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題名:試以相對價值表(RVS)訂定醫師費計算基準--以牙科79個處置為例
書刊名:中華公共衛生雜誌
作者:陳琇玲溫信財楊志良張孝新
作者(外文):Chen, Hsiu-lingWen, Hsyien-chiaYaung, Chih-liangChang, Hsiao Hsin
出版日期:2000
卷期:19:6
頁次:頁411-422
主題關鍵詞:牙醫師相對價值表支付標準醫師費DentistRelative value scalePayment systemPhysician fee
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(6) 博士論文(1) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:11
  • 點閱點閱:139
     目標:本研究試圖訂定牙科處置的相對價值表,以作為未來醫師費計算基準。方法:由牙醫師全聯會推薦專家小組,選定問卷調查的處置及四個次專科基準處置。以全體會員為研究對象分層隨機抽樣,德菲(Delphi)法進行二次問卷調查,請樣本醫師依據該次專科基準處置等級估測每個處置的相對值。問卷結果依照各組樣本數比例修正後,由小組專家外推未調查之處置的相對值,再將各次專科之相對值調整為全科相對值共同量表。結果:(1)在問卷結果信效度可接受情況下,探討出79個牙醫師總工作量的相對值。(2)雖未包含執業成本的投入,研究結果與現行健保支付標準表之 相關性高。四個次專科中,口腔顎面外科相對值與健保支付標準相關性最高,根管治療科相關性最低。(3)影響牙醫師處置之時間、體力、技術及風險四個構面(dimensions)中,作業時間長短並非決定其工作量之主要考量因素。(4) 除了「髓腔開擴+根管治療(三根以上)」外,牙醫師對總工作量之估測,並不會因為執業地點位於城鄉,及執業場所為醫院或診所而有不同。結論:(1)以RBRVS方法適宜探討牙醫師工作評量方法。(2)建立79個本土牙醫師工作量相對價值表。(3)可考慮對目前健保部份處置的支付標準進行修正。
     Objective: The purpose of this study was to establish the relative value scale (RVS) of dental procedures, which may serve as the basis for a dentistry payment system. Methods: Upon the recommendation of the National Dental Association of the Republic of China, a Technical Consultating Group (TCG) was organized to select the Services/Procedures (S/Ps) to be investigated by survey and to establish the basic reference S/Ps for each of the four sub-specialties. After stratified random sampling, the Delphi Tec hnique was used for two rounds of survey. In the questionnaire, we asked the respondents to magnitude estimate the weight of the S/Ps against the base S/P of each sub-specialty respectively. After adjusting the survey results to the sample size, we then asked the TCG to evaluate the results and to estimate the workload of the un-surveyed S/Ps. Finally, we readjusted them to a common scale for all S/Ps of the four sub-specialties. Results: (1) Both the validity and reliability of the survey were acceptable. We have set up a local RVS for 79 dental procedures. (2) Although other factors such as practice costs were not included, the results of the present study correlated well with the dental payment system of the NHI. Of the four sub-specialties, the RVS of Oral Surgery (OS) correlated best with the payment system of the NHI, while the lowest was the RVS of Endodontics (Endo). (3) Time is the least important of the four dimensions of a dentists' workload. (4) The workload of a dentist is not affected by the l ocation of his practice place, urban or rural, hospital or clinic. Conclusion: (1) It is appropriate to use the RBRVS method to establish a RVS for the workload of dentists in Taiwan. (2) We have set up a local RVS for 79 dental procedures. (3) The NHI dental fee scale for some S/Ps needs to be re-evaluated.(Chin J Public Health.
期刊論文
1.宋文娟、藍忠孚、陳琇玲、詹錕鋙(19991000)。臺灣醫師人力政策當前重要課題之專家意見分析。中華公共衛生雜誌,18(5),334-340。new window  延伸查詢new window
2.Hsiao, W. C.、Braun, P.、Kelly, N. L.、Becker, E. R.(1988)。Results, potential effects, and implementation issues of the Resource-Based Relative Value Scale。JAMA,260,2429-2438。  new window
會議論文
1.朱樹勳(1999)。專科人力現況與問題。醫師人力政策研討會。台北。  延伸查詢new window
其他
1.郭信智、楊志良(1994)。醫師目標收入理論之試證。  延伸查詢new window
2.李丞華(199901)。近十年台灣各科別醫師人力的消長。  延伸查詢new window
3.林夢陸(1994)。訂定醫師費計算基準--淺釋醫療資源相對價値表。  延伸查詢new window
4.王景正(1993)。台灣地區醫學中心專科醫師工作相對價値尺度之先導性研究,台北。  延伸查詢new window
5.施天岳、林夢陸(1993)。台北市立綜合醫院實施RBRVS之可行性研究。  延伸查詢new window
6.莊逸洲(1992)。美國RBRVS醫療資源基準相對價値表在長庚醫院之運用。  延伸查詢new window
7.Becker ER, Dunn D, Braun P, Hsiao WC(1990)。Refinement and Expansion of the Harvard Resource-Based Relative Value Scale: The Second Phase。  new window
8.Hsiao WC, Braun P, Becker ER, Thomas SR(1987)。The Resource-Based Relative Value Scale-Toward the Development of an Alternative Physician Payment System。  new window
9.Hsiao WC, Braun P, Becker ER, Becker E.(1988)。Resource-Based Relative Values。  new window
10.Hsaiao WC, Braun P, Dunn D, Becker ER, DeNicola M, Ketcham TR.(1988)。Results and Policy Implications of the Resource-Based Relative-Value Study (Special Report)。  new window
11.Hsiao WC, Madden JM.(1996)。The Impacts and Additional Uses of RBRVS. International Symposium on Health Care: Issues on Physician Payment System。  new window
12.Lee PR, Ginsburg PB, LeRoy LB, Hammons GT.(1989)。The Physician Payment Review Commission Report to Congress。  new window
13.Levy JM, Borowitz MJ, Jencks SF, Kay TL, Williams DK.(1990)。Impact of the Medicare Fee Schedule on Payments to Physicians。  new window
14.McMahon LF.(1990)。A Critique of the Harvard Resource-Based Relative Value Scale (Different Views)。  new window
15.翁國祥(1994)。建立RBRVS的方法。  延伸查詢new window
16.Hsiao WC, Yntema DB, Braun P, Dunn D, Spencer C.(1988)。Measurement and Analysis of Intraservice Work。  new window
17.Hsiao WC, Braun P, Yntema D, Becker ER(1988)。Estimating Physicians' Work for a Resource-Based Relative-Value (Special Report)。  new window
18.Kelly NL, Hsiao WC, Braun P, Sobol A, DeNicola M.(1988)。Extrapolation of Measures of Work for Surveyed Services to Other Services。  new window
19.Reper WL.(1988)。The Resource-Based Relative Value Scale。  new window
20.Spencer AJ, Brennan DS, Adelaide FSPS.(1994)。Trends in Work Effort Among Private General Dental Practitioners。  new window
21.Tuominrn R, Tuominen M.(1994)。Relative Value of Dental Procedures。  new window
 
 
 
 
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