民國91年重大傷病花了健保769億，占總醫療費用的比率達22.64﹪，其中又以血液透析（俗稱「洗腎」）排名第1位，佔總醫療費用的6.18﹪，且年年以12~14﹪速度持續增加中。到了民國91年洗腎的醫療費用支出，已成長了34.3﹪；目前中央健保局已將洗腎納為定額給付制，南部某地區醫院為了了解透析成本之合理性，乃進行血液透析單項成本分析研究，以南部某地區醫院92年度相關單位提供的數據資料，分別計算血液透析之單項成本，將成本分為用人成本（變動與固定人力），藥品及衛材成本，設備費用折舊，管理費用等四大項；細分計算求得總成本。研究結果顯示每次透析成本＄3375元，比較健保單次給付＄4100元，則此院淨利為18%，邊際貢獻率達50.4%，安全率35%，及營運槓桿比為2.85，所分析出的結果顯示，其實目前的給付還是合理的。 In 2002, the serious diseases spend National Health Insurance about 769 hundred million. It took 22.64% rate of the total medical expense. Norever, Hemodialysis took the first place, the rate of medical expense was 6.18% . And it increased 12-14% rate each year. In 2002, the expense of hemodialysis grown 34.3% everage.
Now, the Bureau of National Health Insurance implements the case payment system for hemodialysis. Since reasonable reimbursement is possible only when actual cost data are fully incorporated. Our study was conducted in a regional hospital in south area to investigate these cost. All possible costs related to the dialysis procedures were in cluded and the item span was for the year 2003. Cost items collected were divided into four categories: (1) personal cost (variable personal and fixed personal) (2) material cost (3) equipment overhead (4)administrative expenses. The results of the study showed the cost per hemodialysis was NT3,375 in the regional hospital; And contribution margin rate was 50.4%;Safety margin rate was 35%; degree of leverage was 2.85. The results of the study showed that the reimbursement of NHE was reasonable.
