最近大家談健保，想到四五年前在日本社會保障研究所，擔任訪問學人時研究的一個專題：台灣DRG與日本DPC比較
台灣自1995年實施全民健保，旨在照護全民所需之醫療服務，並以全民納保之前提，確保經濟弱勢之民眾也能得到基本醫療服務。然而近年我國醫療費用年年攀升，遂在2002年7月全面採用總額預算制度，控制醫療費用，並在2010年開始實施DRG（diagnosis-related groups）住院診斷關聯群支付制度，作為品質監測、費用控制之辦法。
惟自實施以來，醫療從業人員針對DRG支付制度對於病患之醫療品質及費用包括方式懷有疑慮，這個小專題，我有跟日本厚生省、日本醫師會、日本國立社會保障人口研究所、日本國立癌症研究中心及日本國立國際醫療研究中心之學者專家訪談，轉眼過了快四五年，不知政策是否有轉變。
不知道各位版上的醫師、醫護朋友，這套機制對於品質監測、費用控制，是否有效？這幾年運轉狀況如何呢？
https://www.koryu.or.jp/Portals/0/nittaichiteki/fellow/2016/2016chenkuanting%20.pdf
＾分享給交流協會的報告有點久遠了，希望一起來把這個研究的更透徹一點
Recently, everyone has been discussing health insurance. These discussions remind me of a topic that I studied as a visiting scholar at the Japanese Social Security Research Institute around five years ago: The Comparison of Taiwan DRG and Japanese DPC.
Since the implementation of National Health Insurance in 1995, Taiwan has aimed to take care of the medical services needed by the entire population, and to provide them with medical insurance even before universal coverage was achieved. This was to ensure that economically vulnerable people could also receive basic medical services. However, in recent years, Taiwan’s medical expenses have increased year by year, so in July 2002, a total budget system was adopted to control medical expenses. In 2010, DRG (diagnosis-related groups) was implemented as part of quality monitoring control methods.
However, since the implementation, medical practitioners have had doubts about the DRG payment system regarding the patient's medical quality and cost according to interviews with scholars and experts from the Cancer Research Center and the Japan National Center for International Medical Research. Five years later, and I’m not sure if there have been any big policy changes.
Do any of my doctor and medical friends view these mechanisms as effective for quality monitoring and cost control? How have these been functioning in the past few years?
https://www.koryu.or.jp/Portals/0/nittaichiteki/fellow/2016/2016chenkuanting%20.pdf
＾The report shared with the Exchange Association is a bit old, I hope to work with others to make this research more thorough.
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