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題名：臺灣地區論人計酬試辦計畫之評估--以醫院忠誠病人模式為例
書刊名：臺灣公共衛生雜誌
作者：羅紀琼 引用關係
作者(外文)：Lo, Joan C.
出版日期：2015
卷期：34:5
頁次：頁463-475
主題關鍵詞：論人計酬；忠誠病人；差異中的差異模型；全民健保；Capitation payment；Loyal patient；Difference-in-differences model；National Health Insurance
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(2) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:7
  • 點閱點閱:30
目標：本文以健保署2012年開始試辦的論人計酬支付制度中的醫院忠誠病人模式為基礎，嘗試探討三家試辦醫院是否達到了促進民眾健康、減少醫療浪費的目標。方法：採用差異中的差異（Difference-in-Differences）模型分析試辦醫院與對應醫院忠誠病人2010年7月至2013年6月全民健保門、住診利用與費用；且以傾向分數配對（Propensity Score Matching）模型篩選對應醫院的忠誠病人。醫院的忠誠病人為試辦前一年在該院門診就診次數達該病人門診就診次數的一半以上。結果：試辦計畫對所有試辦醫院之門診利用皆有顯著減少的成效；然而由於試辦醫院A與C之住院費用顯著提升，以致總醫療費用在試辦醫院A與B沒有顯著變化，但在試辦醫院C則呈顯著增加。結論：目前論人計酬試辦計畫僅僅觀察試辦醫院的忠誠病人在試辦前後的醫療費用，並據以衡量試辦計畫成效的作法，因同期間另有影響醫療費用的總體因素存在，以致試辦前後醫療費用的差異並非僅由試辦計畫所造成。在試辦計畫的成效指標中，適度納入總體因素的考量，應是當行的修正。
Objectives: The aim of this study was to determine if the capitation payment pilot program beginning in 2012 reached its designed target of promoting patient health and reducing medical waste. Methods: We employed the Difference-in-Differences model to study the healthcare expenditures by National Health Insurance in the study group (pilot hospital's loyal patients) and the control group (corresponding hospital's loyal patients), for the periods from July 1, 2010 to December 31, 2011 and January 1, 2012 to June 30, 2013. The Propensity Score Matching method was used to select the final control group. A hospital's loyal patient was defined as one who made more than half of his/her outpatient visits in that particular hospital. Results: Patients' outpatient visits in all three pilot hospitals were significantly reduced, while the inpatient expenditures were significantly increased in hospitals A and C. This resulted in significantly higher total healthcare expenditures in hospital C but not in hospitals A and B. Conclusions: The current tool for the evaluation of the capitation payment pilot program is patients' healthcare expenditures before and after the pilot program. However, since there were other influential factors in existence during the same time period, the expenditure difference observed was not affected solely by the pilot program. Taking those external factors into evaluation consideration is a must.
期刊論文
1.Deyo, R. A.、Cherkin, D. C.、Ciol, M. A.(1992)。Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases。Journal of Clinical Epidemiology，45(6)，613-619。  new window
2.Ashenfelter, O.、Card, D.(1985)。Using the longitudinalstructure of earnings to estimate the effect of training programs。Rev Econ Stat，67，648-660。  new window
3.Lo, J. C.、Hong, Y. C.、Lin, C. C.(2013)。Healthcare utilization of bereaved family members following the 1999 Chichi earthquake: evidence from administrative data。J Psychosom Res，75，484-490。  new window
4.Ayyagari, P.、Shane, D.(2015)。Does prescription drug coverage improve mental health? Evidence from Medicare Part D。J Health Econ，41，46-58。  new window
5.Dudley, R. A.、Luft, H. S.(2001)。Managed care in transition。N Engl J Med，344，1087-1092。  new window
6.Casalino, L.(2001)。Canaries in a coal mine: California physician groups and competition。Health Aff (Millwood)，20，97-108。  new window
7.Kuo, R. N.、Lai, M. S.(2010)。Comparison of Rx-defined morbidity groups and diagnosis- based risk adjusters for predicting。BMC Health Serv Res，10，126。  new window
8.Frakt, A. B.、Mayes, R.(2012)。Beyond capitation: how new payment experiments seek to find the sweet spot in amount of risk providers and payers bear。Health Aff (Millwood)，31，1951-1958。  new window
9.Berwick, D. M.(2011)。Launchingaccountablecare organizations - the proposed rule for the Medicare Shared Savings Program。N Engl J Med，364，32。  new window
10.Berwick, D. M.(2011)。Making good on ACOs' promise - the final rule for the Medicare shared savings program。N Engl J Med，365，1753-1756。  new window
11.Chernew, M. E.、Mechanic, R. E.、Landon, B. E.、Safran, D. G.(2011)。Private-payer innovation in Massachusetts: the alternative quality contract。Health Aff (Millwood)，30，51-61。  new window
12.Adamina, A.、Guller, U.、Weber, W. P.、Oertli, D.(2006)。Propensity scores and the surgeon。Br J Surg，93，389-394。  new window
13.D'Agostino, R. B. Jr.(2007)。Propensity scores in cardiovascular research。Circulation，115，2340-2343。  new window
14.Jackson, C. A.、Manning, W. G. Jr.、Wells, K. B.(1995)。Impact of prior and current alcohol use on use of services by patients with depression and chronic medical illnesses。Health Serv Res，30，87-705。  new window
15.張睿詒、賴秋伶(20040400)。風險校正因子：論人計酬醫療費用預測之基礎。臺灣公共衛生雜誌，23(2)，91-99。new window  延伸查詢new window
16.Rosenbaum, Paul R.、Rubin, Donald B.(1983)。The Central Role of the Propensity Score in Observational Studies for Causal Effects。Biometrika，70(1)，41-55。  new window
17.羅紀琼、尤素娟(20100800)。醫院總額支付制度對住診醫療品質之初步影響。臺灣公共衛生雜誌，29(4)，360-368。new window  延伸查詢new window
研究報告
1.Dehejia, R. H.、Wahba, S.(2015)。Propensity score matching methods for non-experimental causal studies。  new window
2.涂醒哲、石曜堂、李龍騰、許玫玲、林文德、葉德豐(2013)。論人計酬之研究暨現行試辦計畫之輔導及執行成效評估。台北：衛生福利部中央健康保險署。  延伸查詢new window
3.涂醒哲、石曜堂、李龍騰、許玫玲、林文德、葉德豐(2014)。論人計酬制度成果評估與模式改善研究。台北：衛生福利部中央健康保險署。  延伸查詢new window
圖書
1.Katz, M. H.(2006)。Propensity scores. In: Multivariable Analysis-A Practical Guide for Clinicians。New York, NY：Cambridge University Press。  new window
其他
1.中央健康保險局(2013)。全民健康保險論人計酬試辦計畫(102年8月30日健保醫字第1020028540號公告修訂)，http://www.nhi.gov.tw/information/Law_total.aspx?menu=17&menu_id=660&WD_ID=673， 2015/01/20。  延伸查詢new window
2.US. Census Bureau(2015)。The statistical abstract of the United States, various years，http://www. census.gov/compendia/statab/， 2015/01/20。  new window
 
 
 
 
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