我國全民健康保險藥品費用預測模式之探討

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Title:	我國全民健康保險藥品費用預測模式之探討 Forecasting National Health Insurance Drug Expenditures in Taiwan
Authors:	陳仁惠周麗芳徐偉初
Contributors:	會計系
Keywords:	全民健康保險藥品費用預測 National health insurance Drug expenditure Forecasting
Date:	2003-12
Issue Date:	2017-08-17 13:52:40 (UTC+8)
Abstract:	醫療消費意識覺醒以及各種醫護資訊逐漸普及下，促使民眾積極進入醫療照護市場中尋求診療服務，此一需求擴張趨勢導致醫療費用大幅膨脹，成為衛生政策上之壓力，也使得醫療費用預測成為政策關注的重要問題。本文嘗試採取ARIMA作為預測分析模式，對於國內各項健保藥品費用進行預測分析，並探討各項藥品費用之未來變化趨勢。本文研究結果顯示過去藥品費用控制措施僅具有短期效應，醫療院所可能會因應控管方案的調整而改變診療模式或內部管理機制來獲取更大藥品利益，使得健保管理當局即使持續推動不同供給面藥品費用監督控管措施或是需求面抑制非必要性消耗藥品的部分負擔方案，都可能僅具短期政策效果，因此，未來健保擬定藥品費用監控措施應朝專業品質監控或藥品療效監控多做努力，以期降低無法有效監督醫療院所而可能產生道德風險問題。 Medical consumerism with its abundance of information has contributed to the public's active search for medical services. Because the resultant expansion in demand and the inflation of medical care costs generally bring pressure to health care policymaking, the forecasting of medical care expenditures becomes an important issue. In the current study, we adopt ARIMA as a model for forecasting drug expenditure trends in different settings under the National Health Insurance (NHI) program in Taiwan. Our analysis reveal that the measures used to contain drug expenditures by the NHI authorities in the past had no long-term effects. Medical care facilities might accordingly change modalities of provided services or mechanisms of internal control to ensure maximal profits from drugs. Even if drug cost regulations on the supply side and the co-payments on the demand side were to be executed continuouosly, perhaps nothing but short-term effects could be attained. In the future, more emphasis should be put on auditing the quality of professional services and the efficacy of drugs to offset the moral hazard due to failure in supervising medical care facilities.
Relation:	保險專刊 19:2 民92.12 頁157-176
Appears in Collections:	[Department of Accounting & Graduate Institute of Accounting] periodical articles

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