Increase in the cost of medical care services has become an important issue in many countries that have implemented national health insurance, including Taiwan. On July of 2002, the National Health Insurance of Taiwan implemented a global budgeting system for all hospital payments. It was hoped that such a system would control the increase of medical expenses within a certain expected range. However, in the absence of reasonable payment bases and effective utilization management and control mechanism, the outcome of implementing this new payment system has been difficult to measure. Therefore, the National Health Insurance (NHI) studied the possibility of implementing DRGs (diagnosis related groups) for all in-patient payments.
To evaluate the impact of the new payment system, the medicinal datas collected 1 year before and after implementation of TW-DRGs were analyzed. The tested target is an orthopaedic department in a Public Medical Center. The tested items including average of days in hospital, medical costs, application of National insurance, and sub-item total knee replacement (TKR) and total hip replacement (THR). For overall investigation of the tested orthopaedic department, our findings revealed that implementation of TW-DRGs significantly diminished the average of days in hospital and the average of medical costs. However, implementation of TW-DRGs showed slight influence on the National Health Insurance Application. As to investigate common surgeries, TKR and THR, only the average of days in hospital of TKR was significantly decreased by implementation of TW-DRGs. In addition, other specific TW-DRGs numbered items were also examined to determine the alteration of the factors described above. Our results showed that implementation of TW-DRGs significantly diminished the days in hospital, the medical cost, and the National Health Insurance Application for the selected TW-DRGs numbered items. However, the quality in health care didn¡¦t have significant change after implementation of TW-DRGs. More complete data pools are needed for the more precise analysis to evaluate the influence of TW-DRGs system on the management of hospital and other medical factors in Taiwan.
| Identifer | oai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0831112-215332 |
| Date | 31 August 2012 |
| Creators | Liu, Hsin-Hua |
| Contributors | Ying-Ying, Lo, Ying-Chun, Li, Ping-Yi, Chao |
| 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-0831112-215332 |
| Rights | user_define, Copyright information available at source archive |
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