臺灣地區健保 IC 卡試辦作業對各級醫院資訊及作業流程管理影響因
素探討
The Study on the Impact of Incorporating National Health Insurance IC Card into the Hospital Information Systems in Taiwan
中文摘要
臺灣地區全民健保全面實施 IC 卡作業為舉世之創舉，政府自民國八十四年開辦 以來至中央健康保險局從八十五年起在澎湖地區推動健保 IC 卡實驗計劃，均受 到民眾高度的肯定。為了提供民眾更方便的就醫服務及使健保 IC 卡作業的推動 更為順利，醫療院所的配合程度是一大關鍵，故為要了解醫療院所在實施健保 IC 卡實際作業面的狀況及其相關影響因素，遂於九十一年十一月一日起於臺灣地區 各級醫院實施健保 IC 卡試辦計畫。
本計畫之主要目的為了解臺灣地區各級醫院試辦健保 IC 卡相關作業之問題及其 影響因素。本計畫研究所含括之醫療院所分為醫學中心、區域醫院、地區醫院及 地區教學醫院四級。由於醫療院所大小規模不同、地區差異及屬性不同，其作業 方式及就醫服務流程也不同。因此探討並了解各級醫療院所實試辦保 IC 卡之相 關影響因素，以供健保 IC 卡作業後續推動之參考。
本計畫研究方法為搜集試辦醫院資料及相關研討會資料擬成問卷，將量性問卷針 對全國四百八十五家地區醫院以上（含）層級之醫療院所試辦健保 IC 卡作業的 結果及看法實施普查。
本研究回收之有效問卷計一百零八封，回收率 22.2﹪。從問卷結果顯示醫院使用 最多的是瑛茂電子型號 CR-0310 讀卡機，平均認證時間為 11-15 秒為最多。與健 保局 VPN 連線之電路，醫院使用以 512K/512K DSL 為最多。醫院將病患資料上 傳以晚診結束後批次程式一次上傳者為最多。醫院資訊應用系統修改最多的為掛 號系統。而病患持健保 IC 卡無法順暢作業的原因以讀卡機認證失敗為最多。在 IC 卡片異常，以卡片效期已過之比例最高。對健保作業的支持度以「地區醫院」
及「私立醫院」二屬性之醫院支持度較差。對於病患隱私權「私立醫院」有強烈
之疑慮。醫院對健保最不滿之措施為未對「IC 卡作業之週邊設備經費補助」。醫
院對健保 IC 卡作業實施之整體滿意度逾「普通」等級。
英文摘要
The implementation of national health insurance IC card in Taiwan has been noted as the proneer of the world. It has been started since 1995. All being subjected to the hight ratify in public after promoting health insurance IC card in pen-hu in 1996. In order to provide the public more convient service in health care and make the promotion more smoothly in health insurance IC card,the propotion degree of all
medical institution become the major fact. Therefor,in order to understand the current status and the correlation impacts of carrying out the health insurance IC card in each medical institution,all levels of Taiwan medical institutions have implemented the planning of health insurance IC card since November 1,2002.
The main purpose of this planning is to find out those problems of using health insurance IC card and the related effects in all level medical institutions. In this research,we divided all medical center,regional hospital,local hospital and local teaching hospital. Due to the magnitndes of medical institutions;the discrepancy and attributes and the operation method and the flow precess of medical service are different,our study is to find out the problems of implementing and related impacts health insurance IC card findly provide then as references for follow-up promotion.
Our study method is focusing on the quantity questionnaire.We will distribute those questionnaire to the 485 medical institutions including local hospitals and find out the results of implementing health insurance card in Taiwan.
With 108 questionnaire returned,the response rate is 22.2﹪. The results showed that the reader CR-0310s produced in INMAX TEC. CORP. is the most popular model adapted in hositpals.The average authenticating time is 11-15 seconds as the
most;VPN on-line which regard as 512K/512K DSL IS The Most Connecting way to the health insurance bruea.Most of the medical institution prefer to upload the
patients’data whenever the OPD in evening is closed. The registration system has been amended often in hospital information systems.The health insurance IC card can’t be smoothly operated with the reader authentication fail as the most.Whenever the IC card is not functioning the expired date accured as the most.To the supporting degree of the health insurance operation,local hospital and private hospital are the least.To the right of patients’privcy,the private hospital is most douted.The peripheral financial subsidy of the IC card operation is the most dissatisfied performan to Health Insurance Burea.The whole staisfication of implemting the health insurance IC card is rated as above “common”.
