健康與長期照護保險制度
Health and long-term care Insurance
| 節 | 週二 |
|---|---|
1 08:00–08:50 | 健康與長期照護保險制度 YN613 2 節連堂 |
2 09:00–09:50 |
* 根據陽明交大上課時間表所列
| 週次 | 主題 |
|---|---|
| 第 1 週 | a.Introduction b.The historical and social base of social health insurance (SHI) c.Overview of the National Health Insurance in Taiwan d.System, governance and (self-)regulation in SHI and SHI system reform: competition and solidarity |
| 第 2 週 | a.Public financing (財源籌措) and reform of NHI in Taiwan: (補充保費) b.Overview, system design and financing of Long-term Care (LTC) c.LTC Insurance and Ten-Year Long-term Care Plan (LTC 2.0) in Taiwan |
| 第 3 週 | Benefit Design (給付), priority setting and health technology assessment (HTA,醫療科技評估):international experience and 2G-NHI reform |
| 第 4 週 | Benefit design and need assessment of LTCI and LTC 2.0 in Taiwan &international experience |
| 第 5 週 | a.Patients’ cost sharing (users’ charge) and reform:NHI, LTCI, LTC 2.0 and International experience b.Payment system of NHI : overview and international reform experience |
| 第 6 週 | a.Global budget payment system: international experience b.Global budget payment system of NHI(1) |
| 第 7 週 | 校際活動(放假一次) |
| 第 8 週 | Global budget payment system of NHI(2) |
| 第 9 週 | Mid-Term Reports(期中報告, 分組) |
| 第 10 週 | a.Research on Resources-Based Relative Value Scales (RBRVS) b.Research and reform of Taiwan-Relative Value Scales (T-RVS). |
| 第 11 週 | a.Case-mix system overview b.Prospective Payment System (PPS) based on DRGs: international experience NHI Case Payment Initiatives and Tw-DRGs-based payment reform |
| 第 12 週 | a.Prospective payment reform for ambulatory care (APGs.) , long-term care (RUGs & HHRGs) and other setting (Long-term care hospital, inpatient rehabilitation, mental care) b.Payment system design of LTCI and LTC 2.0 c.Setting fee schedules for LTC |
| 第 13 週 | a.Capitation and risk adjustment: International and NHI Initiatives b.Cost containment and strategies to reduce inefficiency (二代健保檢討報告) c.Pay for Performance(P4P), Value-based purchasing: International and NHI experience(論質計酬)。 d.Care integration: for people with multi-comorbidities and among health, medical long-term and community care |
| 第 14 週 | a.Pharmaceutical benefit and payment reform:international experience. b.Pharmaceutical benefit and payment design of NHI c.Price regulation and pharmaceuticals payment system reform of NHI (三同政策,二代健保檢討報告,差額負擔) |
| 第 15 週 | Health and long-term care system reform in OECD countries: country case study: United Kingdoms, China, Sweden, Canada, Australia, Netherland |
| 第 16 週 | Health and long-term care system reform in OECD countries: country case study: Austria, Swiss, Korea, Germany, France, Japan, and United States |
| 第 17 週 | 補充教學 |
| 第 18 週 | 補充教學 |
主要參考書籍: 1.Hu TW, Chiang TL, Cheng SH (ed). Health Care System Reform and Policy Research in Taiwan. In Health Care Policy in East Asia: A World Scientific Reference. World Scientific Publishing. Sigapore, 2020. 2.Gori C. Fernandez JL. Wittenberg R. Long-term Care Reform in OECD Countries. Policy Press:Bristol:UK, 2016. 3.Saltman RB, Busse R, Figueras J. Ed (2004). Social health insurance systems in western Europe. European Observatory on Health Systems and Policies Series.England: Open University Press. 4.OECD (2011): Help Wanted? Providing and Paying for Long-Term Care. 5.Muir, T. (2017), “Measuring social protection for long-term care”, OECD Health Working Papers, No. 93, OECD Publishing, Paris.http://dx.doi.org/10.1787/a411500a-en 6.WHO (2013): 2013 World Health Report: Research for universal Health coverage,WHO: Geneva. 7.WHO (2010): World Health Report: Health system financing-the path to universal coverage,WHO: Geneva. 8.Belloni, A., D. Morgan and V. Paris (2016), “Pharmaceutical Expenditure And Policies: Past Trends And Future Challenges”, OECD Health Working Papers, No. 87, OECD Publishing, Paris. http://dx.doi.org/10.1787/5jm0q1f4cdq7-en 9.Panteli D, Arickx F, Cleemput I (2016): Pharmaceutical regulation in 15 European countries: Review. Health Systems in Transition, 2016; 18(5):1–118. 10.Busse R, Geissler A, Quentin W, Wiley M (eds) (2011). Diagnosis-Related Groups in Europe:Moving towards transparency, efficiency and quality in hospitals. European Observatory on Health Systems and Policies Series. WHO.yReinhard Busse 11.Nolte E, Knai C,Saltman RB (ed)(2014). Assessing chronic disease management in European health system:concept and approaches.WHO. 12.黃煌雄、江東亮主編(2020):第三波健保改革之路:落實醫療資源分配正義,推動健保永續,促進全民健康。台北市:遠見天下文化。 13.楊志良主編(2019):健康保險(五版):台中:文華圖書。 14.衛生福利部中央健康保險署(2019) :全民健康保險年報.2019-2020。衛生福利部中央健康保險署編,臺北市 ,2019。 15.陳小紅(2020) :長照2.0-政策實施初探。台北市:監察院。 16.衛生福利部全民健康保險會(2020):109年全民健康保險醫療給付費用總額協商參考指標要覽。 17.馮燕、李玉春、吳肖琪、吳淑芳、張淑卿編(2018),長期照顧概論。國立空中大學,2018。 18.衛生福利部(2018):跨越醫療天塹:全民健保二期規劃記實。 19.王懿範、邱文達主編(2016):醫療與長照整合:打造全人照顧體系。五南書局。 20.衛生福利部(2016):長期照顧保險規劃報告。 21.衛生福利部(2016):長期照顧十年計畫2.0(核定本)。 22.衛生福利部二代健保總檢討小組 (2014) :二代健保總檢討報告。 23.黃煌雄、沈美真、劉興善 (2012):全民健保總體檢。台北:台北醫學大學 五南圖書公司。 24.經建會(2010):長期照護保險規劃報告。 25.行政院衛生署(2004):二代健保規劃叢書。 網站: http://www.euro.who.int/observatory