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
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
|Appears in Collections:||健康政策與管理研究所|
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.