Page 171 - 臺大管理論叢第33卷第1期

NTU Management Review
Vol. 33 No. 1 Apr. 2023, 163-190
DOI:10.6226/NTUMR.202304_33(1).0005

The Effect of Applying Clinical Pathways on Medical Resource
Utilization among Patients Undergoing a Thyroidectomy

臨床路徑對甲狀腺切除術之醫療資源利用的影響

Li-Fei Pan, Department of General Affairs Administration, Kaohsiung Veterans General Hospital
潘麗馡 / 高雄榮民總醫院總務室
Wen-Der Lin, Department of Health Care Administration, Chang Jung Christian University
林文德 / 長榮大學醫務管理學系
Pei-Ling Tang, Research Center of Medical Informatics, Kaohsiung Veterans General Hospital/
Department of Nursing, Fooyin University
唐佩玲 / 高雄榮民總醫院教學研究部 / 輔英科技大學護理系
Wun-Rong Yan, Department of Medical Affair Administration, Kaohsiung Veterans General Hospital
顏文榮 / 高雄榮民總醫院醫務企管部
Chaohsin Lin, Department of Risk Management and Insurance, National Kaohsiung University of
Science and Technology
林兆欣 / 國立高雄科技大學風險管理與保險系
Shuofen Hsu, Department of Risk Management and Insurance, National Kaohsiung University of
Science and Technology
許碩芬 / 國立高雄科技大學風險管理與保險系
Received 2020/11, Final revision received 2022/7

Abstract
Taiwan’s National Health Insurance Administration (NHIA) began large-scale
implementing the case payment method from 1997 with a view to reducing inpatient costs.
Hospitals have adopted several management control systems such as Clinical Pathways
(CPs) in response to the challenges of maintaining both fiscal soundness and the quality of
medical care. The objective of this study is to assess the effects of CPs on the utilization
of medical resources, particularly on the practice of thyroidectomy. We evaluate a total
of 376 case payments for thyroidectomies operating in an academic medical center from
2001 to 2003 and compare differences between pre- and post-CPs implementation in
terms of medical costs and Length of Stay (LOS). The empirical results show that after the
implementation of the CPs, the reductions in LOS (31.90%) and in medical expenditure
(14.98%) within the General Surgery (GS) department are statistically significant. In
addition, the medical resource utilization in the GS division with CPs is significantly
lower than that in the Ear, Nose, and Throat (ENT) division without implementing such
a program. This study demonstrates that the CPs reduce hospital costs and improve the
standard of medical care for patients. Further research is warranted to investigate the
cost-effectiveness of CPs implementation and the potential risk of cost shifting from the
inpatient to outpatient departments.

【Keywords】case payment, Clinical Pathways (CPs), thyroidectomy, Length of Stay (LOS),
medical expenses

領域主編：余峻瑜教授

163