عنوان

Hospital responses to changes in reimbursement methods :

شماره

TLets550730

عنوان اصلي

Hospital responses to changes in reimbursement methods :

نام عام مواد

[Thesis]

نام نخستين پديدآور

Liang, Lilin

عنوان اصلي به قلم نويسنده ديگر

an economic analysis of Taiwan's national health insurance programme

نام ناشر، پخش کننده و غيره

London School of Economics and Political Science (LSE)

تاریخ نشرو بخش و غیره

2011

جزئيات پايان نامه و نوع درجه آن

Ph.D.

کسي که مدرک را اعطا کرده

London School of Economics and Political Science (LSE)

امتياز متن

2011

متن يادداشت

In 1995, the Taiwanese government introduced the Case Payment Scheme (CPS) to initiate a prospective payment method for diagnosis-related groups under the National Health Insurance (NHI) programme. The aim of the CPS was to rectify the supplier induced demand caused by the fee-for-service plan and to improve the efficiency of health services. However, this scheme created a dual reimbursement system for the NHI, under which, some services were reimbursed on the basis of claims for fees, while others were bundled together and paid a fixed rate per discharge. This study examines changes in hospital behaviour in this context based on the assumption that hospitals have incentives to maximise the profits from both payment plans. The aim is to quantify the effects of reimbursement changes on different dimensions of the delivery of health care. This research also evaluates the global budget programme which has changed the budget allocation mechanism within the hospital sector since 2002. Empirical investigations were carried out for all the hospitals contracted into the NHI over the period 1998-2004. To model hospital behaviour, this study employs different econometric methods, including instrumental variables, panel data model, semiparametric estimation, seemingly unrelated regressions and limited dependent variable models. The results suggest that hospitals react to the shift toward the dual payment system by selecting patients, altering treatment patterns, changing the case mix and adjusting treatment intensity. Policymakers do not appear to have anticipated these phenomena. These findings indicate that there could be fundamental problems in the parallel use of retrospective and prospective payments, due to the improper reimbursement incentives embodied within the system. As mixed payment systems have been adopted around the world, this research has implications for existing and future reimbursement reforms.

موضوع مستند نشده

HC Economic History and Conditions

موضوع مستند نشده

RA Public aspects of medicine

مستند نام اشخاص تاييد نشده

Liang, Lilin

مستند نام تنالگان تاييد نشده

London School of Economics and Political Science (LSE)

نام الکترونيکي

فرمت انتشار

p

نوع ماده

[Thesis]

کد کاربرگه

276903

سطح دسترسي

a

تكميل شده

Y