醫院集團的醫療結果表現

NCUIR > School of Management at National Central University > Graduate Institute of Industrial Economics > Electronic Thesis & Dissertation > Item 987654321/61523

Please use this identifier to cite or link to this item: http://ir.lib.ncu.edu.tw/handle/987654321/61523

Title:	醫院集團的醫療結果表現
Authors:	謝育邦;HSIEH,YU-PANG
Contributors:	產業經濟研究所
Keywords:	醫院集團;規模經濟效果;市場競爭程度;multihospital system;scale economies;market competition
Date:	2013-08-27
Issue Date:	2013-10-08 15:19:03 (UTC+8)
Publisher:	國立中央大學
Abstract:	隨著全民健康保險的施行，台灣的醫療產業結構產生了巨大的轉變，而導致醫院之間的競爭變得更加劇烈，本論文旨在探討台灣近幾年興起的醫院集團化現象，是否對於病人的醫療救治結果有所影響。本研究使用「台灣地區醫院醫療服務量與醫事機構現況」資料庫以及「1998-2009年全民健康保險資料庫」進行實證研究，並選擇初次罹患急性心肌梗塞且接受住院治療的病患當作研究對象。我們以病患出院後是否7天內、30天內、90天內發生死亡、出院後30天內是否再住院以及病患當次住院的醫療費用做為衡量病人醫療救治結果的指標，並建構醫院集團化所衍生出來的規模經濟、市場競爭等效果，這些效果的影響下是否能提升病患的醫療結果，而讓醫院集團擁有較好的醫療服務品質。本論文的實證結果顯示，規模經濟及市場競爭的效果有助於醫院集團降低病患出院後的死亡率與再住院率，而提升醫院集團的醫療服務品質，且以規模經濟效果為主要原因；然而，在病患醫療利用方面，病患於醫院集團就醫的醫療費用也相對較高。 With the implementation of the National Health Insurance, the structure of medical industry has experienced a significant change in Taiwan, leading to more intense competition among hospitals. This paper aims to investigate whether the member of multihospital system has better treatment outcomes in terms of patients’ mortality, readmission and medical expenditures than solo hospitals. We extract the hospital characteristics and acute myocardial infarction (AMI) patients’ features from 1998-2009 Statistics for Medical Institution & Hospital Medical Services Database and National Health Insurance Research Database as research. Patients’ treatment outcomes are evaluated via the likelihood of death within 7, 30 and 90 days after the discharge from hospital, the readmission rates within 30 days after discharge, and patients’ medical expenditures. The effects of scale economies and market competition may distinguish the patients’ treatment outcomes between members of multihospital system and solo hospitals. The empirical results show that the effect of scale economies from multihospital system significantly reduces the patients’ mortality and readmission after discharge. However, patients’ medical expenditures in multihospital system are relatively higher than those in solo hospitals.
Appears in Collections:	[Graduate Institute of Industrial Economics] Electronic Thesis & Dissertation

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