An Investigation of Physician Fee
| Autor: | Mei Jung Hu, 胡美容 |
|---|---|
| Rok vydání: | 2009 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 97 Purpose: The purpose of this study was to investigate the physician fee (PF)re-distribution system of the sample hospital in terms of appraisal method, factors attributing to re-distribution, and results of re-distribution to facillatate.decision making of the administration. Method: There were 570 physicians from 5 major specialties and 32 sub-specialties affected by the PF re-distribution during sample period 2005 to 2007. Physician fee data were collected .monthly. Points earned were calculated according to seniority, position rank, teaching, research, administration position, and participation in executive board of medical societies. Subsequently point value of each sub-specialty was calculated. Then PF re-distribution results, in terms of dollar gained or losed were estimated. ANOVA tests and regressions were used to analyze annual re-distribution fees, point values, and re-distribution results. Results: Among the 6 factors affecting the re-distribution, seniority and position rank had the most significant influence on PF re-distribution, about 68%. Teaching and research only accounted for 3.7% and 12%, respectively. Internal appraisal results differed significantly across specialties. Yet there were no significant differences between total points and point value over time within each sub-specialty. Seniority, age, higher position, teaching, and administration experience were positively associated with re-distribution gains. Results of multiple regressions showed that seniority, administration position, teaching, research, and participation in executive board of medical society were positively associatedwith the amount of re-distribution system. All else equal, compared to physicians of internal medicine, physicians of surgery, gynecology/obstetrics, and pediatrics gained less from the re-distribution system. In the 3 years of study period, the highest monthly value of professorship was NT$41,389, NT$36,216 for research, and NT$15,521 for a administration position. Conclusion: Results of this study suggest that medical specialty is the most significant factor affecting the point value of the sample hospital. The design of current re-distribution system mainly reflects seniority, teaching, and research. Teaching and research had low average points and had little impact on most physicians. However, it could bring considerable reward to a small number of physicians who performed well in this area. All else equal, the same position rank, professorship, and research paper would bring unequal reward to physicians of different specialties. The re-distributing physician fees showed that high-income physicians subsidized low-income physician, and that junior physicians subsidized senior physicians. During the 3 year period, there was no much variation of re-distributed physician fee within each sub-specialty. Therefore physicians could have steady financial plans. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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