頁籤選單縮合
| 題 名 | 影響住院醫療利用之因素及癌症患者住院醫療利用的估計=Factors Influencing Inpatient Medical Utilization and Its Estimation for Cancer Patients |
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| 作 者 | 許碩芬; 林兆欣; 張書瑜; | 書刊名 | 壽險管理 |
| 卷 期 | 38 2025[民114] |
| 頁 次 | 頁(3)1-(3)46 |
| 分類號 | 419.44 |
| 關鍵詞 | 全民健保; 自費醫療支出; 癌症患者; National health insurance; NHI; Out-of-pockets; OOP; Cancer patients; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 隨著醫療技術進步及高價藥物開發,全民健保當中的自付金額及項目也不斷增加。 本文利用某醫學中心住院資料,探討影響全民健保給付及自費、住院天數的因素,並提 供癌症患者之健保給付、自費金額、住院天數、以及平均每日住院自費金額的估計值。 研究結果顯示:人口統計因素、先前醫療使用情形以及癌症相關共病對醫療資源使用 及自費有顯著影響。惡性腫瘤患者每次住院的健保費用、自付費用、住院天數以及每日 住院自費金額之估計值分別為 81,576 元,28,840 元,8.4 天以及 5,729.262 元。而轉移 性腫瘤患者每次住院之健保費用、自費金額、住院天數以及每日住院自費金額之估計 值則分別為 103,106 元,33,887 元,10.1 天以及 2,660.005 元。本文研究結果可提供全民健保與商業醫療保險協做互補之參考,並可作為保險業者設計癌症保險給付金額的 依據。 |
| 英文摘要 | Advances in medical technology and the introduction of high-priced drugs have driven up medical costs. Out-of-pocket (OOP) expenses, therefore, play an important role in the National Health Insurance (NHI) system since it can fill the coverage gap in the NHI. However, it also increases the financial responsibility for the insured. There is a rising need of private health insurance to accommodate with the increase in number of items that patients must pay for out-of-pockets themselves. This study explores the influencing factors of NHI coverage and OOP and provides their estimates for cancer patients. Our results showed that demographic characteristics, previous medical utilization, and cancer-related comorbidities had a significant impact on medical resource utilization. In particular, patients in self-pay wards have higher medical expenses and OOP than those in NHI wards, but shorter length of stay. For patients with malignant tumors, the estimations for NHI coverage, OOP, hospital stays and OOP per length-of-stay are NT$81,576, NT$28,840, 8.4 days and NT$5,729.262, respectively. In contrast, for patients with metastatic tumors, the estimations are NT$103,106, NT$33,887, 10.1 days and NT$2,660.005, respectively. The results of this study should be of interest to regulators and the insurance industry as they consider the role of private health insurance in the context of a universal healthcare system. |
本系統中英文摘要資訊取自各篇刊載內容。