Thesis (Ph. D.)--Oregon State University, 2007. / Printout. Includes bibliographical references (leaves 161-176). Also available on the World Wide Web.

Thesis (Ph.D.)--Ohio University, August, 2009. / Title from PDF t.p. Includes bibliographical references.

Universiẗat, Diss., 2006--Berlin.

Abstract National Health Insurance (NHI) has been implemented in Taiwan for nearly eight years; since then, over 96% of 23 million residents of Taiwan have benefited from this program, and 70% of them are satisfied. Recently, the growth rate of healthcare expenditure, however, has been phenomenally rapid, owing to the ageing population, the economic development, the expansion of health insurance, the increased supply of healthcare resources, and the innovation of medical technology. Under the circumstance that the bill of raising the insurance premium rate could not be passed by the legislative congress, the Bureau of NHI (BNHI) was forced to economize on expense to achieve the financial balance. Currently, the BNHI implements ¡§total amount control¡¨ to control the total medical claimed payments of each medical healthcare provider. Facing the increasing volume of documentary auditing, the BNHI has to make its efforts on how to improve its auditing efficiency. This is also one of the purposes of this thesis. This study aimed to establish a reasonable and fair auditing procedure of medical claim payment, termed ¡§medical claim payments auditing (MCPA) procedure¡¨. At the stage of professional auditing, adopted the ¡§MIL-STD-105E sampling plan¡¨ to select data for professional audit and used the auditing results as a payment criterion. To verify the adaptability of the MCPA procedure, the researcher used the data provided by the institutes of Kaohsiung and Pintong as simulation objects. Further, the estimated cost model was adopted to increase the possibility of using this procedure. The MCPA procedure consists of the following characteristics: 1) The number of sampling is much lower than that of the current system used by the NHI, thus the audit labor-force and time can be reduced significantly. 2) The incentive mechanism design encourages the healthcare providers to honestly apply their medical claim payments and avoids inappropriate healthcare services. 3) Adopting international standards of sampling technology makes the MCPA procedure trustworthy and simultaneously can reduce the implementing obstructs. Keywords: National Health Insurance; Sampling plan; Incentive mechanism design

The National Health Insurance (NHI) program was officially launched in Taiwan on 1 March 1995. Three objectives are stressed in the program¡¦s implementation: (1) universal enrollment and equal-opportunity medical care; (2) balanced finances and long-term operational viability; (3) better quality medical care and better health for citizens. The initial balance of revenues and expenditures was stable, but there is a deficit during 1998. In order to prevent the financial status from keeping on worsening, the Bureau of NHI (BNHI) implement the global payment system, and expand the payroll-related premium base. What are the long-tem influences of these policies on the financial status and medical quality? Up to now, those researches of handling the financial problem of the NHI, focused mostly on those influences of the individual policies, rare studied the long-term whole influences of multiple policies. Moreover, those methods of the researches were mostly questionnaires, data analysis, regression, rare simulated methods. Hence, this dissertation applies system dynamics to explore the long-term influences of multiple policies on handling the financial problem of the NHI. There are two purposes in the research. One is that using those interacted relationships of decisions taken by the BNHI, beneficiaries, and contracted medical care institutions to understand those causes of the financial problem of the NHI, the other is that evaluating the long-term influences of multiple policies on handling the financial problem of the NHI. This research reaches two achievements. First, submitting casual loop diagrams focused on the financial problem of the NHI, can provide the BNHI, beneficiaries, and CMCI to have a further understanding on the financial problem of the NHI. Second, building the model of the financial problem and policies of the BNHI can simulate and evaluate he results of multiple policies on handling the financial problem of the NHI. In order to improve the financial imbalance of the NHI, the BNHI proposes three policies. Policy I, implement the global payment system. Policy II, implement the global payment system and expand the payroll-related premium base. Policy III, implement the global payment system, expand the payroll-related premium base and promote health communication. The simulation results are as follows: Policy III can solve the financial imbalance of the NHI and improve the health of citizens. This research has two reservations. First, only explore the financial status and medical quality. Second, different criteria using for judging the priority of policies under multilple objectives may have different results. Hence, the future research can deeply consider extending the model boundary and selecting the criteria using for judging the priority of policies under multilple objectives.

Abstract Due to the rapid rise in medical expenses and unanticipated accumulation of overdue premiums, Taiwan's National Health Insurance has impacted the management of all-size hospitals. For the purpose of survival and maintaining good performance, the hospitals need to adopt suitable strategic management. Medical centers take the responsibilities of service, teaching, and research, it should be some hard thinking as to how to manage the hospital continuously and make every effort to achieve the goal of ¡§health for all in the twenty-first century¡¨. This study was conducted in three stages: questionnaire development and testing, surveying, and data analysis. The 34-item questionnaire was self-made according to the definition and contents of community health nursing defined in United Kingdom Central Council (UKCC). Seven hundred and forty questionnaires were send to the community inhabitants with 679 were returned and valid, representing a response rate of 91.8%. Descriptive analysis, Chi-Square test, Pearson correlation analysis, factor analysis, and stepwise regression analysis were used for the statistical analysis. The information about community health nursing was obtained from bureau of public health in the majority of inhabitants (57%). As for the satisfaction of service of community health nursing to the inhabitants, people who were satisfied is less than those who weren't (21.4% vs 41.2%). Though fewer inhabitants who had a favorable impression on the medical center, more people prefer medical center to practice community health nursing. Community health nursing was classified into seven dimensions according to the factor analysis, "home health care" had a highest score (4.23), and "mental health care" got a lowest score (3.64). There was significant negative correlation between satisfaction and "supporting school health nursing", "home health care is of more humane care", "hospital gains profit from home health care", "willing to take home health care", and "hospital cooperates with community to care mental disabled". Significant positive correlation was noted between satisfaction and "accepting mental disabled in the community". In age 30-39 and 40-49, relating to the satisfaction of community health nursing, inhabitants who were unsatisfied are more than those who weren't, significant difference was noted. People who had higher educational background felt unsatisfied to the service of community health nursing, and the higher the less. Through stepwise regression analysis, "establish referral system" had the best predictability in using facilities efficiently to economies of scale to reduce operating cost; "ability to provide better service" had the best predictability in confidence of practicing community health nursing in medical center; "medical center is a good neighbor" had the best predictability in increasing benefits from practicing community health nursing; and "public health nursing helping disease prevention" had the best predictability in government health policy.

Thesis (Ph. D.)--University of Sydney, 2005. / Title from title screen (viewed 20 May 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Sociology and Social Policy, Faculty of Arts. Degree awarded 2005; thesis submitted 2004. Includes bibliographical references. Also available in print form.

Thesis--Auburn University, 2008. / Abstract. Vita. Includes bibliographical references (p. 138-146).

Thesis (Ph. D.)--University of Wisconsin--Madison, 1953. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 411-436).

Thesis (Ph. D.)--University of Wisconsin--Madison, 1954. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 355-360).