全民健保支付標準相對值考量因素之研究－－以小兒科為例

Factors of Relative Values in NHI Payment Standards -- The Case of Pediatric Specialties

本研究目的為建立合理的全民健係醫療費用支付標準相對值考量因素之 模型，作為凝聚立場不同專家團體共識的有效方法。研究過程以美國資源耗 用相對值表為藍本，選擇台灣小兒科醫師團體，先以德菲法整合專家意見， 再將有共識之意見以層級分析法無構成分析模型做實證分析。小兒科模型第 一層評量構面有三項，第二層評量準貝11 有十二項。實證求出專家團體各評量 構面與準則的比重排序；結果顯示本模型應用於小兒科專家意見時，可以有 效凝聚小兒科醫師專家共識。

The purpose of this study is to construct a model for forming experts consensus on the issue of selecting factors for establishing rational payment standards in a national health insurance program'. The resource-based relative value scale (RBRVS) used by the U.S. Medicare is the basis in our questionnaire design. The Delphi method is first used to survey the opinions of pediatric specialists in Taiwan. The results are then applied to construct two analytic hierarchy process (AHP) model to condense the opinions of experts. In the pediatric group, three first-tier sub-objectives and twelve second-tire criteria were used in the AHP model. The results of our study strongly support that the model constructed are effective in forming consensus of pediatric specialists.