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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 鍾國彪(Kuo-Piao Chung) | |
| dc.contributor.author | Chun-Chieh Liang | en |
| dc.contributor.author | 梁竣傑 | zh_TW |
| dc.date.accessioned | 2021-06-16T02:45:27Z | - |
| dc.date.available | 2017-09-14 | |
| dc.date.copyright | 2015-09-14 | |
| dc.date.issued | 2015 | |
| dc.date.submitted | 2015-07-20 | |
| dc.identifier.citation | 1.Baker, J. J. (2002). Medicare payment system for hospital inpatients: diagnosis-related groups. J Health Care Finance, 28(3), 1-13.
2.Baker, L. C. (2001). Measuring competition in health care markets. Health Services Research, 36(1 Pt 2), 223-251. 3.Baltagi, B., Moscone, F., & Tosetti, E. (2012). Medical technology and the production of health care. Empirical Economics, 42(2), 395-411. doi: 10.1007/s00181-011-0472-1 4.Berkowitz, E. N., Pol, L. G., & Thomas, R. K. (1997). Healthcare Market Research: Tools and Techniques for Analyzing and Understanding Today's Healthcare Environment: Irwin. 5.Bevan, G., & Skellern, M. (2011). Does competition between hospitals improve clinical quality? A review of evidence from two eras of competition in the English NHS. British Medical Journal, 343. 6.Busato, A., & von Below, G. (2010). The implementation of DRG-based hospital reimbursement in Switzerland: A population-based perspective. Health Research Policy and Systems, 8. 7.Busse, R., Geissler, A., Quentin, W., & Wiley, M. (2011). Diagnosis-Related Groups in Europe: Moving towards transparency, efficiency and quality in hospitals. Maidenhead: Open University Press and WHO Regional Office for Europe. 8.Chang, Wang, Huang, Hsieh, Tsui, & Lai. (1999). The implementation of clinical paths for six common urological procedures, and an analysis of variances. BJU International, 84(6), 604-609. doi: 10.1046/j.1464-410x.1999.00274.x 9.Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis, 40(5), 373-383. 10.Chen, C.-C., & Cheng, S.-H. (2010). Hospital competition and patient-perceived quality of care Evidence from a single-payer system in Taiwan. Health Policy, 98(1), 65-73. 11.Cheng, S.-H., Chen, C.-C., & Tsai, S.-L. (2012). The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: A population-based study. Health Policy, 107(2-3), 202-208. 12.Cheng, S. H., & Chiang, T. L. (1997). The effect of universal health insurance on health care utilization in Taiwan. Results from a natural experiment. Jama, 278(2), 89-93. 13.Cheng, S. H., Wei, Y. J., & Chang, H. J. (2006). Quality competition among hospitals: The effects of perceived quality and perceived expensiveness on health care consumers. American Journal of Medical Quality, 21(1), 68-75. 14.Chou, S.-Y., Deily, M. E., Li, S., & Lu, Y. (2014). Competition and the impact of online hospital report cards. Journal of Health Economics, 34(0), 42-58. 15.Chu, C.-L., Chiang, T.-L., & Chang, R.-E. (2011). Hospital competition and inpatient services efficiency in Taiwan: a longitudinal study. Health Economics, 20(10), 1268-1280. 16.Cooper, Z., Gibbons, S., Jones, S., & McGuire, A. (2011). Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms*. The Economic Journal, 121(554), F228-F260. 17.Cots, F. (2004). La sostenibilidad del sistema hospitalario en Cataluña. El balance de una década. Gaceta Sanitaria, 18(1), 64-67. 18.Daley, J., Henderson, W. G., & Khuri, S. F. (2001). Risk-adjusted surgical outcomes. Annu Rev Med, 52, 275-287. 19.DesHarnais, S., Kobrinski, E., Chesney, J., Long, M., Ament, R., & Fleming, S. (1987). The early effects of the prospective payment system on inpatient utilization and the quality of care. Inquiry, 24(1), 7-16. 20.Elzinga, K. G., & Hogarty, T. F. (1973). The problem of geographic market delineation in antimerger suits. The Antitrust Bulletin, 18(1), 45-81. 21.Elzinga, K. G., & Hogarty, T. F. (1978). The product of geographic market delineation revisited. The Antitrust Bulletin, 23, 1-18. 22.Farrar, S., Sussex, J., Yi, D., Sutton, M., Chalkley, M., Scott, T., & ma, A. (2007). National Evaluation of Payment by Results. Aberdeen: University of Aberdeen Health Economics Research Unit. 23.Farrar, S., Yi, D., Sutton, M., Chalkley, M., Sussex, J., & Scott, A. (2009). Has payment by results affected the way that English hospitals provide care? Difference-in-differences analysis. BMJ, 339. 24.Fitzgerald, J. F., Fagan, L. F., Tierney, W. M., & Dittus, R. S. (1987). Changing patterns of hip fracture care before and after implementation of the prospective payment system. Jama-Journal of the American Medical Association, 258(2), 218-221. 25.Forgione, D. A., & D'Annunzio, C. M. (1999). The use of DRGs in health care payment systems around the world. J Health Care Finance, 26(2), 66-78. 26.Garnick, D. W., Luft, H. S., Robinson, J. C., & Tetreault, J. (1987). Appropriate measures of hospital market areas. Health Services Research, 22(1), 69-89. 27.Gay, E. G., & Kronenfeld, J. J. (1990). Regulation, retrenchment--the DRG experience: problems from changing reimbursement practice. Social Science & Medicine, 31(10), 1103-1118. 28.Gaynor, M. (2004). Concurrence et qualité sur le marché des soins de santé. Ce que l'on sait ; ce que l'on ignore encore Economie Publique, 15(2), 3–40. 29.Gaynor, M. (2006). What Do We Know About Competition and Quality in Health Care Markets? National Bureau of Economic Research Working Paper Series, No. 12301. 30.Gaynor, M., Moreno-Serra, R., & Propper, C. (2012). Can competition improve outcomes in UK health care? Lessons from the past two decades. Journal of Health Services Research & Policy, 17, 49-54. 31.Gaynor, M., Moreno-Serra, R., & Propper, C. (2013). Death by Market Power: Reform, Competition, and Patient Outcomes in the National Health Service. American Economic Journal-Economic Policy, 5(4), 134-166. 32.Gaynor, M., & Vogt, W. B. (2003). Competition among hospitals. Rand Journal of Economics, 34(4), 764-785. 33. Gowrisankaran, G., & Town, R. J. (2003). Competition, payers, and hospital quality. Health Services Research, 38(6), 1403-1421. 34.Gregor, C., Pope, S., Werry, D., & Dodek, P. (1996). Reduced length of stay and improved appropriateness of care with a clinical path for total knee or hip arthroplasty. Jt Comm J Qual Improv, 22(9), 617-628. 35.Gresenz, C. R., Rogowski, J., & Escarce, J. J. (2004). Updated variable-radius measures of hospital competition. Health Services Research, 39(2), 417-430. 36.Hamada, H., Sekimoto, M., & Imanaka, Y. (2012). Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan. Health Policy, 107(2-3), 194-201. 37.Hensen, P., Beissert, S., Bruckner-Tuderman, L., Luger, T. A., Roeder, N., & Mueller, M. L. (2008). Introduction of diagnosis-related groups in Germany: evaluation of impact on in-patient care in a dermatological setting. European Journal of Public Health, 18(1), 85-91. 38.Hox, J. (2010). Multilevel Analysis: Techniques and Applications, Second Edition: Taylor & Francis. 39.Kahn, K. L., Keeler, E. B., Sherwood, M. J., Rogers, W. H., Draper, D., Bentow, S. S., . . . Brook, R. H. (1990). Comparing outcomes of care before and after implementation of the DRG-based prospective payment system. Jama-Journal of the American Medical Association, 264(15), 1984-1988. 40.Kahn, K. L., Rubenstein, L. V., Draper, D., Kosecoff, J., Rogers, W. H., Keeler, E. B., & Brook, R. H. (1990). The effects of the DRG-based prospective payment system on quality of care for hospitalized Medicare patients. An introduction to the series. Jama-Journal of the American Medical Association, 264(15), 1953-1955. 41.Kessler, D. P., & Geppert, J. J. (2005). The effects of competition on variation in the quality and cost of medical care. Journal of Economics & Management Strategy, 14(3), 575-589. 42.Kessler, D. P., & McClellan, M. B. (2000). Is hospital competition socially wasteful? Quarterly Journal of Economics, 115(2), 577-615. 43.Kondo, A., & Kawabuchi, K. (2012). Evaluation of the introduction of a diagnosis procedure combination system for patient outcome and hospitalisation charges for patients with hip fracture or lung cancer in Japan. Health Policy, 107(2-3), 184-193. 44.Lee, Y.-C., Huang, Y.-T., Tsai, Y.-W., Huang, S.-M., Kuo, K., McKee, M., & Nolte, E. (2010). The impact of universal National Health Insurance on population health: the experience of Taiwan. BMC Health Services Research, 10(1), 225. 45.Lien, H.-M., Chou, S.-Y., & Liu, J.-T. (2008). Hospital ownership and performance: Evidence from stroke and cardiac treatment in Taiwan. Journal of Health Economics, 27(5), 1208-1223. 46.Lien, H.-M., Chou, S.-Y., & Liu, J.-T. (2010). The Role Of Hospital Competition On Treatment Expenditure And Outcome: Evidence From Stroke And Cardiac Treatment In Taiwan. Economic Inquiry, 48(3), 668-689. 47.Liu, H., & Phelps, C. E. (2008). Nonprice competition and quality of care in managed care: The New York SCHIP market. Health Services Research, 43(3), 971-987. 48.Liu, Y. M., & Kinsey, J. (2005). The effect of competition on the practice of outpatient services for diabetes patients at different levels of hospitals in Taiwan. Applied Economics, 37(12), 1411-1422. 49.Louis, D. Z., Yuen, E. J., Braga, M., Cicchetti, A., Rabinowitz, C., Laine, C., & Gonnella, J. S. (1999). Impact of a DRG-based hospital financing system on quality and outcomes of care in Italy. Health Services Research, 34(1), 405-415. 50.Lu, J. F., & Hsiao, W. C. (2003). Does universal health insurance make health care unaffordable? Lessons from Taiwan. Health Aff (Millwood), 22(3), 77-88. 51.Luft, H. S., & Maerki, S. C. (1984). Competitive potential of hospitals and their neighbors. Contemporary Policy Issues, 3(2), 89-102. 52.Mayes, R. (2007). The origins, development, and passage of Medicare's revolutionary prospective payment system. J Hist Med Allied Sci, 62(1), 21-55. 53.Morrisey, M. A., Sloan, F. A., & Valvona, J. (1988). Defining geographic markets for hospital care. Law and Contemporary Problems, 51(2), 165-194. 54.Mukamel, D. B., Zwanziger, J., & Tomaszewski, K. J. (2001). HMO penetration, competition, and risk-adjusted hospital mortality. Health Services Research, 36(6), 1019-1035. 55.Muller, A. (1993). Medicare prospective payment reforms and hospital utilization. Temporary or lasting effects? Medical Care, 31(4), 296-308. 56.Palangkaraya, A., & Yong, J. (2013). Effects of competition on hospital quality: an examination using hospital administrative data. European Journal of Health Economics, 14(3), 415-429. 57.Propper, C., Burgess, S., & Gossage, D. (2008). Competition and quality: Evidence from the NHS internal market 1991-9. Economic Journal, 118(525), 138-170. 58.Propper, C., Burgess, S., & Green, K. (2004). Does competition between hospitals improve the quality of care? - Hospital death rates and the NHS internal market. Journal of Public Economics, 88(7-8), 1247-1272. 59.Rachel Lu, J. F., & Chiang, T. L. (2011). Evolution of Taiwan's health care system. Health Econ Policy Law, 6(1), 85-107. doi: 10.1017/s1744133109990351 60.Rogowski, J., Jain, A. K., & Escarce, J. J. (2007). Hospital competition, managed care, and mortality after hospitalization for medical conditions in California. Health Services Research, 42(2), 682-705. 61.Rosko, M. D., & Broyles, R. W. (1987). Short-term responses of hospitals to the DRG prospective pricing mechanism in New Jersey. Med Care, 25(2), 88-99. 62.Schuetz, P., Albrich, W. C., Suter, I., Hug, B. L., Christ-Crain, M., Holler, T., . . . Mueller, B. (2011). Quality of care delivered by fee-for-service and DRG hospitals in Switzerland in patients with community-acquired pneumonia. Swiss Medical Weekly, 141. 63.Sethi, R. K. V., Henry, A. J., Hevelone, N. D., Lipsitz, S. R., Belkin, M., & Nguyen, L. L. (2013). Impact of hospital market competition on endovascular aneurysm repair adoption and outcomes. Journal of Vascular Surgery, 58(3), 596-606. 64.Shepherd, W. G. (1986). On the Core Concepts of Industrial Economics. In H. W. de Jong & W. G. Shepherd (Eds.), Mainstreams in Industrial Organization (Vol. 6, pp. 23-67): Springer Netherlands. 65.Stigler, G. J., & Sherwin, R. A. (1985). The Extent of the Market. Journal of Law and Economics, 28(3), 555-585. 66.Theurl, E., & Winner, H. (2007). The impact of hospital financing on the length of stay: Evidence from Austria. Health Policy, 82(3), 375-389. 67.Tung, Y.-C., Chang, G.-M., & Chen, Y.-H. (2009). Associations of Physician Volume and Weekend Admissions With Ischemic Stroke Outcome in Taiwan A Nationwide Population-Based Study. Medical Care, 47(9), 1018-1025. 68.Weissenberger, N., Thommen, D., Schuetz, P., Mueller, B., Reemts, C., Holler, T., . . . Hug, B. L. (2013). Head-to-head comparison of fee-for-service and diagnosis related groups in two tertiary referral hospitals in Switzerland: an observational study. Swiss Medical Weekly, 143. 69.Wong, H. S., Zhan, C. L., & Mutter, R. (2005). Do different measures of hospital competition matter in empirical investigations of hospital behavior. Review of Industrial Organization, 26(1), 61-87. 70.Xirasagar, S., & Lin, H. C. (2004). Cost convergence between public and for-profit hospitals under prospective payment and high competition in Taiwan. Health Services Research, 39(6), 2101-2115. 71.Xirasagar, S., & Lin, H. C. (2006). Effects of payment incentives, hospital ownership and competition on hospitalization decisions for ambulatory surgical procedures. Health Policy, 76(1), 26-37. 72.Zwanziger, J., Melnick, G. A., & Mann, J. M. (1990). Measures of Hospital Market-Structure - a Review of the Alternatives and a Proposed Approach. Socio-Economic Planning Sciences, 24(2), 81-95. 73.中央健康保險署. (2011). DRG支付制度實施一年之整體成效. 74.江東亮, 文羽苹, & 謝嘉容. (2014). 全民健康保險制度的發展與問題. 臺灣醫學, 18(1), 33-42. 75.李玉春, 黃昱瞳, 黃光華, 葉玲玲, & 陳珮青. (2014). 全民健保支付制度改革之回顧與展望. 臺灣醫學, 18(1), 53-66. 76.李卓倫, 洪錦墩, 陳文意, 蔡梓鑫, & 紀駿輝. (2013). 診斷關聯群附加支付的發展與應用. 臺灣公共衛生雜誌, 32(3), 205-219. 77.林民浩, 楊安琪, & 溫在弘. (2011). 利用地區差異與人口學特徵評估全民健保資料庫人口居住地變項之推估原則. [Using Regional Differences and Demographic Characteristics to Evaluate the Principles of Estimation of the Residence of the Population in National Health Insurance Research Databases (NHIRD)]. 臺灣公共衛生雜誌, 30(4), 347-361. 78.林秀碧, 楊銘欽, & 葉宏明. (2001). 醫院服務區域的界定與市場競爭程度之分析－以台中市某區域醫院為例. 醫護科技學刊, 3(1), 67-83. 79.林瑩. (2013). 實施台灣診斷關聯群對醫療品質的影響. 長榮大學. Available from Airiti AiritiLibrary database. (2013年) 80.施犖善, & 施蓓莉. (1999). 經濟學辭典. 臺北: 貓頭鷹. 81.張清溪, 許嘉棟, 劉鶯釧, & 吳聰敏. (2000). 經濟學-理論與實際(二版). 臺北: 雙葉書廊. 82.陳啟禎, & 鄭守夏. (2008). 醫療市場競爭的測量：從市場劃區與競爭指標著手. [Measuring Competition in the Health Care Market: Starting with Market Area Definition and Competition Indicators]. 臺灣公共衛生雜誌, 27(4), 292-300. 83.陳婉茗, 朱慧凡, 錢慶文, 蘇喜, & 吳肖琪. (2006). 醫院對即將全面實施DRGs支付制度之因應表現. 醫務管理期刊, 7(2), 193-205. 84.廖惠華, 李偉強, 張偉斌, & 魏秀美. (2014). 台灣導入診斷關聯群對醫療利用之影響－以內科系心導管診斷及治療為例. 醫務管理期刊, 15(2), 111-127. doi: 10.6174/jhm2014.15(2).111 85.衛生福利部中央健康保險署. (2014). 全民健康保險醫療服務給付項目及支付標準」第七部全民健康保險住院診斷關聯群. 86.盧瑞芬, & 謝啟瑞. (2003). 台灣醫院產業的市場結構與發展趨勢分析. 經濟論文叢刊, 31(1), 107-153. doi: 10.6277/ter.2003.311.5 87.錢慶文, 魏秀美, & 張樹棠. (2011). 第一階段實施之DRG民眾就醫滿意度及自費情形調查. 台北市: 衛生署中央健康保險局. 88.韓揆, & 許怡欣. (2010). 論病計酬DRG原理. 臺北: 合記圖書出版社. 89.羅郁婷, 張冠民, & 董鈺琪. (2015). DRG為基礎前瞻性支付制度對髖關節骨折�置換術的醫療利用與照護結果之影響. 臺灣公共衛生雜誌, 34(2), 180-192. doi: 10.6288/tjph201534103115 | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/54223 | - |
| dc.description.abstract | 根據經濟合作發展組織統計資料指出全球醫療保健支出不斷上漲，即使是在台灣也不例外。台灣在尚未有全民健康保險前，社會保險就已面臨費用上漲問題，全民健康保險自1995年3月1日實施後亦然，為解決費用上漲問題，中央健康保險署不斷研擬相關政策，包含保險費收取費率、支付制度改革等。台灣於2010年1月1日起台灣診斷關聯群（Tw-DRGs）第一階段正式實施，其實施之目的為降低醫療資源耗用與增進照護品質，分攤各醫療院所財務風險。過去許多研究曾針對台灣診斷關聯群（Tw-DRGs）之效益進行評估，但其結果不一致，且並無觀察市場結構與結果之關係。因此，本研究以2007-2011年間曾執行心導管、經皮心臟血管手術、冠狀動脈手術區域醫院等級以上醫院為研究對象，將探討台灣診斷關聯群（Tw-DRGs）實施對醫療資源耗用與照護品質效果，另外還針對市場競爭程度與資源耗用及照護品質關係進行探討。
根據上述研究背景與動機，本研究之目的有二：（一）探討台灣診斷關聯群（Tw-DRGs）實施對醫療資源耗用與照護品質之影響；（二）探討台灣診斷關聯群（Tw-DRGs）實施下市場競爭程度對醫療資源耗用、照護品質之關聯性。 本研究資料來源為國家衛生研究院所發行之全民健康保險研究資料庫-2005年承保抽樣歸人檔，研究期間為2006-2012年，並選取2007-2011年間曾執行心導管、經皮心臟血管手術、冠狀動脈手術區域醫院等級以上醫院，計算其各年醫療資源耗用（平均住院天數與平均醫療費用）與照護品質（出院後30日內再住院率與出院後30日內死亡率），並以SAS 9.3進行資料處理與統計分析，統計分析方法包含描述性統計、多變量變異數分析與多階層迴歸分析-成長模型。 利用多階層迴歸分析-成長模型進行研究假說驗證，結果顯示在控制醫院特質後，台灣診斷關聯群（Tw-DRGs）實施後平均住院天數逐年減少6.3%，平均醫療費用是實施逐年減少6%，風險校正前出院後30日內再住院率逐年增加0.8605%，風險校正後出院後30日內再住院率逐年增加13.43%，至於市場競爭程度與醫療資源耗用及照護品質無顯著相關，綜合上述結果，台灣診斷關聯群實施對有助於減少醫療資源耗用，照護品質無太大差異，市場競爭程度與醫療資源耗用與照護品質無太大關係。本研究認為台灣診斷關聯群（Tw-DRGs）品質監控措施可能失靈，衛生主管機關應加強品質監控與改善。 | zh_TW |
| dc.description.abstract | According to Organization for Economic Co-operation and Development (OECD) report, healthcare expenditure increasing globally, Taiwan is included. Before universal health insurance implementation, the insurer was eager to solve the issues of the increasing healthcare expenses. However, the issue had not be solved as National Health Insurance implement on March 1, 1995. To terminate the rate increasing, National Insurance Administration adapted several strategies, including elevating the premium rate and payment system reform. In order to decrease medical resource utilization, to improve quality, and decreasing the financial risk, Tw-DRGs implemented in Taiwan on January 1, 2010. Even though several studies has evaluated the efficacy of Tw-DRGs, the studies conclusion is inconsistent, simultaneously, those did not assess the association between market structure and outcomes. Thus, this study aimed to assess the impact of Tw-DRGs implementation on medical resource utilization and quality, the association of market competition on medical resource utilization and quality under Tw-DRGs for cardiac cath, Percutaneous Transluminal Coronary Angioplasty (PTCA), Coronary Artery Bypass Graft (CABG) surgery conducting in medical centers and residential hospitals from2007 to 2011.
This study aimed to assess the impact of Tw-DRGs implementation on medical resource utilization and quality, the association of market competition on medical resource utilization and quality under Tw-DRGs. This study used National Health Insurance Research Database (NHIRD) of Taiwan from 2006 to 2012. The data included cardiac cath, Percutaneous Transluminal Coronary Angioplasty (PTCA), Coronary Artery Bypass Graft (CABG) surgery conducting in medical centers and residential hospitals from2007 to 2011. The indicators of medical resource utilization included length of stay and medical cost, and the indicators quality 30- day readmission rate, 30-day post-discharge mortality rate. Using SAS 9.3 software, statistical analysis included description, multi-variant analysis, and Hierarchical linear growth model. Under Hierarchical linear growth model, as considering hospital characteristics Tw-DRGs caused length of stay decreasing 6.3% per year, average cost reducing 6% per year, 30- day readmission rate before calibration increasing 0.8605% per year, and 30- day readmission rate after calibration growing 13.43% per year. As evaluating the impact of market competition on hospital medical resource utilization and quality under Tw-DRGs, the market competitions had not correlation with medical resource utilization and quality. As the results, Tw-DRGs had positive impact on hospital medical resource utilization, elsewise, Tw-DRGs had a little negative effect on quality. In addition, there was no significant association to medical resource utilization and quality. This study indicated quality assessment system of Tw-DRGs might failure. Therefore, the health policy authorities might improve quality through adapting appropriate intervention approach. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-16T02:45:27Z (GMT). No. of bitstreams: 1 ntu-104-R02848016-1.pdf: 6374910 bytes, checksum: 0a0d5e6cc1384e8bcc091dac33e5ffb5 (MD5) Previous issue date: 2015 | en |
| dc.description.tableofcontents | 致謝 ………………………………………………………………………………………………………………….ii
中文摘要 ……………………………………………………………………………………………………….iv Abstract ………………………………………………………………………………………………………………….vi 目錄 ……………………………………………………………………………………………………………...viii 圖目錄 ……………………………………………………………………………………………………………..x 表目錄 ……………………………………………………………………………………………………………..xi 第一章 緒論 ……………………………………………………………………………………………………..1 第一節 研究背景與研究動機 ……………………………………………………………………..1 第二節 研究目的 …………………………………………………………………………………..………..5 第二章 文獻探討 ……………………………………………………………………………………………..6 第一節 診斷關聯群 ………………………………………………………………………………………6 第二節 市場範圍定義與市場競爭程度測量 ………………………………………………10 第三節 診斷關聯群實施對醫療資源耗用與照護品質影響之實證研究 ……… 16 第四節 診斷關聯群實施前後市場競爭程度與醫療資源耗用及照護品質相關性之實證研究 ……………………………………………………………………………………………………23 第五節 文獻結語 …………………………………………………………………………………………28 第三章 研究方法 ……………………………………………………………………………………………30 第一節 研究設計與研究架構 ……………………………………………………………………30 第二節 研究假說 ……………………………………………………………………………………………31 第三節 研究資料來源與研究對象 …………………………………………………32 第四節 研究變項與操作型定義 …………………………………………………35 第五節 統計分析方法 ……………………………………………………………………………..………42 第四章 研究結果 ………………………………………………………………………………………44 第一節 研究對象特質描述性統計 ……………………………………………44 第二節 市場競爭程度描述性統計 ……………………………………………46 第三節 醫療資源耗用描述性統計 ………………………………………………………………50 第四節 照護品質描述性統計 ………………………………………………………………………54 第五節 多階層迴歸分析-成長模型 …………………………………………………62 第五章 討論 ……………………………………………………………………………………………86 第一節 研究方法之討論 ………………………………………………………………………86 第二節 研究結果之討論 ………………………………………………………………………90 第三節 研究限制 …………………………………………………………………………………94 第六章 結論與建議 …………………………………………………………………………………95 第一節 結論 ……………………………………………………………………………………95 第二節 建議 ……………………………………………………………………………………95 參考文獻 …………………………………………………………………………………………………97 附錄 ………………………………………………………………………………………………103 | |
| dc.language.iso | zh-TW | |
| dc.title | 台灣診斷關聯群實施、市場競爭程度與醫療資源耗用及照護品質之相關性探討-以心導管、經皮心臟血管手術、冠狀動脈繞道手術為例 | zh_TW |
| dc.title | Association of the Tw-DRGs and Market Competition upon Medical Resource Utilization and Quality of Care Using Cardiac Cath, PTCA and CABG as an example | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 103-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 唐高駿(Gau-Jun Tang),鄭守夏(Shou-Hsia Cheng),王惠玄(Hui-Hsuan Wang) | |
| dc.subject.keyword | 台灣診斷關聯群,醫療資源耗用,照護品質,成長模型,全民健康保險研究資料庫, | zh_TW |
| dc.subject.keyword | Tw-DRGs,Medical Resource Utilization,Quality,Growth Model,National Health Insurance Research Database (NHIRD), | en |
| dc.relation.page | 103 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2015-07-20 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 健康政策與管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
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