A Study the Impact of Tw-DRGs Full Implementation with the NHI’S Payment System for Regional Hospital and upon in Central Taiwan

• Main Authors: CHEN,SHU-ZHEN, 陳淑真
• Other Authors: CHANG,HSING-YUN
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/70491065501818930687

碩士 === 中臺科技大學 === 醫療暨健康產業管理系碩士班 === 104 === Background:Through policy tools to improve medical using efficiency and control the reasonable growth of medical payment are gradually steering from the need side to the supply side . Since 2010, Health Insurance Department has implemented Tw-DRGs by 5 stages , and intends to full import the medical payment in 2016.Medical institutions face the double policy pressure of the disease classification tool revision and full import the diagnosis related group (Tw-DRGs).Which will bring the level of influence and impact? Whether related clinical and the administrative work must be re-matching with the response? Object：The study aims to understand the effects and impact of Tw-DRGs full implementation with the NHI’s payment system for regional hospitals and medical center level level hospital, and be derived in response of proposals to provide policymakers,newly established,or other district medical institutions on medical management references. Methods: By studing 8 medical departments related to DRG management conductors of the hospitals above central regional hospitals ,in qualitative and semi-structured in-depth interviews. Through the SWOT, review institutes prior to the comprehensive import Tw-DRGs, which will be the superiority or weakness within the Organization's conditions, and the affects of the external environment's opportunities and threats ?Furthermore,take financial risks, resources invested,and process management,as three dimensions for the perspective,carry on TOWS matrix strategy cross-matched. Results:After the TOWS matrix cross-matching, on the various matrices are derived in response to recommendations are as follows: 1. SO (Max-Max): Growth strategy to develop the key features of medical care and severe restructuring and development of hi-tech medical projects at their own expense to boost competitiveness as the main. 2.ST(Max-Mini):Diversity strategies to the active involvement of senior management and enhanced information supporting clinical pathways designed to shorten the process and ensure the quality of care as the main. 3.WO (Min-Max):Reversing strategies to build community and referral to cooperate and implement discharge planning and post-acute care referrals as the main. 4.WT (Min-Min): Defensive strategies to strengthen the management of hospital stay and with appropriate incentive system link and integrating disease classification and filing human worker as the main. Conclusion:For different levels of hospitals, should recommends the following: Regional level public hospitals to develop diversity policies for spindle；regional levels of private hospitals and foundation hospitals to reverse policy；medical center-level public hospitals in defensive strategy based；medical center foundation level hospitals places based growth strategy.