Establishing the Fee Schedule for Chinese Medical Hospitalization Procedures in Taiwan’s National Insurance Program

• Main Authors: Bow-Ching Chu, 褚柏菁
• Other Authors: Jaung-Geng Lin
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/09776756140245885972

碩士 === 中國醫藥大學 === 中國醫學研究所碩士班 === 95 === Chinese medical insurance was included in the Labor Health Insurance in 1975, the Government Worker Insurance in 1988 and the Farmer Health Insurance in 1989 respectively. Taiwan’s National Health Insurance (NHI) program was established in March 1995, and the Chinese medical outpatient service was included in NHI. So far, the NHI has been established for more than ten years but the Chinese medical hospitalization (CMH) has not yet been incorporated in NHI, still stays in the appraisal stage. It is very important to establish the reasonable fee schedule for developing CMH. This study uses the Delphi method and Grounded theory method to reach a common consensus among the specialists. We held two the specialists meetings in which 33 experts discussed together and gave very helpful suggestions. After the meetings, we arranged all the suggestions and made the Delphi questionnaire. 44 Delphi questionnaires were sent and the results were shown in the two-rounded Delphi questionnaire. There are three parts of the Delphi questionnaire：the first part is “the attitude toCMH”.In the subject of “CMH should be involved in NHI? ”, most experts strongly approved it. In the subject of “partially diseases should be involved in Chinese medical hospitalization”, the attitude of experts turned from approval to strongly approval during two rounds. In the subject of “Chinese herbal medicine should be paid for daily charge? ”, the attitude of experts turned from unapproval to approval during two rounds that appeared that they had different view of it. In the subject of “the cost-sharing for hospitalization of Chinese medical hospitalization should higher than western medicine”, most experts didn’t approve it. The second part is “the evaluation for the subjects of Chinese medical hospitalization”. Most experts approved that the medical center with Chinese medical department is the priority to practice the CMH.The major purpose of CMH is for developing the research of Chinese medicine. The Committee on Chinese Medicine and Pharmacy, Department of Health, Executive Yuan should lead to establish the CMH.Stroke and treatment of post chemo-radial therapy should be prior to be involved in CMH. The third part is “the suggestions of the fee schedule of CMH”. Over 80％ experts approved that room fee of Chinese medical hospitalization, diagnosis fee of Chinese medicine,diagnosis fee of western medicine ,fee of prescription , fee of treatment of acupuncture, nursing care fee of traditional Chinese traumatologic manipulation、fee of nutritional direction、fee of pharmacist、accupressure、splint、pulse signal measurement、electroacupuncture stimulation、nasogastric feeding、testing、X-ray should be paid. Less than 80％ experts approved that altinative chinese medical equipments and fire cupping should be paid. Most suggestive fee were close to the fee schedule of experimental plan,and the fee in second round is closer to fee schedule of experimental plan than the first round. The results are the common consensus for Chinese medical hospitalization procedures among the specialists，and it could be a guideline for Chinese medical hospitalization procedures in the future. We also investigate the distribution of Chinese medical hospitals and doctors in Taiwan, for the preparation for Chinese medical hospitalization.