Hospital’s Administrative Perspectives—An Example of the “Global Budget System” and “Hospital Excellence Program”

• Main Authors: Ho, Yung-I, 何勇毅
• Other Authors: Chou, Yi Chun
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/02292548301048349359

碩士 === 玄奘大學 === 社會福利學系碩士班 === 95 === The National Health Insurance has been in act for more than ten years, but over these years, increasing demands for health care eventually led to financial pressure. “Global Budget System” was proposed to solve this situation. The purpose of this system (over the long run) is to control hospital medical fee expenditures, but after the execution of this plan, we find the results ineffective. The Health Insurance Department then suggested the “Hospital Excellence Program” and reassured that this time, individual hospital budgeting, not hospital budgeting, would be the center of control of medication costs for each hospitals. Unfortunately, this proposed program was also proven ineffective. To understand further, this research report will discuss the impact of different policies on hospital administrations. The main research method is based on documents and records, scientific or non-scientific. In-depth interviewing in this research, which is directed towards administrative officers and doctors, is to further support and analyze these documents. Analysis depends on the contents of the interviews— important factors include the job position of the interviewee in the hospital and his/her knowledge and experiences on this topic. Research results show that the reasons for financial pressure in the Health Insurance Department are the following: 1. Increase of senior population 2. Improvement of medical equipment and technology 3. Health care fee is fixed and cannot be changed upon request 4. The city government still owes funds to the Health Care Department 5. Hospital examination could use reform The above reasons are why the Health Insurance Department proposed "Global Budget System" and "Hospital Excellence Program" in order to control endless medical fee expenditures. After understanding the purpose of the two plans, the next thing to do is to compare and contrast the two. This is done by listing (and proving) different impacts that policies have on hospitals: 1. The plans that the Health Insurance Department have on controlling the expenditure of a hospital 2. The “Floating Conversion System” 3. A doctor's routine on medical treatment 4. A doctor’s professional autonomy Through the "Global Budget System”, the floating conversion decreases as hospital services increase, which jeopardize the management of hospitals in developing areas. The "Hospital Excellence Program" is then presented to solve this problem. However, because this new plan holds expenditure in a tight fist, fewer patients are allowed to seek medical treatment. As the number of sick people within a country increases, the doctors’ professional autonomy is blemished and their salaries will, as an impact, decrease. Through intense discussions, analysis, and interviews about suggested policies about improving health care, this research serves as a reference to the National Health Department, all the hospitals, as well as future research.