為了有效控制醫療費用成長，健保局陸續實施醫院自主管理及總額預算制度。面對此一給付制度的變革，過去以看診量為重之經營模式，將會受到限制。唯有同時兼顧醫療品質與適度監控醫療費用支出，才能在有限資源下，達到最佳醫療品質並同時維持醫院之正常營運。病人在醫院所發生的醫療行為及其產生之費用，可以由結構面、過程面與結果面三方面來觀察。健保局為控制醫療支出，同時維持醫療品質，亦以此三方面指標來觀察簽訂自主管理合約的醫院。 本研究已建立醫院自主管理指標資訊系統。系統針對中央健保局所定之醫院自主管理指標，將目前個案醫院之管理指標予以圖形化及數量化；另外運用了OLAP技術提供使用者對細部資料之分析。在醫院管理者發現異常時，可以依其需求找出問題所在，以達到多角度、持續性監控及事先預防異常之目的。; For controlling the growth of the medical fee of the hospitals, the Bureau of National Health Insurance (NHI) is pushing the measures of global budgets and self-managements. To face the change of the payment of the medical fees, the hospitals cannot rely on increasing the amount of the patients to maintain their regular operations any more. When a patient makes a reservation with the hospitals, the quality of the healthcare and its associated fees can be monitored from the structural, processing and resultant aspects of the care. When NHI makes the contracts of self-management with the hospitals, NHI will observe the above three aspects to control the medical fees and to keep the quality of the healthcare. This research has developed a self-management system for the hospitals. The system is designed based on the related pointers required by the self-managements from NHI. The system displays these pointers in graphs and provides an OLAP tool for detail analyses to the managers. The managers can use the tool to unveil the problems when irregular conditions occur. In a time-spanned and multiple-angle viewpoint, the managers can monitor the operational status of the hospitals in order to avoid irregular conditions and increase the profits.
