會議論文
| 學年 | 95 |
|---|---|
| 學期 | 1 |
| 發表日期 | 2006-11-28 |
| 作品名稱 | 健保十年，醫療服務產業的演化 |
| 作品名稱（其他語言） | The evolution of healthcare industry within the 10-year National Health Insurance in Taiwan |
| 著者 | 蔡偉德; 劉育昇 |
| 作品所屬單位 | 淡江大學經濟學系 |
| 出版者 | 臺北市：行政院公平交易委員會 |
| 會議名稱 | 第14屆競爭政策與公平交易法學術研討會 |
| 會議地點 | 臺北市, 臺灣 |
| 摘要 | 民國84年全民健康保險實施至今已超過10年，醫療服務市場的規模不斷擴大，但 是醫療服務的產業結構卻產生很大的變化。本研究分析了84-94年健保實施期間，醫 療服務產業演化的原因與呈現的結果。健保實施至今，醫院總家數急速下降，而診所 家數穩定成長，醫療服務產業產生「大醫院與小診所」的兩極化發展。健保的價格機 制、醫院評鑑升級的誘因、消費者的偏好、與政府對財團法人醫院的租稅優惠，都是促使醫院趨向大型化的原因，然而儘管醫療資源因醫院的大型化而較集中，但醫療資 源也向偏遠地區擴散。其次，近來公立醫院逐漸整併或裁撤，對照於私立醫院(特別 是財團醫院)的擴建，醫療體系私有化的趨勢益加明顯;以及醫院為抗衡健保支付的 財務壓力，紛紛以水平或垂直整合上下游醫療機構，或投入自費醫療市場，這種醫療 服務企業化與市場化的趨勢，將對醫療費用的掌控、醫療資源的配置、與健保醫療服 務質量的確保產生嚴峻的挑戰。This paper investigates the evolution of Taiwams health care industry since the institution of National Health Insurance (NHI) in 1995. The enactment of National Health Insurance has boosted the general public)s utilization of health care services and, as a result, enlarged the market size of the health care industry. However, the expansion of market size has also led to a sharp decline in the number of small hospitals. By contrast, there is an increase in the scale and number of large hospitals. Moreover, the number of clinics grows stably as well. Thus, there is a polarization of the health care industry in Taiwan. The growth in the scale of hospitals can be attributed to (a) the design of the NHI payment and copayment systems, which financially favors large scale hospitals, (b) consumers) preference for quality of service, and (c) the tax concession of capital investment by private hospitals. On the other hand, the hospital market becomes more concentrated also due to the exit of small hospitals. In addition, the consolidation of public hospitals and size expansion of private hospitals has tilted Taiwams health care industry toward the private sector. To improve their profit margins, hospitals have increasingly introduced services not covered by NHI and expand vertically or horizontally by acquiring other medical organizations. The trend of rising market share of private hospitals and marketization of health care bring about new challenges to the NHl>s approach to cost containment, resource allocation, and assurance the quantity and quality ofNHI health care. |
| 關鍵字 | 全民健保;醫療服務產業;醫院;National Health Insurance;Healthcare Industry;Hospital |
| 語言 | zh_TW |
| 收錄於 | |
| 會議性質 | 國內 |
| 校內研討會地點 | |
| 研討會時間 | 20061128~20061128 |
| 通訊作者 | 蔡偉德 |
| 國別 | TWN |
| 公開徵稿 | |
| 出版型式 | |
| 出處 | 第14屆競爭政策與公平交易法學術研討會論文集，頁291-316 |
| 相關連結 |
機構典藏連結 ( http://tkuir.lib.tku.edu.tw:8080/dspace/handle/987654321/85168 ) |