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碩士 === 國立東華大學 === 公共行政研究所 === 94 === Abstract During these ten years, the medical insurance of Taiwan transforms from the original Free for Service (FES pattern) to the Global Budgets-centered Control Self-Assessment (CSA pattern) gradually. Also, from paid by medical unit changes to regional Global...
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ndltd-TW-094NDHU50550112015-12-16T04:39:01Z http://ndltd.ncl.edu.tw/handle/56823078679477254991 none 我國全民健康保險支出政策變遷之探討:以醫院卓越計畫為例 Fu-Ying Tsai 蔡富櫻 碩士 國立東華大學 公共行政研究所 94 Abstract During these ten years, the medical insurance of Taiwan transforms from the original Free for Service (FES pattern) to the Global Budgets-centered Control Self-Assessment (CSA pattern) gradually. Also, from paid by medical unit changes to regional Global Budgets policy, and then converts to the hospital Control Self-Assessment, which varies widely. In order to inspect the process of National Heath Insurance (NHI) expenses transition, this study uses the theory of Policy Change to analyze the interaction of relations in Hospital Excellence Program toward The Stream of Historical, The Stream of Policy, The Stream of Political Network, The Stream of Social Relations, and The Stream of Text to know the correlation through questions, plans, participants, and choosing opportunities to observe the formative policy contents to discuss the carry- out process of Hospital Excellence Program. During the carry-out process of Hospital Excellence Program, it not only produced new questions but also opened Policy Window after two medical protests. The program ceased on December 31st, 2004. Through extrinsic policy environment and intrinsic analysis of factors discussion reveals the dynamic process; we can see the variances between the policy decider of government and medical demand. Obviously, the process of policy decision can not be explained by an objective and reasonable process or a gradually policy decision mode. The policy decision process of Excellence Program is the evidence of policy change mode. In addition, this study applied the built-destruct-rebuilt concept of policy change theoretical structure which Lin Shuei Bo proposed, and after study the case of hospital Excellence Program we found that the original policy’s systematic rules did not collapsed, however it construct newly complementary rules instead challenge original structure to suit the situational needs of “Policy Growth”. Amended proposal then proposed “assured project for a total quota of hospital quality”. This amended proposal continues to carry on “Policy Evolutions” change form in policy loop and the process of policy change in a panoramic view. Finally, this study found the spirit for introduces for Control Self-Assessment of Hospital Excellence Program is to promote the autonomy of treatments and furthermore to promote the quality of treatments; so far Hospital Excellence Program is still to disburse the fee based on a total quota which is not solved the problem for the system of fee for service. The research has found that it needs the cooperation of general public, professional medical personnel, and insurer (Bureau of National Health Insurance) to solve this problem. Key words: Hospital Excellence Program, Global Budgets, National Health Insurance, Policy Change, Policy Window none 魯炳炎 2006 學位論文 ; thesis 200 zh-TW |
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碩士 === 國立東華大學 === 公共行政研究所 === 94 === Abstract
During these ten years, the medical insurance of Taiwan transforms from the original Free for Service (FES pattern) to the Global Budgets-centered Control Self-Assessment (CSA pattern) gradually. Also, from paid by medical unit changes to regional Global Budgets policy, and then converts to the hospital Control Self-Assessment, which varies widely.
In order to inspect the process of National Heath Insurance (NHI) expenses transition, this study uses the theory of Policy Change to analyze the interaction of relations in Hospital Excellence Program toward The Stream of Historical, The Stream of Policy, The Stream of Political Network, The Stream of Social Relations, and The Stream of Text to know the correlation through questions, plans, participants, and choosing opportunities to observe the formative policy contents to discuss the carry- out process of Hospital Excellence Program. During the carry-out process of Hospital Excellence Program, it not only produced new questions but also opened Policy Window after two medical protests. The program ceased on December 31st, 2004. Through extrinsic policy environment and intrinsic analysis of factors discussion reveals the dynamic process; we can see the variances between the policy decider of government and medical demand. Obviously, the process of policy decision can not be explained by an objective and reasonable process or a gradually policy decision mode. The policy decision process of Excellence Program is the evidence of policy change mode.
In addition, this study applied the built-destruct-rebuilt concept of policy change theoretical structure which Lin Shuei Bo proposed, and after study the case of hospital Excellence Program we found that the original policy’s systematic rules did not collapsed, however it construct newly complementary rules instead challenge original structure to suit the situational needs of “Policy Growth”. Amended proposal then proposed “assured project for a total quota of hospital quality”. This amended proposal continues to carry on “Policy Evolutions” change form in policy loop and the process of policy change in a panoramic view.
Finally, this study found the spirit for introduces for Control Self-Assessment of Hospital Excellence Program is to promote the autonomy of treatments and furthermore to promote the quality of treatments; so far Hospital Excellence Program is still to disburse the fee based on a total quota which is not solved the problem for the system of fee for service. The research has found that it needs the cooperation of general public, professional medical personnel, and insurer (Bureau of National Health Insurance) to solve this problem.
Key words: Hospital Excellence Program, Global Budgets, National Health Insurance, Policy Change, Policy Window
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none Fu-Ying Tsai 蔡富櫻 |
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Fu-Ying Tsai 蔡富櫻 |
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Fu-Ying Tsai 蔡富櫻 none |
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Fu-Ying Tsai |
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http://ndltd.ncl.edu.tw/handle/56823078679477254991 |
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