The Impacts of Global Budget on the Medical Utilization of Dialysis Patients in Taiwan
Date Issued
2005
Date
2005
Author(s)
Wang, Po-Wen
DOI
zh-TW
Abstract
Abstract
With the progress of medical and public health, the chronic diseases have replaced the epidemics become the main cause of death in Taiwan. Among the chronic diseases, however, renal diseases are often neglected. With the development of medical technology, patients who have end-stage renal disease(ESRD) could prolong their life by renal replacement therapy such as kidney transplant, hemodialysis and peritoneal dialysis. In Taiwan, the Bureau of National Health Insurance facing the pressure of the growth of dialysis medical expenditure, because the number of dialysis patients increase year by year.
In order to control the medical expenditure, the Bureau of National Health Insurance implemented global budget system on physician clinics from July of 2001. The purpose of this study is trying to compare those dialysis medical claims eighteen months before and after the global budget system launching and explore the impacts that system brought on dialysis patients.
The results of this study are as follows:
1. After launching the global budget system, the number of dialysis visits and expenditure claims increase significantly.
2. After launching the global budget system, the number of non-dialysis visits does not have obvious change.
3. After launching the global budget system, the non-dialysis medical expenditure claims decrease significantly.
4. After launching the global budget system, although the non-dialysis visits on physician clinics decrease, the dialysis visits on physician clinics increase higher than the other type of medical institutions.
5. After launching the global budget system, the inpatient visits and length of stay of patients with chronic dialysis does not change obviously.
In summary, this study is proposed as follows:
1. After launching the global budget system, the physician clinics provide higher dialysis service. Other mechanism should be taken to monitor the global budget system effects on quality of dialysis service.
2. Patients with chronic dialysis are those who have productivity and increasing year by year. It is suggest that in order to reduce dialysis medical expenditure, the Department of Health should take action to prevent renal diseases.
Subjects
末期腎臟疾病
透析
醫療利用
end-stage renal disease
dialysis
medical utilization
SDGs
Type
thesis
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