第 一 篇 全 民 健 保 組 織 與 制 度
Chapter 1 NHI Administrative Framework
43
The fee-for-service mechanism remains the main
system used by the NHIA to reimburse providers under the
global budget system, but the “case payment” and “pay-for-
performance” methods have been successively introduced to
improve the quality of medical services and the public’s health.
Another system – Taiwan’s version of Diagnosis Related
Groups (Tw-DRGs) – was launched in July 2010 to further
increase efficiency and give patients more holistic care, and a
capitation payment system was introduced on a trial basis in
July 2011.
Aside from care delivered under case-payment or DRG
plans, standard reimbursements for medical services and
treatment are based on an RBRVS (resource-based relative
value scale) system that was launched in July 2004. The
system assigns relative values to medical services based
on the medical resources used to provide the service, and
these relative values can be adjusted periodically through
consultations with experts fromvarious medical circles.
醫療服務診療項目之支付標準，除論病
例計酬及
DRGs
支付制度採包裹給付外，相
同之診療服務多訂定相同之支付點數。點數
之合理性，除依各界建議不定期協商調整外，
有關特定診療項目，於
2004
年
7
月起，導入
以醫療資源耗用愈多，則支付點數愈多之相
對值表制度
(
Resource-Based Relative Value
Scale, RBRVS)
。