The Simulation for Operating in Family Medicine under the Global Budget Payment System

• Main Authors: Wu, Ming-hui, 吳明徽
• Other Authors: Chung Chien-Ping
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/50129798335382186785

碩士 === 明道大學 === 產業創新與經營學系碩士班 === 100 === The population structure in Taiwan is in an aging trend, thus greatly increasing needs for medical care, and the successful operation of family medical services (family medicine) has come to be a critical element. In this study, past literature on the operations of family medicine under the National Health Insurance global budget system have been collected and processed through a system dynamics that helped to construct a comprehensive system of mode of operations comprising of several interacting operational elements. Next, operational factors consisting of numbers of physicians, actual identification, and networked identification were proposed. With response variables of earnings, quality of care, and network quality, a policy proposal was compiled using Taguchi’s orthogonal table. Lastly, analytic hierarchy process theory was applied to facilitate multi-criteria decision-making in order to determine the order of priorities within the proposal. This study found that the rise in physician numbers, actual identification and networked identification has positive influences on the increase of incoming patients. However, as increases in physician numbers and actual identification require higher cost, family medicine earnings would decline if the above two factors were strengthened indefinitely. On the other hand, lower costs are required for networked identification, and the advantage of quickly and conveniently dispersing information via networking may help to enhance the quality of care in family medicine and patients’ general knowledge. Furthermore, when physician numbers and networked identification are both at high standards, it is possible to greatly enhance quality of care and to enhance and strengthen patients’ general medical knowledge. In terms of actual identification, because patients already have a high level of identification in this aspect, further endeavors would not produce significant results. If actual identification were at a lower standard, it would be more beneficial to the healthcare insurance system and the earnings of family medical services.