The impact of global budgeting on health service utilization, health care expenditures, and quality of care among patients with pneumonia in Taiwan
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- 作者：C.-Y. Lin ; T. Ma ; C.-C. Lin ; C.-H. Kao
- 刊名：European Journal of Clinical Microbiology & Infectious Diseases
- 出版年：2016
- 出版时间：February 2016
- 年：2016
- 卷：35
- 期：2
- 页码：219-225
- 全文大小：267 KB
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T. Ma (2)
C.-C. Lin (3) (4)
C.-H. Kao (5) (6)
1. Department of Nuclear Medicine, Research Assistant Center, Show Chwan Memorial Hospital, Changhua, Taiwan
2. Fudan Hospital & Healthcare Management Co., Ltd., Shanghai, China
3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
4. College of Medicine, China Medical University, Taichung, Taiwan
5. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taiwan
6. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan - 刊物类别：Biomedical and Life Sciences
- 刊物主题：Biomedicine
Medical Microbiology
Internal Medicine - 出版者：Springer Berlin / Heidelberg
- ISSN：1435-4373
文摘
This study evaluated the effect of global budgeting on health service utilization, health care expenditures, and the quality of care among patients with pneumonia in Taiwan. The National Health Insurance Research Database (NHIRD) was used for analysis. Data on patients diagnosed with pneumonia during 2000–2001 (the prebudget group) were used as the baseline data, and data on patients diagnosed with pneumonia during 2004–2005 (the postbudget group) were used as the postintervention data. The length of stay (LOS), diagnostic costs, drug costs, therapy costs, total costs, risk of readmission within 14 days, and risk of revisiting the Emergency Department (ED) within 3 days of discharge before and after implementing the global budget system were analyzed and compared. Data on 32,535 patients with pneumonia were analyzed. The mean LOS increased from 6.36 ± 0.07 to 10.78 ± 0.09 days after implementing the global budget system. The mean total costs in the prebudget and postbudget groups were 22,697.82 ± 542.40 and 62,016.7 ± 793.19 New Taiwan dollars (NT$), respectively. The mean rate of revisiting the ED within 3 days decreased from 5.5 ± 0.2 % to 4.6 ± 0.1 % in the prebudget and postbudget groups, respectively. The mean rates of readmission within 14 days before were 6.1 ± 0.2 % and 8.2 ± 0.2 % in the prebudget and postbudget groups, respectively. Global budgeting is associated with a significantly longer LOS, higher health care costs, and poorer quality of care among patients with pneumonia.