頁籤選單縮合
題名 | 醫院權屬別與醫療收費=Hospital Ownership and Medical Service Pricing |
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作者 | 張樂心; 鄭守夏; 楊銘欽; 江東亮; Chang, Le-hsin; Cheng, Shou-hsia; Yang, Ming-chin; Chiang, Tung-liang; |
期刊 | 臺灣公共衛生雜誌 |
出版日期 | 20040400 |
卷期 | 23:2 2004.04[民93.04] |
頁次 | 頁130-140 |
分類號 | 419.45 |
語文 | chi |
關鍵詞 | 醫院權屬別; 醫療費用; 自付費用; 住院天數; 支付制度; Ownership; Medical expense; Out-of-pocket; Length of stay; Payment system; |
中文摘要 | 目標:我國私人醫院比例高於美國三倍以上,不同權屬別醫院收取醫療費用是否不同,本研究提供臺灣實證資料。方法:以糖尿病、中風、剖腹產與闌尾切除四種常見疾病病人為研究對象,共4945名,分析不同權屬別醫院之醫療費用;包括醫院向病人收取之自付費用、向健保局申報之醫療費用,以及住院天數。並以同病再入院與術後傷口發炎率作為品質指標。結果:論病例計酬的剖腹產與闌尾切除病人,私人醫院的申報費用最低,但收取最高的自付費用與醫療總費用;論量計酬的糖尿病與中風患者,私人醫院的申報費用、自付費用與總費用皆顯著高於公立醫院。無論那種支付方式,公立醫院的平均住院天數皆較長。結論:私人醫院論病例計酬的申報費用低於公立醫院,論量計酬類則較高,其因應健保支付制度之費用策略可能較公立醫院明顯。公立醫院可能因公務預算補助等因素,收取最低的自付費用,但住院天數偏長。 |
英文摘要 | Objective: The proportion of private hospitals in Taiwan is 3 times higher than that in the United States. This study addresses the question as to whether private hospitals charge higher prices by providing empirical evidence from Taiwan. Method: There were 4945 patients with one of the common diagnoses/procedures of diabetes, stroke, Cesarean section, or appendicitis included in the analysis. The between-hospital comparisons were measured by patients?out-of-pocket payment, NHI claimed expenses, and patients?length of stay. We also adopted the readmission rate and post-operation infection rate as quality indicators for comparison. Results: Multiple regression models showed that private hospitals had the lowest level of claimed expenses, but higher out-of pocket and total expenses than their counterparts for procedures under the case payment method. Moreover, both their claimed reimbursements and out-of-pocket charges were both higher than that of public hospitals for diseases under the Fee-for-Service system. On average, public hospitals had the longest length of stay. Conclusion: Private hospitals seem more flexible in response to the NHI payment policy than public hospitals. Owing to the governmental subsidy, public hospitals charge lower out-of-pocket prices but have a longer length of stay. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。