Simulation Analysis of the Impact of Implantation of Tw-DRG on the Income of General Surgery

• Main Authors: Yu-Ling Hsieh, 謝瑜玲
• Other Authors: Hao-En Chueh
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/qp2t7y

碩士 === 元培科技大學 === 數位創新管理研究所 === 100 === The Diagnosis Related Groups(DRG) was first built in the United States and a significant impact on every subspecialty was shown after the implementation of DRG in 1983.The Bureau of National Health Insurance of Taiwan planed setup the Taiwan’s Diagnosis Related Groups (Tw-DRG) payment system as one of the medical coverage coming into force in phases within the 4 years between 2010 and 2014.This study used data mining analysis and decision tree analysis technologies to simulating the impact of implantation of Tw-DRGs on medical specialties. In-patient expense of 2000 to 2009 years in health insurance database for analysis. The simulation analyzes the change of medical specialties’ income after the implementation of Tw-DRGs to understanding the impact. The findings after simulation were, the income increases in: MDC5、MDC11、MDC12. The income reduces in: PreMDC、MDC4、MDC6、MDC7、MDC8、MDC9、MDC10、MDC16、MDC21. Total negative benefits were -3,971,625,516 points from 2004 to 2009, and the average loss was -661,937,586 points per year. The simulation analysis discovered that, after the Tw-DRGs implementation, the similar medical behavior can get different income because of the attribute of specialties and systems. Under the Tw-DRGs payment system, the income reduced in the Digestive surgery, hepatobiliary surgery and Breast surgery. These specialties will have to control the medical cost; otherwise in may soon face the negative benefits and the changing of medical ecosystem.