coefficients and the Stepwise Multiple-regression analysis.
The admission route, major surgery, the length of stay in Intensive Care Unit (ICU), discharge destination and the length of medical practice have influence on the days of long-stay-patient. There is statistically significant difference in medical resources consumption in terms of population characteristics and diseases among patients and the characteristics of doctors. Regarding patients’ diseases and the characteristics of doctors, there is statistically significant difference in treatment charge and medication charge. There is statistically significant difference in examination charge and medication charge in terms of the characteristics and diseases of patients and the characteristics of doctors. It is statistically significant that the different length of long-stay-patient has influence on medical resources consumption. Especially, respiratory Diseases, the length of stay in ICU and the length of long-stay-patient have positive impact on medical resources consumption. The study has no evidence to indicate that chronic illnesses have influence on the length of long-stay-patient and medical resources consumption.
First, it is highly recommended to develop a risk screening scale for long-stay patients. Secondly, individual care plans, discharge plans and/or the referrals to long-term care facilities are critical for patients suffering from the diseases of respiratory system, so that the limited amounts of hospital beds and medical resources can be effectively utilized and reasonably managed.
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