The Impacts of Tw-DRGs Payment System on Medical Care Utilization: Using Otitis Media as an Example

• Main Authors: Hui-Jung Cheng, 鄭卉容
• Other Authors: Ming-Chin Yang
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/qng6vw

碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 103 === Backgroud：To reduce rising health care costs, Taiwan has implemented a DRG-based prospective payment system in the beginning of 2010. Few studies examined the impact of DRG-based payment systems on otitis media surgery. Objectives: The objective of this study was to analyze the impact of DRG-based payment systems on medical care utilization, medical care expenditure and medical care quality while payment system changed from the previous to TW-DRGs—using otitis media surgery as an example. Methods: This study selected those who received otitis media surgery in 2009 or 2012 from “2010 sampling cohort database of 1,000,000 insureds” of National Health Insurance Research Database (NHIRD). Outcome variables were medical care utilization, medical care expenditure, and medical care quality.With SAS 9.4 software, this study tested the hypotheses by t test, chi-square test, analysis of variance, generalized linear model and multiple logistic regression analysis. Results: Both medical care utilization and medical care expenditure reduced due to the implementation of Tw-DRGs. The average health expenditure decreased 30%, the average length of stay reduced from 3.83 to 3.02. As a result, hospitals will adjust the behavior according to the standard of payments. Besides, there were no differences in outpatient service.Medical care quality did not have significant difference after implementing TW-DRGs system.