提昇某地區醫院精神科病房醫務收入之利潤率

A Project of Improving the Profit of Medicine Incomes of Psychiatry Ward in a Local Hospital

面對健保局自主管理政策，醫院面臨前所未有的困境，為求正常營運，成本管理顯得格外重要。本病房於2004年6月10日至2004年10月31日期間，經由成本及效益分析，發現2003年醫務收入利潤率為30.26%，遠低於同級轄內同儕醫院35%，經特性要因圖、柏拉圖分析及對醫療團隊進行問卷調查，發現導因依序為護理人員漏記帳、醫療團隊病歷書寫不完整、高價藥品使用不當及無藥品使用規範。藉由建立護理人員衛材使用登記制度、建立病歷書寫完整性監測及合理用藥機制等措施後，使得醫務收入利潤率提高至42.29%，因本專案的實施，使精神科醫務收入利潤得以提昇，進而增加醫院之競爭力。

In face of current policy agenda of hospital independent operation and job target and responsibility set out by National Health Insurance Bureau, hospitals are presented an unprecedented dilemma. To maintain hospital operation, cost containment issues are becoming extremely important. The ward staff performed cost-benefit analysis from June 10th, 2004 to October 31st 2004. The result shows that the profit rate of medical income was 30.26% in 2003. The data was much lower than the average rate among regional peer, 35%. By cause-effect diagram, Pareto analysis and the questionnaire survey of department members, the accountability factors include, in order of proportion: poorly kept accounting records by nursing staff, incomplete medical record, inappropriate use of expensive medicines, and lack of standardized regulation of prescription. By setting up the device registration mechanism, monitoring the medical record integrity and reasonable prescription, the profit rate of medical income increased by 42.29%. The profit rate of the psychiatric department was improved and the competitiveness of the hospital boosted by this project.