中醫住院治療健保給付之可行性探討(2-1)

楊賢鴻
長庚大學
我國全民健康保險自1995年3月開始實施以來，迄今已有12年，初期規劃全民健保之時，由於缺乏中醫的相關資料及數據，因此初期僅以中醫門診支付列為給付項目，然而歷經數年，甚至總額預算制度已開始實施，中醫住院醫療照護仍尚未獲准給付，導致國內兩家醫學中心附設中醫部門的中醫住院業務以病患自費方式進行醫療服務，如此導致病患權益深深受損，此外對中醫臨床教學也有連帶之影響。 本研究將收集、整理過去衛生署所委託之相關研究成果，計畫中先將上述資料匯整，並邀該計畫主持人，以座談式方法進行經驗交流及意見整合，以先取得初步之共識。接著則再進一步透過邀約包含：衛生署官員、中央健保局官員，中西醫界，醫療、藥學、護理、醫管專家學者，費協會專家、法律相關專家及精算師，以專家座談會的方式討論中醫住院給付之可行性及未來進行之方法，作為未來推動健保中醫住院給付的相關依據，期間也將同時調查、收集及整理大陸及國外相關醫療單位對中醫住院之保險給付，並調查收集台灣兩家醫學中心中醫住院實際產生之項目及費用，提供作為專家座談會討論未來中醫住院健保支出之費用設計之參考。本研究結果將藉由專家座談會的方式，增進中醫界與健保局、費協會等相關機構之互動及了解，以減輕未來推動健保給付中醫住院醫療之阻力，同時研究成果將作為未來健保給付之依據參考。
關鍵字：中醫住院；全民健康保險

Evaluation the possibility of Chinese medicine admission care by global budget payment(2-1)

Yang, Sien-Hung
Chang Gung University
In Taiwan, healthy insurance was done since march of 1995, within these 12 years, only out patients department were enrolled to the goal of budget payment due to less of data of studies and experiences, that why now two Chinese medicine department of medical centers only can treated the admission patients without healthy budget payment, the events troubled many patients needs medical care by Chinese medicine and the doctors of Chinese medicine. This study will collected the results of studies offer by committee on Chinese medicine and pharmacy, Department of Health Executive Yuan, from last 5 years, the combined meeting including specialist from both doctors of Chinese medicine and western medicine, Healthy Executive Yuan, Bureau of National Health Insurance will enrolled in meeting in order to discuss and provide the recommend, besides, we will investigate the reasonable payment of admission care by Chinese medicine. The results of this study will offer to the future of budget payment of admission care by Chinese medicine.
關鍵字：Chinese medicine admission care；Budget payment