健康與長期照護保險制度
Health and long-term care Insurance
| 節 | 週四 |
|---|---|
3 10:10–11:00 | 健康與長期照護保險制度 YN613 2 節連堂 |
4 11:10–12:00 |
* 根據陽明交大上課時間表所列
課程目標 了解健康與長照財務制度改革之重點與為何要推動全民健康覆蓋(universal health coverage)。 洞悉健康照護與長照財務、給付與支付制度規劃之原理原則。 理解台灣全民健保與長照體制與財務制度之規劃與改革。 清楚台灣全民健保與長照給付與部分負擔制度及其改革。 了解台灣全民健保與長照支付制度及其改革。 明瞭台灣全民健保與長照2.0的優缺點以及未來改革方。
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演講、報告、討論
1.分組報告:25% 2.課堂討論:15% 3.期末報告:60% (口頭報告25%,書面35%)
| 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 |
| 第 2 週 | 老師出國,錄影上課 a. System, governance and (self-)regulation in SHI and SHI system reform: competition and solidarity b. System reform: 2G-NHI reform(二代健保改革) c. Overview and system design of Long-term Care Insurance (LTCI) and Ten-Year Long-term Care Plan (LTC 2.0) |
| 第 3 週 | a. Public financing (財源籌措) and reform of NHI in Taiwan: (補 充保費) b. Financing Long-term Care (LTC) c. LTC Insurance and Ten-Year Long-term Care Plan (LTC 2.0) in Taiwan |
| 第 4 週 | a. Benefit Design (給付), priority setting and health technology assessment (HTA,健康科技評估): international experience and NHI reform b. 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 | 放假(兒童節及民族掃墓節連假) |
| 第 8 週 | a. Global budget payment system of NHI(2) b. How countries without global budget constrain total expenditures? |
| 第 9 週 | Mid-Term Reports (期中分組報告) |
| 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. 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,藥品給支付改革MEA, HTA, HTR,)癌症新藥基金 |
| 第 12 週 | a. Case-mix system overview b. Prospective Payment System (PPS) based on DRGs: international experience c. NHI Case Payment Initiatives and Tw-DRGs-based payment reform |
| 第 13 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 and evaluation of fee schedules for LTC, LTC 3.0 |
| 第 14 週 | a. Capitation and risk adjustment: International and NHI Initiatives b. Cost containment and strategies to reduce inefficiency & low-value care (二代健保檢討報告) |
| 第 15 週 | a. Pay for Performance(P4P), Value-based purchasing: International and NHI experience (論質計酬、價值為基礎的支付、大家醫計畫)。 b. Care integration: for people with multi-comorbidities and among health, medical, long-term and community care(多重慢病/醫養健整合). c. NHI mid-& long-term reform: cross-sectors integration and collaboration(健保中長程改革). |
| 第 16 週 | Health and long-term care system reform in OECD countries: country case study: United Kingdoms, China, Sweden, Canada, Australia, Netherland(期末報告) |
| 第 17 週 | Health and long-term care system reform in OECD countries: country case study: Austria, Swiss, Korea, Germany, France, Japan, and United States(期末報告) |
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