Summary: | 碩士 === 國立屏東科技大學 === 高階經營管理碩士在職專班(EMBA) === 100 === Ever Since the National Health Insurance (NHI) was implemented years ago, changes in medical circumstances had taken place in recent years and the consumptive awareness among the general public had been raised as well. Faced with changes in the National Health Insurance Reimbursement and limited medical resources available, hospitals has competed with each other and suffered much pressure from the services offered as many to their patients.
Ever since 1995 Taiwan implemented the NHI that people from Europe and the United Sates has envied, the Reimbursement Program based on quantity had been applied to save unnecessary medical waste. However, as the phenomenon that people in Taiwan are “fond” of seeing doctor no matter he severity level of illness is unlikely to change in the short run, demands for health insurance had also kept on the rise, which ultimately led to the incessantly climbing health insurance premiums and the deterioration in healthcare financing. In the meantime, hospitals in the competitive market, faced with changes in health insurance reimbursement policy, had one by one launched the “user pays” program where patients must pay based on their needs for certain medical items.
As indicated by literatures, personal traits and medical-behavior properties will indeed influence the rate of use of Ambulatory Care among patients. In this study, we look at the higher-level customer group that had gone to hospital in Pingtung during the period from 2006 to 2011 and review their medical-behaviors to establish a Data Warehouse. Using the On-Line Analytical Processing (OLAP) and Data Mining (DM), etc., to derive the vital indicator among those “user pays” patients from their medical behaviors. The indicator could then become an identification reference for hospitals to identify customers that are likely to pay on their own, so that limited resources can be allocated for those customers most in need of services at their own expense.
Research results had shown that as one of the Three High Chronic Diseases is likely to occur among people before 35 years old, all of the Three High Chronic Diseases are likely to occur among people at the age of 51 when their body conditions start to wind down. As such, health examinations should begin for people before 35 years old. As people at the age between 51 and 60 often suffer a lot from cardiovascular problems, it can be inferred that the bodies of people over 50 years old are already in a recession, especially in their heart functions; on the other hand, there is a large proportion of young people who have problems in their digestive systems, and therefore, health examinations had better be implemented for people before they become middle-aged. Future development of health examinations should advocate preventive healthcare and increase gastrointestinal examination projects for people before the age of 35. The Three High Chronic Diseases are within the focus of attention for people over the age of 50 in order for early detection and early prevention. Meanwhile, according to the study over the scale of health examinations among local residence, aborigines had undergone health examinations only a few times and the amount they spent on health examinations were lower than average. This phenomenon is worth further investigation so that we can understand the concepts that those rural residents behold against health examinations as well as the correlating factors that affect their willingness to undergo such examinations to contribute to the development of marketing strategies of health examinations.
Keywords: health examinations, medical-behavior properties, on-line analytical processing, data mining
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