先看病後繳費之門診單﹣收費系統

IMPLEMENTATION OF UNIFIED FEE COLLECTION SYSTEM FOR EXAMINATION BEFORE PAYMENT

通常病人到醫院門診就診，從掛號、診察、檢查、治療到拿藥，幾乎都要經歷好幾次排隊等候之過程，不但病人受罪，工作人員亦增加了數倍的工作負荷。在醫院人力難以擴增，而政府與人民便民措施不斷伸張下，如何簡化病人看病繳費的程序及提昇醫療服務品質，乃為當今醫院最重要的課題。台北市立療養院於民國七十四年六月率先開始對門診病患實施先看病後繳費的門診單－收費制度。病人於掛號後，不必即時繳交掛號診察費，就可馬上到診察室看病，待病人就診完畢，工作人員才將病人所有的處方、檢查及治療費用全部開具，交病人到櫃台一次批價並繳清所有費用，不但工作人員節省了一半以上的工作量，病人也免除了多次排像繳費之苦 。本文乃對此制度之建立作一概括性的介紹，並對實施一年後的結果統計評估，以為本院改進及其他醫院推行之參考。由統計資料顯示，只有1％的病人漏繳費用，而所有漏繳金額僅佔門診總收入的0.08％，此損失數額對醫院而言可謂微不足道，然雙方卻深獲其利。

In previous practicet a patient generally had the inconvenience of queueing up when he or she came to a hospital for an out-patient examination. The patient went through procedures for registration, examination, checkup, therapy, or to collect drugs, thus increasing the work load of hospital employees. When the hospital cannot expand its manpower and the government is encouraging simplified procedures for patient convenience, it becomes very important for hospitals to simplify their procedures, yet still upgrade the quality of their service. In June 1985, the Taipei City Psychiatric Center initiated a uniform fee collection system for examination before payment. After registering, the patient now pays no fees in advance, and can be examined immediately. After the examination, the hospital staff make a single statement of expenses for the examination, checkup and therapy; the statement is handed to the patient who then pays the cashier. This system not only reduces the workers' load by more than half, it also frees the patient from frustrating waste of time. This article presents a general introduction to this system, as well as an evaluation of the results after a one-year trial implementation, to be revised as needed for improvement. The statistics show that only 1% of the patients failed to pay, and the payment lost was only 0.08% of the total income from all out-patient examinations. The loss was comparatively insignificant for the hospital management system; there was considerable gain for patients and hospital stafff, as well as the satisfaction of improved service.