以人力資本法估算社會經濟成本損失-急性呼吸窘迫症侯群(ARDS)為例

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Title:	以人力資本法估算社會經濟成本損失-急性呼吸窘迫症侯群(ARDS)為例 Use of Human Capital Approach to Estimate the Losses of Socio economic Costs – Taking Acute Respiratory Distress Syndrome (ARDS) for Example
Authors:	李淑玉
Contributors:	國際企業管理學系碩士在職專班
Keywords:	人力資本法住院診斷關聯群分類系統急性呼吸窘迫症侯群 Human Capital Approach Taiwan Diagnosis Related Groups Acute Respiratory Distress Syndrome
Date:	2014
Issue Date:	2014-10-06 10:12:09 (UTC+8)
Abstract:	本研究以社會整體觀點，探討疾病嚴重度對ARDS疾患之社會負擔角度，以疾病盛行觀點為基礎，分析一年直接成本，再進一步根據人力資本法採用官方網站統計的人力資源數據資料(勞動參與率、就業率、經濟成長率、該年齡別平均薪資)來估算間接成本，並針對健保給付制度資源耗用相近原則進行探究。透過回溯性病歷研究自2011年10月至2013年12月共二年期間，實際符合研究對象為271位，完整率90.33%；研究結果顯示直接成本佔率76.63%，間接成本佔率23.37%，直接成本中位數高出個人醫療保健支出10倍，間接成本(中位數)占人均GDP 12%，若以3% 折現率長期趨勢來看，每增加一位急性呼吸窘迫症侯群患者健保局將支付現在幣值398,297.86元；而每增加一位急性呼吸窘迫症侯群死亡患者既降低人均GDP 18.22%之社會生產力，而DRGs支付制度無法呈現急性呼吸窘迫症侯群資源耗用程度差異性，DRGs支付制度對於非群組的疾患評估上仍有其限制性。 This study investigates the social burden caused by disease severity of ARDS from the perspective of overall society, analyzes 1-year direct cost based on the prevalence of disease, estimates indirect cost using human capital approach to analyze the human resource statistical data (labor participation rate, employment rate, economic growth rate, and age-specific average income) from official websites, and probes into the similar resource consumption principle of national health insurance copayment system. According to the retrospective study on medical records, from October 2011 to December 2013, the data of 271 research subjects were actually complete, with a completion rate of 90.33%. The research results showed that, direct cost accounted for 76.63%, and indirect cost accounted for 23.37%. The median of direct cost was higher than 10 times of personal health care expenditure. The median of indirect cost accounted for 12% of the GDP per capita. From the perspective of long-term trend of 3% discount rate, every increase of one patient with ARDS will lead to the increase in copayment of National Health Insurance Administration by NTD 398,297.86. In addition, every increase of one death of patient ARDS will lead to the decrease in social productivity of GDP per capita by 18.22%. Moreover, DRGs payment system could not reflect the difference in level of resource consumption. DRGs payment system’s assessment of non-group disorders is still limited.
Appears in Collections:	[Department of Business Administration & Graduate Institute of International Business Administration ] Thesis

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