8,436 research outputs found
Application of the Exponential Grey Model on the Maintenance Cost Prediction for a Large Scale Hospital (vol 15, pg 379, 2011)
No full textThe Impacts of National Health Insurance Program of 「Hospital Excellency Project」on Hospital Behavior - A Case Study of a Medical Center in Taiwan
No full text中央健保局自九十三年七月一日起實施『九十三年度醫院卓越計畫支付原則』(簡稱「醫院卓越計畫」) 政策，對於健保給付總額中的門診和住院各訂有固定比例(45:55)之總體目標，由各家醫院擬具醫院卓越計畫書，向健保局各分局提出申請，希望對個別醫院進行總量管制以達到抑制醫療費用逐年上升的目的。
本研究係以個案醫院門診病患就醫情形為對象，探討醫療院所實施「醫院卓越計畫」 政策之影響因子介入前、中及取消後對醫療院所之門診就醫人次及各項醫療費用等醫療行為之變化情形，以估評健保卓越計劃對醫療院所營運所造成之影響。
本研究主要結果如下：
一、門診病患看診人次、醫療費用、檢查費用及藥費方面：
政策實施中期間，門診病患就診人次、醫療費用、檢查費用及藥費有明顯減少；政策取消後，醫療費用、檢查費用及藥費有明顯增加，但門診病患就診人次沒有明顯增加。
二、在醫師平均看診人次改變方面：
政策介入對於醫師門診看診之病患人次有下降，政策取消後醫師門診看診之病患人次仍呈現減少。
三、門診佔率改變方面：
政策實施前每月門診佔率為42.94%，於實施中每月門診佔率為40.39%，但政策取消後每月門診佔率些微上升為42.17%。
四、藥費佔率方面：
政策實施中每月門診藥費佔率減少約3%；政策取消後藥費微幅上升不到1%。
五、對各臨床部科門診之影響：
政策實施中各科之門診看診人次減少，但門診醫療費用包含檢查費及藥費沒有明顯減少。政策消失後各科之看診人次沒有回升，門診醫療費用包含檢查費及藥費也沒有明顯回升。
六、對急診之影響：
政策取消後比政策實施中之急診每週發生之醫療費用沒有明顯增加，但是急診病患每人次的醫療費用有明顯增加。
根據以上的結果，本研究提出的建議如下：
一、對醫療政策制定者的建議
政策制定時應審慎訂定符合就醫病患需求及醫療院所的特性之政策及管理指標，並避免朝令夕改，讓醫療院所能有所依循，以提供就醫病患穩定的醫療品質。
二、對醫院管理者的建議
針對醫療院所的使命與願景提供病患良好的醫療服務品質，並讓不同需求的病患接受適切的醫療照護。
三、對後續研究者的建議
其他醫療院所醫療行為之改變、醫療政策介入對門診病患醫療行為改變、醫師醫療行為特質對政策介入之影響等可列入後續研究之範圍。The Bureau of National Health Insurance officially put into enforcement the “Hospital Excellency Project Payment Principles, 2004”(“Hospital Excellency Project”) on July 1, 2004. Under the Plan, all hospitals should file applications to the Bureau of National Health Insurance with their respective Hospital Excellency Projects in writing at the fixed ratio between outpatient and inpatient services at (45:55). It is hoped that the medical treatment costs can be put under control from further rises year-by-year by means of total quantity control (total mass control) by hospitals themselves respectively.
The present study aims at the outpatients who called the case hospitals as the samples to probe into the variation curves of the numbers of patients, medical treatment costs and such medical behaviors before, during involvement of the factors in the “Hospital Excellency Project” enforcement, and after annulment of such enforcement. Through the findings so obtained, the study is to assess the influence of the Hospital Excellency Project upon hospitals and clinics upon their operations.
The major findings yielded in the present study are enumerated below:
I. In the aspects of number of outpatients, medical treatment costs, examination costs and pharmaceutical costs:
During enforcement of such Plan, number of outpatients, medical treatment costs, examination costs and pharmaceutical costs showed significant signs of decline. After the plan was annulled, the medical treatment costs, examination costs and pharmaceutical costs were found to have significant increase while the number of outpatients did not have a significant increase.
II. Variation of the number of outpatients attended by doctors/physicians:
The involvement of the Plan led to a drop in the number of outpatients attended by doctors/physicians. After the Plan was annulled, the number of outpatients attended by doctors/physicians still showed signs of decline.
III. Variation in the ratio taken by outpatient services:
The outpatient services accounted for 42.94% to the total every month prior to enforcement of the Plan. The ratio down to 40.39% every month during enforcement of the Plan and a slightly up to 42.17% after the Plan was terminated.
IV. Ratio of pharmaceutical expenses:
The ratio of pharmaceutical expenses decreased by approximately 3% every month during enforcement and rose insignificantly within less than 1% after the enforcement came to a halt.
V. The influence upon outpatient services of various clinical departments:
During enforcement of the Plan, the numbers of outpatients visiting various departments came down. The outpatient service expenses, including examination expenses and pharmaceutical expenses did not come down. After the Plan was suspended from enforcement, outpatient service expenses, including examination expenses and pharmaceutical expenses did not come up significantly.
VI. The influence upon the emergency cases:
The emergency treatment expenses incurred every week did not show a significant increase after the Plan was suspended from enforcement compared with the expenses incurred during enforcement. The per patient treatment costs, nevertheless, showed a significant rise.
Summing up the key findings quoted above, the present study would offer the following proposals:
I. Proposals posed toward the medical treatment policymakers:
Upon policymaking process, it is advisable to come to the politic and managerial targets which would accurately aim at patients’ demand and hospital characteristics. The policies, once made, should be enforced consistently as far as possible, with as little change as possible. In turn, the hospitals will get a firm rule to comply with and thus upgrade the quality of medical treatment.
II. Proposals posed toward hospital management:
Aiming at the respective hospital missions and visions, the hospitals should try their utmost efforts to offer the best possible quality of medical treatment. Meanwhile, they should try to have patients of varied demands receiving medical care as appropriate.
III. Proposals posed toward subsequent researchers:
Change in other medical treatment behaviors of hospitals, change in the behaviors of medical care toward outpatients, the characteristics of doctors/physicians toward the involvement of the policies and such issues are advisable issues for subsequent study in the future.摘要 ………………………………………………………………… i
目錄 ………………………………………………………………… v
表目錄……………………………………………………………… vii
圖目錄……………………………………………………………… ix
第一章 緒論………………………………………………………… 1
第一節 研究背景………………………………………………… 1
第二節 研究動機與目的………………………………………… 3
第二章 文獻探討…………………………………………………… 4
第一節 各國健康保險制度……………………………………… 4
第二節 醫療保險之道德危機度………………………………… 15
第三節 總額支付制……………………………………………… 17
第四節 台灣地區總額支付制度實施狀況……………………… 27
第五節 目前我國台灣地區支付制度實施現況………………… 35
第三章 研究方法…………………………………………………… 38
第一節 研究對象及範圍………………………………………… 38
第二節 研究架構………………………………………………… 38
第三節 研究設計與抽樣方法…………………………………… 40
第四節 研究假設………………………………………………… 41
第五節 資料蒐集………………………………………………… 42
第六節 資料分析………………………………………………… 43
第四章 研究結果…………………………………………………… 44
第一節 門診病患平均就診次數及費用分析…………………… 44
第二節 醫師平均看診人次分析………………………………… 60
第三節 門診佔率之分析………………………………………… 62
第四節 藥費佔率之分析………………………………………… 62
第五節 對各臨床部科影響之分析……………………………… 63
第六節 對急診影響之分析……………………………………… 66
第五章 研究討論…………………………………………………… 74
第一節 門診病患平均就診次數及費用之探討………………… 74
第二節 醫師平均看診人次改變之探討………………………… 79
第三節 門診佔率之探討………………………………………… 80
第四節 藥費佔率之探討………………………………………… 81
第五節 對各臨床部科影響之探討……………………………… 82
第六節 對急診影響之探討……………………………………… 83
第六章 結論與建議…----………---……………………………… 86
第一節 結論……………………………………………………… 86
第二節 研究限制………………………………………………… 92
第三節 建議……………………………………………………… 93
參考文獻 …………………………………………………………… 96
英文部分……………………………………………………………… 96
中文部份 …………………………………………………………… 97
附件………………………………………………………………… 9
AV title: Wen-tzu Lo, graduate recital
No full textThere is no abstract available for this creative project.Thesis (M.M.)School of Musi
A study of the Allusions to Chuang Tzu in the reception of Su Shi's Poetry
No full textThe world is a sea of books; all creations are based on the achievements of their predecessors. Su Shi has stated clearly his admiration for Chuang Tzu; we can understand the poetry of Su Shi with his remembrance and tribute to Chuang Tzu by exploring the phenomenon of allusions to Chuang Tzu in the poetry of Su Shi. Academic research has already found that Chuang Tzu is actually the practitioner of \ue2making articles as amusement\ue2 and Su Shi is in the same vein with a concrete manifestation of \ue2making poems as amusement\ue2 to show the freedom of artistic creation space. Scholars have proposed that the Outer and Miscellaneous Chapters of Chuang Tzu had been neglected by people was due to Su Shi. Through the practical concerns of the poetry of Su Shi in this study, we found that the poetry of Su Shi did not ignore the outer and miscellaneous chapters of Chuang Tzu, on the contrary, the degree of attention is no less than the Inner Chapters. Scholars have proposed that the phenomenon of allusions in the poetry of Su Shi is mostly into words. In this paper, however, the author proposes with examples and indicates that the allusions to Chuang Tzu in the poetry of Su Shi are not only into words but also a major feature of imaginative thinking in images. Through the discussion of the phenomenon of allusions to Chuang Tzu in the poetry of Su Shi in this paper, it can be observed that the acceptance and creative interpretation of Chuang Tzu in the poetry of Su Shi, the concrete practice of making the old things new, and the implicit beauty of the real meaning is implied. And further confirmed the comment of \ue2Dongpo stems from Chuang Tzu is nine out of ten\ue2 stated by Liu Xizai in Qing, as well as understand the specific connotation of "Peotry of Zizhan, with clear words in sleet and powder, are the poetry of Taoist\ue2 called by Liu Shipei
Influence of collegiate youth career through the cultivation of non-profit organization : evidence from Tzu Chi Collegiate Youth Association
No full text碩士慈濟大專青年聯誼會（以下簡稱慈青）是由非營利組織（慈濟）在各大專院校成立的服務性社團，以「做就對了」的方式來培育大專青年具有社會責任及環保意識，來補充學校正規教育體系之不足。本研究主要探討慈青透過志工活動及生命教育的培育，對大專青年職涯規畫的影響。本研究先採用內容分析法，擷取2006年5月至2010年慈青活動新聞網的資料加以整理分析，藉以瞭解慈青活動內容及培育方向;再用質性研究的深入訪談法，訪問六位北區慈青學長會的學長姐及六位某大學慈青社的學生。第一階段採內容分析法將慈青活動內容整理後發現，慈青活動分為實踐活動及心靈活動，實踐活動佔56.75%，心靈活動佔43.25%，顯示慈青讓大專青年先對志工服務精神從心靈層面深根，再由活動實踐激發大專青年服務熱忱，但以活動比例來看慈青較偏重用做就對了的方式來培育大專青年。慈青實踐活動又分二區塊，分別為環保績效及社會績效，環保績效佔39.29%，社會績效佔60.71%，顯示慈青培育屬全面性，非單一區塊，以培育大專青年具備CSR及社會企業家所應具備的環境底線及社會底線。第二段階段採質性研究中發現，有41.67%的慈青希望回到慈濟志業體，有58.33%想至一般企業工作，但他們會利用其他時間做志工服務，顯示受過慈青培育會激發他們志願服務的熱忱。本研究的結果顯示，透過慈青的培育，加上證嚴法師「職志合一」的期許，大專青年入社會後大多繼續跟隨證嚴法師的腳步，部分是有固定的工作後，會利用假日當慈濟志工；部分則選擇進入慈濟志業體內服務。較不會以創業方式來改善社會問題，認為慈濟組織已很完善，若想解決社會問題就依循慈濟志業體;而對企業經營是否具備CSR不是考量因素，但企業雖可不具CSR，但絕不可違反社會道德規範，因個人會自動自發利用時間參與志工活動。國內雖有許多資料呈現慈青對大專青年生命意義及參與志工活動過程的研究，但就慈青的培育所產生的職涯規畫影響的研究卻尚未有所探討，因此本研究首先針對慈青活動對大專青年職涯規畫影響做初探研究，結果可供後續研究者參考。Along with economic development, enterprise operating activities brought the growing problem of environmental pollution and waste of resources. College youth is the future of our country, the concept of social responsibility should be woken up early. Tzu Chi Collegiate Youth Association is "just do it" attitude to nurture students with social responsibility and environmental responsibility to make up for the lack of family and school education. This study investigates the Tzu Chi college youth through the cultivation of Tzu Chi activities and life education, employment whether the concept of social responsibility or do a Social Entrepreneurs. This study used qualitative research in-depth interview, access six graduation and six students of Tzu Chi Collegiate Youth, explore participate the Tzu Chi activities whether affect their career planning or work attitude, try to understand the Tzu Chi activities whether change the attitude towards life of the Tzu Chi college youth. According to the results of the interview, four analytic structures were affirmed: 1. Tzu Chi activities affect or change the chi collegiate youth life； 2. Tzu Chi Collegiate Youth Association training collegiate youth； 3. Tzu Chi activities on the impact of college youth career planning or direction； 4. Tzu Chi activities on the discovery and discussion of the Tzu Chi college youth. According to the problem and interviews of this study analysis the results showed that Tzu Chi college youth through the Tzu Chi cultivation and Master Cheng Yen expectations unity of vocation, Tzu Chi college youth work planning for the future is vacations do Tzu Chi volunteers or into Tzu Chi vivo service. Tzu Chi college youth the cultivation by the Tzu Chi, Tzu Chi college youth want to follow Master Cheng Yen, do not want to do a Social Entrepreneurs and less likely to consider the business with corporate social responsibility. They think they will use the time to come back to participate in Tzu Chi volunteer activities.第壹章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 3
第三節 研究範圍與限制 4
第四節 研究流程 6
第貳章 文獻探討 8
第一節 非營利組織 8
第二節 慈濟基金會 14
第三節 慈濟大專青年聯誼會 19
第四節 社會企業家 23
第五節 企業社會責任 30
第參章 研究設計 39
第一節 質性研究 39
第二節 研究方法 41
第三節 個案簡介與訪談對象 45
第四節 訪談大綱規畫 47
第五節 研究的嚴謹與倫理 48
第四章 個案分析 52
第一節 慈濟大專青年聯誼會組織傳承及培育 52
第二節 受訪者的背景介紹 63
第三節 慈青對大專青年生活態度的影響 69
第四節 慈青的培訓對大專青年職涯的影響 73
第五章 結論與建議 78
第一節 研究結論 78
第二節 研究建議 81
中文文獻 82
英文文獻 85
附錄-問卷內容 90
表目錄
表1 慈青實踐活動表 58
表2 慈青心靈活動表 59
表3 營隊活動內容整理表 60
表4 慈青活動分析表 61
表5 受訪者基本資料表 63
圖目錄
圖1 研究探討設計 2
圖2 研究流程圖 7
圖4 企業之社會責任觀念發展階段 32
圖5 企業社會責任金字塔 32
圖6 三重底線原則 33
圖7 企業社會責任的四個面向觀 34
圖8 社會責任的三個層次 37
圖9 全球慈濟大專青年聯誼會組織架構圖 53學號: 799600332, 學年度: 10
Perishability as a Determinant of Vertical Coordination in the U.S. Egg, Poultry, and Pork Industries
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