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研究生： 林其鋒
Chi-Feng Lin
論文名稱： 全民健康保險制度下影響中醫診所經營績效因素探討
Determinants of the Performance of Traditional Chinese Medicine Clinics under the National Health Insurance System
指導教授： 張順教
Shun-Chiao Chang
口試委員: 李居仁
Jie-Jen Lee
林建甫
Chien-Fu Lin
康峻宏
Jiunn-Horng Kang
張光第
Guang-Di Chang
張順教
Shun-Chiao Chang
學位類別： 博士
Doctor
系所名稱： 管理學院 - 企業管理系
Department of Business Administration
論文出版年： 2019
畢業學年度： 107
語文別： 英文
論文頁數： 62
中文關鍵詞： 中醫 、固定效應模型 、經營績效 、Hausman-Taylor模型 、全民健康保險
外文關鍵詞： Traditional Chinese medicine clinics, Fixed-effects model, Hausman-Taylor model
相關次數： 點閱：230  下載：8 
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    • 本研究以全民健康保險1998年至2012年期間全民健康保險資料庫中4,905家特約中醫診所數據為依據，分析台灣中醫診所的特徵對其經營績效的影響。其中固定效應模型以及Hausman-Taylor模型的實證結果顯示，病人特徵，如：縣市別失能傷害人數，對中醫診所提供的醫療服務量有正面的影響。這些結果意味著，當人們面臨發生身體傷害時，可能會選擇中醫作為醫療選擇。此外，中醫診所的規模，包括醫師數，醫療人員數以及診所提供的專科服務，對中醫診所的表現有顯著的影響，而診所與健保署的合約期程也具有相同的效果，簽約時間越長，對績效的影響越顯著。最後，在實施總額預算後，由於同儕審查機制的推動，在抑制中醫診所收入方面發揮了重要的關鍵作用。

    The study attempts to investigate the features and determinants of the performance of Taiwanese Traditional Chinese Medicine (TCM) clinics using data for 4,905 TCM clinics over the 1998 to 2012 period. The empirical results from the fixed-effects model and the Hausman-Taylor Model with cluster-robust standard errors reveal several interesting findings. First, consumer characteristics such as the frequency of disabling injuries have positive impacts on the volume of medical services provided by TCM clinics. These results imply that people are likely to select TCM as the option for medical treatment when they face the occurrence of physical injury in Taiwan. In addition, the scale measurements for TCM clinics including the numbers of physicians, medical personnel and divisions have significantly positive effects on the performance of TCM clinics, while their survival length also has the same effect. Finally, the global budget system under the NHI plays a key role in suppressing the revenue of TCM clinics through the peer review mechanism.

    中文摘要...............................................I Abstract..............................................II 致謝..................................................III Contents..............................................IV List of Tables........................................VI List of Figures.......................................VII Chapter 1 Introduction................................1 1.1. Background and Motivation........................2 1.2. Purposes of the Research.........................6 1.3. Research Framework...............................7 Chapter 2 Literature Review...........................8 2.1. The development of TCM...........................8 2.2. Determinants of performance......................9 2.2.1. Internal control factors.......................9 2.2.2. External environmental factors.................10 Chapter 3 Materials and Methods.......................14 3.1. The variables of the empirical model.............14 3.2. Materials........................................14 3.2.1. Data source....................................14 3.2.2. Total points system............................15 3.2.3. Descriptive statistics.........................16 3.2.4. The multicollinearity test.....................18 3.3. Methods..........................................21 3.3.1. Model Derivation...............................21 Chapter 4 Empirical Findings and Analysis.............34 4.1. Factors determining clinic performance...........34 4.2. Musculoskeletal issues and TCM...................35 4.3. Aging affects the maintenance cost...............36 4.4. A higher unemployment rate increases HCE.........36 4.5. TCM lacks competitiveness in urbanized areas.....37 4.6. The impact of the Global Budget..................38 Chapter 5 Conclusions and Suggestions.................39 5.1. Conclusions......................................39 5.2. Suggestions......................................41 Appendix..............................................42 Table A: Summary of Variables.........................42 Table B Regional Classfication........................44 References............................................46

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