The Comparison of Resource Utilization and Quality of Care between Before and After the Implementation of Taiwan Diagnosis Related Groups(Tw-DRGs) – A Case in Total Hip Replacement

• Main Authors: Lu, Yen-Sheng, 呂彥陞
• Other Authors: Yeh, Te-Feng
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/tj4jfv

碩士 === 中臺科技大學 === 醫療暨健康產業管理系碩士班 === 101 === Background and goal: In order to control the increasing of medical expenses, Bureau of National Health Insurance started to implement the DRGs(Diagnosis Related Groups) payments in January, 2010. As the result of rapid raise of aging population in Taiwan, Osteoarthropathy is one of the main diseases of seniors in sixties. Artificial hip joint replacement has been generally regarded as the most effective surgery to treat Osteoarthropathy. Furthermore, the first stage of DRGs payments also includes artificial hip joint replacement. The purpose of this study are figure out the influence on health resources utilization and quality of care before and after the implementation of Tw-DRG and the accosiaed patient characters on artificial hip replacement by using NHI claim data. Methods：This research refers to the data of hospitalized patients applied by a regional hospital in the middle Taiwan during Jan,2008 to Dec,2011. We organized the information and analyzed the examination by using ACCESS 2003 and SPSS 19.0. There where 382 cases selected in this study,179 were before Tw-DRG implemented and 203 were after Tw-DRG inplenented respectively. Results: After excuting the DRGs, the average length of stay reduced 1.69 and the average health expenditure decreased 12,345. The characters of patients, such as gender, age, Dialysis would influence the average health expenditure. However, the DRGs made little impression on medical quality and characters of patients. Conclusion: Both health expenditure and length of stay reduced due to the implementation of Tw-DRGs. As the result, hospitals will adjust the healthcare services according to the standard of payments, in case of making deficits.