台灣不同特質醫院放射線診斷專科醫師服務量與產值之比較分析.

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台灣不同特質醫院放射線診斷專科醫師服務量與產值之比

較分析

.

Comparison of the Service Volume and

Productivity of Diagnostic Radiologists in

Three Hospital Types in Taiwan

陳榮邦;洪聖慈;張政彥;廖漢文;萬永亮;于俊

摘要 比較台灣不同特質醫院之放射線診斷專科醫師服務量與產值。利用國家衛生研究 院提供之全民健保資料庫抽樣檔,分析 2001-2004 年台灣醫療利用情況。門診 分析佔母體 1/500 的使用人次,住院分析佔母體 1/20 的使用人次,以申報醫令項 目代碼,計算台灣各家醫院放射線科相關檢查服務量及申報點數。2001-2004 年台灣放診專科醫師人數由 447 位增加到 521 位。每位放診醫師平均每月服務 量:醫學中心為 2,645 件,區域醫院 3,399 件,地區醫院 2,122 件。每位放診醫 師平均每月產值:醫學中心為 2,309(千)點,區域醫院 2,103(千)點,地區醫 院 834(千)點。各醫院平均每件檢查產值:醫學中心為 911 點,區域醫院 611 點,地區醫院 379 點。各評鑑等級醫院皆以一般 X 光檢查的件數佔最多,CT 檢查次之。而申報點數部份,醫學中心以 CT 申報點數的比例佔最高,區域醫院 則以一般 X 光檢查申報點數佔最高。台灣的放診醫師人力為美國的四分之一, 工作量高出近三倍。區域醫院每位醫師的平均服務件數雖高於醫學中心,但平均 產值卻是以醫學中心較高。 Abstract

The aim of this study was to measure the workload and productivity of diagnostic radiologists according to hospital type in Taiwan.

Between 2001 and 2004, the number of examinations performed and a measure of productivity, relative value units (RVUs), in the radiology departments of hospitals were obtained from a sample of data from the National Health Insurance Plan database in Taiwan. The outpatient data sample was 1/500 and the inpatient data sample was 1/20 from the raw database.

The number of radiologists increased from 447 to 521 over the four-year period. On average, 2645 examinations were performed by each radiologist per month in medical centers, 3399 in regional hospitals, and 2122 in local hospitals. Medical centers, regional and local hospitals had averages of 911, 611 and 379 RVU points

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by each radiologist per month, respectively. The highest number of examinations, notwithstanding the type of hospital, was for conventional radiography, followed by CT scan. CT examinations produced the highest number RVU points in medical centers. The radiologist workforce in Taiwan was only 25% that of the United States,

and the workload was 3-fold. Radiologists in regional hospitals performed more examinations than those in medical centers, but the RVU points per radiologist were higher in medical centers than in the regional hospitals.

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