| Summary: | 碩士 === 國立臺灣大學 === 財務金融學研究所 === 90 === It has been seven years that the National Health Insurance (NHI) program of Taiwan was carried out. The payment policy of NHI has deeply influenced the health organizations and medical environment. Out patient services become the main business of medical industry due to easy money earning, resulting an uneven allocation of medical resources in major cities. Physician distributed either in big hospitals or in small private clinics. Few doctors offer their service in middle- or small-sized hospitals.
The National Taiwan University Hospital (NTUH) is a non-for-profit organization and focuses on education, research and service missions since her ground opening in 1895. However, Taiwan is involved in the global economic fading. The NHI financial payment is reduced gradually. Furthermore, the government financial supporting budget is also declined year by year. Thus, NTUH had to alter business operation to be a more efficient and profitable institute. Therefore, it is necessary to forecast the outcome of future financial status of NTUH. The purpose of this study was to find out the critical factors or key concerns that influence revenue and profit, and to predict future business model by financial structure simulation and sensitivity test.
The baseline data were NTUH revenue and cost of 2000 and January to October 2001. The income was derived from medical affairs, government fund and earning from non-medical affairs. There are two parts of medical affairs, one is income from out patient service including first visit and subsequent visits, and emergency service; the other is income from patient admission. The revenue items of medical affairs include registration fee, physician charge, laboratory allowance, pharmacy expense, hospital room rate, and other bills from individual patient. The government fund is mainly for education and research, and a small part for employees’ salary. The income of non-medical affairs includes interest income from hospital basic fund, parking charge, and others. The overall expense of NTUH was identified as an incrementally elevated constant by 3% yearly. All the components of income were forecasted on the basis of historic data, present condition, and future prediction by a triangular distribution with a least, a largest, and a most probable data. By simulation, these variables were randomly sampled and simulated 600 runs for each scenario.
The results indicated that out patient service and hospital admission were the two most important incomes of the hospital. The decrease of pharmacy expense was the most critical factor for both of them. Patients number was the other key factor influenced out patient service income. Laboratory allowance and suspended rate of receivable payment from NHI were the other two key factors affected the patient admission income. In contrast to present thinking, total profit of out patient first visit was less than subsequent visits, because the higher laboratory allowance of the first visit was less valuable than the higher pharmacy charge of the subsequent visits. Thus, it should be more concern for the policy making to release more subsequent visit patients from the hospital. Although the pharmacy expanse has no contribution to hospital net profit at the present time, the huge cash flow plays an important role for further investment or other financial manipulations. Furthermore, NTUH should make more efforts to earn legally permitted profit from pharmacy trading.
Physical check up is a low cost and high profit project. It is important to increase physical check up business scale of NTUH in the future for financial improvement. In addition to interest income, financial managements of public organizations like NTUH are recently approved by Taiwan government. The hospital basic fund could be invested into financial market to get capital gain if the profitability is predictable. In summary, by the parameters of this study, there will be no negative profit of NTUH by simulation from 2002 to 2011.
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