管理式醫療介紹

Managed care has dominated the U.S. health delivery system since the end of 20th century.
The umber of those enrolled in Health Maintenance Organizations jumped from 9 million in 1980 to 81 million in 1999. Managed care not only reshape the health care delivery system of the United States, but is also considered as the best mechanism to contain costs and to assure quality of medical care. The purpose of this paper is to help health professionals expand their understandings of other countries’ health delivery system through the introduction of managed care. The essence of managed care has been applied by many Asian countries such as Korea, Japan, Hong Kong , and Singapore into their own health delivery systems. The Bureau of Taiwan National Health Insurance also uses the capitation payment method, one kind of managed care payment mechanism, to pay for the health care service in outlying islands, such as Penghu, Lanyu, and Green Island. The adoption of managed care has become a popular strategy for the health industry to contain costs and to assure quality of medical care. This article states the definitions, origins, and developments of managed care. It also explores the major factors which facilitate the transition from traditional fee-far-service insurance to managed care and discusses the influences of managed care on the health care delivery system.