全民健保實施後，陸續有些醫院反應急性病床一床難求，部份慢性病患佔用急性病床。為能瞭解此一情形，本研究以全民健保84年7至12月急性病床住院申報資料進行分析，以住院超過30日定義為超長住院，則超長住院患者的比率為4.0%，超長住院人日佔總住院人日24.4%，若能避免超過30日的住院，則估計可空出10.1%之病床，估計此部份費用佔健保住院費用13.1%。以公私立別區分，公立醫院超長住院率7.5%遠較私立2.7%高，公立超長住院人日為35.1%，私立為18.2%。以層級別區分，醫院層級愈高超長住院愈嚴重，公立與私立醫學中心的超長住院率分別為8.9%與5.6%；其超 長住院人日分別為39.6%與27.9%。依專科別區分，內科病床超長部份利用率10.4%，雖遠較復健科32.9%為低，但由於內科病患最多，故超長住院人次居最冠。由前述分析，可以發現超長住院是迫切需要被正視的問題，建議未來應朝落實出院計畫、鼓勵發展各類長期照護服務、提高住院部份負擔比例、拉大醫院層級部份負擔差距、提高自行負擔金額上限等方向努力。

　　　　　Following implementation of Taiwan's National Health Insurance (NHI) some hospitals have reported a shortage of acute beds as a result of long hospital stays by some patients. To study this situation, we analyzed inpatient data (n=930,751) in acute hospitals covered by NHI from July December, 1995. Overstay was defined as a hospital stay of over 30 days. The overstay rate was 4.0%. The days of care taken by overstay patients accounted for 24.4% of all days of care in the hospital. Thus, if overstay co uld be prevented, NHI could conserve 10.1% of total hospital beds and 13.1% of inpatient expenditures. Overstay has different effects in public and private hospitals; the overstay rate in public hospitals exceeded that in private hospitals (7.5% vs. 2.7%). The days of care for overstay patients in public and private hospitals were 35.1% and 18.2% of all days of care, respectively. Differences were also found by rating level of accredited hospitals those with higher ratings had higher overstay rates. Ove rstay in medical centers also differed by the nature of the center; the overstay rate for public and private medical centers was 8.9% and 5.6%, respectively. For days of care for overstay patients, again, public outweighs private at 39.6% vs. 27.9% of all days of care. Although the occupancy rate of acute beds for patients in internal medicine is significantly lower than rehabilitation medicine (10.4% vs. 32.9%), the number of occupied acute beds is higher because there are more patients in internal medic ine. We recommend that in order to effectuate discharge planning, the government and hospitals develop a long term care delivery system and raise inpatient co-payments.