A study on the factors associated with normal delivery medical expenses - A case study at a military teaching hospital

The National Health Insurance (NHI) was implemented in Taiwan on March 1, 1995. The Bureau of NHI later requested all hospitals' normal deliveries be paid by case payment afetr July 1, 1995. This shows that the Bureau of NHI wants to change the 'Fee for Service' payment system to the Prospective Payment System(PPS). Maintaining quality of care with a set cost will be a challenge of obstetricians and hospital administrators. We collected and analyzed the expenses of 555 wowen who delivered babies at a military teaching hospital from May, 1995 to April, 1996, and found: (1) Military dependents total expense were higher and length of stay (LOS) was longer than NHI insured. (2) The woman's age affects the total expenses and LOS. (3) Some physicians' medical behavior was influencd by the woman's identity. (4) According to the multiple regression that LOS, Doctor. 4, Doctor. 6, Doctor. 9, Doctor. 15 are important factors that effect total expenses. (5) The reasons that the woman's expenses are higher than the NHI case payment were attributed to diagnoses, LOS, epidural anesthesia, special exams and drugs.