National Health Insurance (NHI) is more than 13 years in Taiwan. The NHI paid medical fees to service providers on the basis of "fee-for-service" in the beginning. However, the cases numbers were increased by health providers for erned more money. Besides, it was very difficult to review the cases. The health capital expenditure was increased gradually. The Bureau of National Health Insurance took a serial measures to finance control, such as ¡§case-payment¡¨, ¡§self-management¡¨, ¡§hospital excellence program¡¨ and ¡§global budget reimubursement system¡¨. But the medical needs elevate due to the life quality and life expectancy increased, unbalance of payments is very serious¡COur government began to investigate the excellent ¡§diagnosis related group payment system¡¨ which carried out in America and other OECD countries for many years. The prospective payment system made medical costs more easily control. Though Taiwan diagnosis related groups was finished and was revised to the third edition on the basis of experts consensus during many times of discussion, the exacted time of execution is delayed again and again. Mainly in Taiwan medical league doubted and blocked the new measure. Moreover, people worried about would become medical garbage because health institute refused critical patient owing to DRG fixed payment or few percentage additional charges, especially in medical centers. It might decrease the examination items and compromised the patient rights and quality of medical care. Eeverytimes when NHI implemented new measure to control medical capital expenditure, it resulted in some degree damage to medical institute in fact.
This study analysed the regional hospital income and the difference of implementation DRG by major diagnosis categories and sections in 2006 and 2007 with BCG model. The hospital begame to promote DRG payment system in 2007, compared to 2006, may simulate the difference after implementation of DRG. We also compared the medical performance and medical care quality of 2007 to 2006 to simulate the difference after implementation of DRG.
The thesis reviewed the results of execution DRG in others countries and summarized some experts and scholars advisement abut the impaction of DRG carried out in Taiwan. At last, we interviewed to the department directors about the opinions and suggestions of DRG in-depth and addressed the responsive strategies and balanced scorcard implementation¡C
DRG payment system was proved as an excellent measure by others countries. It could control the medical cost effectively and did not compromise medical care quality. There are several measures, including ¡§global budget reimubursement system¡¨, ¡§case- payment¡¨ and ¡§fee-for-outcome¡¨in Taiwan. Is the result of DRG implementation in Taiwan diffierent to other DRG countaries¡HOur conclusions are implementation DRG may not damage to hospital finance and medical care quality may decrease a little in the first time. For checking on medical care quality critically, it is necessary for hospitals and Bureau of NHI to set up peer review organization
| Identifer | oai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0806108-220309 |
| Date | 06 August 2008 |
| Creators | Lee, Man-gang |
| Contributors | JAW, BIH-SHIAW, Min-chu, Yu, Wang, Christina Yu-Ping, Chang, Alex Kung-Hsiung |
| Publisher | NSYSU |
| Source Sets | NSYSU Electronic Thesis and Dissertation Archive |
| Language | Cholon |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0806108-220309 |
| Rights | not_available, Copyright information available at source archive |
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