| Summary: | 碩士 === 長榮大學 === 醫務管理學系碩士班 === 96 === Purpose:
To analyze the efficiency of the clinics under Family Medicine Integration Project Payment B to increase the effect of this project.
Material and Method:
According to the application data of Family Medicine Integration Project members from Bureau of the one of the National Health Insurance Region Branch from 2005 to 2006, eliminating the top 1% members for their high policlinic charge or not visiting and 3 special division clinics on ophthalmology, dermatology and psychiatric, there are 78 clinics and 71072 members for the final samples. Adjusted Clinical Groups is adopted to classify the levels of how serious the patients are and use paired t testing to check the range in two years. The members in the family physician clinic visit times be a external validity. To use Pearson correlation coefficients test the correlation of efficiency between 2005 and 2006 for reliability. Use Spearman correlation coefficients test the correlation of efficiency position between 2005 and 2006. The positive cost paid by all members divided by the member cost expected by ACGs equals the efficiency of the clinic. Lower the ratio is, higher the efficiency is.
Result:
There isn’t a big change on one member in two years. The efficiency rates of 78 clinics are from 0.7 to 1.5. Besides, the correlation of efficiency in two years is 0.93 and the correlation of efficiency position is 0.91, both reach the obvious level. The correlation of the efficiency of the clinic and the times that the member goes to this clinic is 0.41, which also reaches the obvious level.
Conclusion:
Classify with ACGs is stable and the clinic’s efficiency according to cost expected by ACG also gets good reliability and validity. We could use it to compare clinics’ efficiency in the future to raise the efficiency of the clinics.
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