The Study on Catheterization Examinations or Treatments of Medical Resources Utilization，Mortality Rate and Rate of Return among with Different Hospital Groups.

• Main Authors: Peng-Cheng Liu, 劉鵬程
• Other Authors: Ya-Seng Hsueh
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/66411643771277002008

碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 94 === Research Objectives: The objectives of this research were to analyze and to explore the catheterization examinations or treatments of medical resources utilization, mortality rate and return rate among with different hospital groups. The essential factors of medical resource utilization and medical quality were included: (1) General medical payment, (2) the length of stay, (3) mortality rate, and (4) the return rate of catheterization. To approach the research objectives, one makes the following three hypotheses under controlling other related factors. The hypotheses were proceeded (1) different hospital groups factors affect the outcomes on catheterization examinations or treatments of medical resources utilization (General medical payment/the length of stay), (2) different hospital groups factors result in different mortality rate outcomes on catheterization examinations or treatments, (3) different hospital groups factors influence the patients return catheterization rate on catheterization examinations or treatments. Method: The cross-sectional research analysis was conducted by adopting the selective National Health Insurance data of 83,547 cases (72,325 case payment, 11,222 non-case payment) from 2000 to 2002. Results: 1.The impacts of different hospital groups affect the outcomes on catheterization examinations or treatments of medical resources utilization (General medical payment/the length of stay). The highest Mean value of General medical payment on catheterization examinations declare are attributed to Non-profit Metropolitan Hospital. Moreover, in terms of catheterization treatments, the highest of General Medical payment s are attributed to Non-profit Metropolitan Hospitals、Public Medical Centers、Non-Profit Medical Centers respectively. 2.The means o f the length of stay on various case payment items in multiple regression model are all shown significant(p＜.0001). However, considering catheterization treatments, one found there were merely the Private Metropolitan Hospitals and Public Medical Centers (Reference Group) showed significant(p＜.0001), meanwhile, the length of stay are shown significant decline as well. Concerning the means of the length of stay from high to low are ranked as Non-Profit Medical Centers、Public Medical Centers、Public Metropolitan Hospitals、Non-profit Metropolitan Hospital、Private Metropolitan Hospitals in order. 3.The mortality rates on catheterization examinations or treatments in different hospital groups are shown significant (p=0.0003). Two situations are discussed. There is no significant of 30-day mortality rate in the case payment items among with different hospital groups. On the other hand, there is significant (p＜0.01) in the non-case payment. Accordingly, the mortality rate of Private Metropolitan Hospitals was 3.62%, which was 441% higher by comparison Public Metropolitan Hospitals (0.82%). In comparison with 30-day mortality rate or above 30-day mortality rate, the mortality rate of Private Metropolitan Hospitals was 209% higher than Public Medical Centers (Reference Group), and the result showed significant (p=0.0002) as well. 4.The results of this research revealed that different hospital groups indeed affected patients return rate on catheterization examinations or treatments. Accordingly, the lowest return rate of Non-Profit Medical Centers was 0.90%, and the highest return rate of Non-profit Metropolitan Hospital was 2.20%. Suggestions: A. To public health policy makers 1.The public health bureau needs establish strictly investigate system and penalty stipulation for guiding hospitals to declare in accordance with rules. 2.The public health bureau needs stipulate basic training and access criterion to evaluate on-training physicians to secure patients health. B. To medical institute manager 1.The hospitals need provide well-training physicians. 2.The hospitals need monitor the quality of low-operation physicians to raise the medical care standard. 3.The hospitals should cooperate with professional to observe the effects of treatments and prevent any harmful complication from being occurred. C.To further researchers In this study, one can not obtain the detail information of severity of patients’ heart blood vessel blocked in National Health Insurance database, consequently, it needs access by Chart-review studies. Thus, one suggests a well-understanding anamnesis needs well-training professional groups to access and to explain by applying double-blinded studies model to improve the further research result accurately.