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題名:Identifying Interesting Patterns in a Medical Database System--Fixed Amount Payment's Order Items
書刊名:資訊管理學報
作者:蔣肇慶林熙禎 引用關係
作者(外文):Chiang, Jaw-chingLin, Shi-jen
出版日期:2005
卷期:12:1
頁次:頁215-240
主題關鍵詞:定額支付基本醫令群值比率Basic order groupValue rateFixed amount payment system
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:2
  • 點閱點閱:45
全民健康保險制度是自給自足的社會保險制度。因而,對於醫療給付單位及醫療院所而言,在有限的醫療給付資源情形之下,必須建立醫療的收支平衡,方為持續經營之道。醫療給付單位為有效的控制醫療費用,實施總額預算制的醫療給付制度,其目的在協助醫療院所能有效的規劃醫療資源、控制醫療成本及提昇服務品質。在總額預算制度之定額支付的病例,醫令執行項目內容的問題,可以藉著醫令合理性予以適當的解決。因此,本研究提出一個ART_N.V.計劃,藉由修改後之關連式規則與值比率的組合,將定額支付下之疾病醫令項目,實驗得出基本醫令群。此基本醫令群不但可以協助醫療給付單位,更精確的計算出病例的必須執行醫令項目及支付的費用;而且在醫療院所方面,可以節省不必要的處置與成本支出,提升營運的績效。此研究論證定額支付的病例之醫項目及支付的費用,作為目前及未來在定額支付之下病例開立醫令的參考。
Maintaining a financial balance given limited medical payments is essential for health insurance payment units and hospitals. The Bureau of National Health Insurance (BNHI) implemented the Prospective Payment System of the Global Budget System to assist hospitals in planning and controlling medical care costs and service quality. Meanwhile, the BNHI also devised various plans for strengthening the operational utilization of medical resources. This study suggests the ART_N.V. scheme for computing Basic Order Groups (BOG) and assessing their costs/benefits in a Fixed Amount Payment System. The BOGs used to provide a contrast in the experiment are more savings in medical care costs than health insurance reporting payments. Therefore, the BOG can not only assist payment units in reducing costs, but also can assist hospitals in operating efficiently using the Fixed Amount Payment System. Consequently, this study demonstrates a standard of payment for current and future basic and suitable order items of Fixed Amount Payment system references.
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