「呼吸器依賴患者整合性照護前瞻性支付試辦計畫」自2000年實施後，政府陸續地調整支付點數、醫院品質評鑑等項目，補強制度上的不足。西元1999年到西元2012年的病患數與申報點數從衛生福利部統計資料中顯示這些項目數不斷地上升，已經造成衛生福利部醫療給付上的負擔。 本研究透過統計分析與系統思考模式，分析政府政策與醫院經營這兩者間的關係變化，第一部分使用統計分析驗證呼吸照護政策改變前後是否對於醫院經營有影響，第二部分則是使用系統思考模式，畫出因果回饋圖，描繪出當政府修改呼吸照護政策時，醫院端醫院經營會產生的經營行為。 試辦計畫在政策執行後十餘年，產生了許多當時未預期的現象。希望透過本研究結果對於政府或是政策擬定者，對於未來呼吸照護政策或是醫院經營者都能有更多的參考價值。 Since 2000, the Ventilator Dependent Patients Integrated Delivery System has been initiated by National Health Insurance. After the IDS implementation, the government have to revise the medical payment standard and the hospital accreditation for making up the policy defect. But according to the statistics of the National Health Insurance, the patients and filing fees are rising. It is the huge burden of medical payments. In this study, we use the statistical analysis and system thinking to analyze the relation between respiratory care policy and hospital management. The first part is use of statistical analysis to verify the respiratory care policy change have an effect on hospital management. The second part is use system thinking to draw the causal feedback loop diagram. The causal feedback loop diagram can represent the relation between respiratory care policy and hospital management . After policy implementation, ventilator-dependent patients integrated care pilot plan had produced many unexpected phenomenon. Based on the conclusions of this research, we hope that government and hospital manager can get more understandings and references for relation of respiratory care policy and hospital management in future.
