中醫住院支付標準、給付內容及成本效益分析

賴俊雄
中國醫藥大學
本研究之目的希望能完成中醫住院納入健保給付之相關問題如下：1. 擬定中醫住院醫療費用支付項目及各項目支付標準，作為全民健保醫療費用協定參據。2. 瞭解目前中醫醫院設施與醫事服務人力現況與中醫醫院之地理分佈。3. 研究建立中醫住院醫療服務品質控管機制。4. 針對一般民眾進行中醫住院之成本效益分析。5. 建議中醫住院費用之財務機制與擬定總額之評估。本研究擬從民眾對中醫住院之醫療體系供給面、民眾需求面、與專家政策面，三方面進行中醫住院醫療費用支付項目及各項目支付標準之評估。其中供給面的探討除了傳統研究中針對醫療體系進行各種性質的量化描述之外，也包括進行中醫住院業務的成本估算。需求面的研究則主要針對中醫住院的民眾效益進行估算。透過這樣的方式進行中醫住院的成本效益分析，並以此作為依據來進行專家會議與提出政策建議。在醫療體系供給面部分，以問卷調查目前台灣地區中醫醫療院所的相關設施，以醫院之醫師人力、醫療設施、服務科別等結構面指標，嘗試區分不同之醫院等級以評估支付標準是否分級之可能，同時也參照中醫醫院評鑑指標與評估方式。
關鍵字：中醫住院；健保給付；支付標準

Planning for Inpatient Care of Chinese Medicine in National Health Insurance Scheme

jiun shiung-lai
China Medical University
The purpose of this study is to solve the related problem about subsuming the inpatient of Chinese medicine in national health insurance. There are five problems？G？]1？^framing the expenditure payment items and payment criterion of Chinese medicine hospitalization , in terms of NHI expenditure agreement？F？]2？^understanding the facilities , the medical manpower and the geographical distribution of Chinese medicine hospital？F？]3？^ establishing the medical quality control mechanism of Chinese medicine hospitalization？F？]4？^using cost-benefit analysis on Chinese medicine hospitalization aiming at the public people ？F？]5？^suggesting the financial mechanism of Chinese medicine hospitalization expenditure and the evaluation of global budget. This research from three dimensions to evaluate Chinese medicine hospitalization expenditure payment items and payment criterion, including medical system supply side, public demand side and expert policy side. Supply side includes estimation of Chinese medicine hospitalization cost, in addition to quantity description of Chinese medical system. Demand side mainly aims at estimation benefit of Chinese medicine hospitalization.
關鍵字：Chinese medicine hospitalization；NHI payment；payment criterion