護理之家成本分析研究

Cost Analysis of Nursing Homes

10.6558/MTJM.2001.6(4).5

李采娟(Tsai-Chung Li)；賴玫君(Mei-Chun Lai)；楊文惠(Wen-Hui Yang)；張麗雅(Li-Ya Chang)；邱怡玟(Yi-Wen Chiu)；李佳霙(Chia-Ing Li)；呂美華(Mei-Hua Lu)；林正介(Cheng-Chieh Lin)

護理之家 ； 成本分析 ； cost analysis ； nursing home

Mid-Taiwan Journal of Medicine

6卷4期（2001 / 12 / 01）

223 - 232

繁體中文

目的：收集並分析台灣地區立案護理之家的營運狀況，以建立國內護理之家成本分析的資料，作為各護理之家經營方針的參考，並提供衛生主管機關未來輔導未立案護理之家營運方針之指引，及未來設置護理之家標準的參考。 方法：以台北市、高雄及台灣其他地區市於民國87年7月前立案之護理之家為目標群體，共37家，郵寄結構式問卷進行資料收集，共獲得有效樣本22家。為能描述各種規模與經營方式的營運狀況，依機構規模大小分為30床以下、31床至60床及61床以上，在各規模下又區分為醫院附設及獨立經營，因此共有六種層級，本研究的分析皆以這六個層級來描述。 結果：在各層級中，醫院附設每月照護費均高於獨立經營者：規模愈大，每個案月服務成本愈低，且獨立經營均低於醫院附設者。平均收取費用皆低於平均服務成本，皆呈現入不敷出的現象。各護理之家固定成本以人事費用最多，在成本上以人事費佔總成本比率為最高，其人事費對醫療收入比率之均值達69.9%，高於一般標準(40%至50%)。在公、私立醫院附設護理之家中，以公立醫院附設的每個案每月照護費、每個案每月服務成本及佔床率均較高。 結論：本研究發現回收樣本中以61床以上且為獨立經營型態的經營成本狀況較佳，從成本分析之結果建議已立案的護理之家及未來設置護理之家時，應減少人事成本及固定成本的花費，以能永續經營。

Background: The main objective of this study was to create a database to be used as a guideline for administrative decision making with regards to nursing home cost analysis. The study results will provide detailed information about the administration of licensed nursing homes in Taiwan, serve as policy guidelines for unlicensed nursing homes, and help in-the establishment of licensed nursing homes in the future. Methods: In order to describe the cost of different sizes and administration methods of nursing homes, we classified bed-size into three categories: under 30-beds, 31-60-beds, and over 6l-beds. Under each category, nursing homes were further classified according to operation method: hospital-operated and self-operated. Therefore, there were a total of 6 types for the combination of bed-size and operation method. The analysis of this research was based on these levels. Results: This cost analysis revealed that the monthly nursing fee of hospital-operated nursing homes of all types was more than that of the self-operated nursing homes, i.e., the larger the bed-size, the lower the monthly service cost. The average admission fee was below the average service cost for al11eveIs. Except for self-operate-d nursing homes with over 61-beds, nursing homes could not make both admission fees and service costs meet. The largest proportion of the fixed cost was personnel expenses. The ratio of costs for personnel expense to the revenue of nursing homes is 69.9%, which is over the miminum requirement of 40% to50%. Thus, each nursing home is in the red. Conclusions: The research suggests that the model of the self-operated nursing home with 61-beds should be taken into consideration when establishing a new nursing home. Reducing the personnel and fixed costs allows nursing homes to operate more successfully.

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