The purpose of this research aims to (1) construct the predict model by system dynamics on the outpatient visits; (2) investigate the influence on hospital performance after drug price policies made; and (3) offer feasible schemes by scenario simulation. National Health Insurance (NHI) system intends to safeguard the right to health care for all residents in Taiwan. NHI system has gained high public satisfaction so far. However, medical expenditures and pharmaceutical costs have propelled the rapid growth in recent years because of the stipulation of the insurance premium rate, the general push for improved health care quality, and inclusion of new drugs as well as new technologies. To prevent the deficit of the NHI system¡¦s finances from widening further, the Bureau of NHI is urged to reform the reimbursement policies, including Adjustments of Drug List and Payment Scheme, Global Budget Payment System, and Adjust Reasonably Reimbursement Criteria as well. Based on the statistics, a quarter of the total revenues were for the drug cost. Legally mandated drug price adjustments have a great influence on the financial burden of the medical institutions.
On the basis of the simulation analysis, the major findings of this research are summarized as follows: (1) The adjustments of the prescription depend on the amount of the profit gained from the drugs; (2) The increase the refillable prescriptions for patients with chronic illnesses enhances the profit of the drugs; (3) With the implementation of the system dynamics, the counterintuitive phenomenon can be identified and used to guide the future policies of the medical institutions. This research also suggests that the total comprehension of finding the leader loop in the dynamic complexity system within the management of the medical institutions is beneficial in providing the relative adjustment policies for a hospital.
| Identifer | oai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0709110-110750 |
| Date | 09 July 2010 |
| Creators | Cheng, Yen-shih |
| Contributors | Yuan-Yi, Chia, Ping-Yi, Chao, Shan-Chang, Chao, Yi-Min, Tu |
| 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-0709110-110750 |
| Rights | campus_withheld, Copyright information available at source archive |
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