https://scholars.lib.ntu.edu.tw/handle/123456789/109488
標題: | 資源管理基礎之病人護理照護分類系統初探 | 作者: | 張睿詒 | 公開日期: | 31-一月-2003 | 出版社: | 臺北市:國立臺灣大學公共衛生學院醫療機構管理研究所 | 摘要: | 在論病例計酬與診斷相關群(DRGs)等前瞻性付費制度之發展趨勢下,醫 院經營除著重於提昇病人照護的品質外,成本的分析與控制益顯重要。如何 有效控制成本與發揮資源最佳效益,檢視各部門的資源分配與運用,已是刻 不容緩的重要課題。由於護理照護耗用必須許多資源,其成本佔醫院相當之 分量,若能有效地運用及控制這些資源,應可大幅提昇醫院管理效能,並增 進病人照護之品質。 過去護理病人分類系統對於管理護理人力資源與提供病患適切照護,多 所貢獻。然而,在前瞻性支付制度下,結合病人分類系統與DRGs 以強化成 本控制,並使病人獲得適當照護,已廣為國外醫院管理者致力推動的重要管 理工具。 反觀國內,仍缺乏將病人分類系統應用在DRGs 上的研究。另外,不論 國內外之發展,於病人分類之成本計算,多只針對護理人力探討,並未將完 整照護所需之藥材、耗材、設備等納入考量。即便是藉由護理單項成本分析, 亦尚有缺憾。 本研究以資源管理為基礎將病人之照護分為六類,並結合病人科別、主 診斷與住院日數,建立一前瞻性的照護系統,整合病人照護管理、資源管理、 以及成本效益計算的完整系統,以因應未來之醫療環境。 Under the development of prospective payment systems such as case payment or diagnosis related groups (DRGs), cost analysis and control become important for hospital management, in addition to improving the care quality of patients. Effectively controlling costs and utilizing resources as well as evaluating resources allocation and distribution throughout departments are the imminent task for hospitals. Due to large consumption of resources, the cost of nursing care is accounted for a considerable portion of total hospital costs. Therefore, tremendous rewards with respect to patient care and managerial capability will be benefited if these resources can be effectively and efficiently utilized. Nursing patient classification system (PCS) had significantly contributed to nursing human resource management and patient care in the past. However, under the prospective payment systems it is widely accepted that the PCS should be integrated with DRGs to obtain the advantages of strengthening cost control and patient care. On the contrary, few domestic works has performed this integration. Moreover, studies conducted domestically and internationally seldom consider the full cost of nursing care. The cost of manpower is most frequently examined. This approach underestimates the potential total costs of nursing care. Other alternatives which calculate nursing costs through the manufactory approach still inherit some major deficiencies. In the near future, health insurance plans will increase its control in the utilization of health care resources due to the financial pressure. Moreover, competition becomes intense as well. In confronting these difficult challenges, hospitals need a integrated management system to attain a most cost-effectiveness way to care patients. This study has conducted a pilot study to establish a prospective care management system. Employing an activity-based approach, distinguish different cost pools for classifying patient days into six clusters. Patients whose care is managed by clinical paths are included as the subjects studied. This system will provide a comprehensive management system which incorporates patient care management, resource management, and cost accounting as a management tool for the future health care environment. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/5020 | 其他識別: | 902320B002185 | Rights: | 國立臺灣大學公共衛生學院醫療機構管理研究所 |
顯示於: | 健康政策與管理研究所 |
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902320B002185.pdf | 172.62 kB | Adobe PDF | 檢視/開啟 |
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