In order to use the medical resources more efficiently and improve the quality of medical services, under the system of global budgeting, the Bureau of National Health Insurance implemented the Center of Excellence from July 1st , 2004 to December 31st, 2004, with the concept of hospital self-management and individual budgeting.
The hospital?s expenditure is true-up quarterly. Since the bureau does not allow the hospitals to roll over the unused points of in-patient and outpatient expenditure, the hospitals will have to take some financial risks if the expenditure goes beyond the target quota. When the points of expenditure of first two months of the quarter are approaching the target quota, the hospitals will control the amount of medical services in the last month to avoid the risks. Thus, the quantities of services reduce tremendously, which is called ?Quarter-End Effect? in this research.
This research finds out the growth of accumulating amount of outpatient services of all hospitals joining the Center of Excellence slows down in the late September 2004. This fact can explain we do have the ?Quarter-End Effect?. Those non-participating hospitals don?t have noteworthy change in the amount of medical services, which means they don?t have the ?Quarter-End Effect?. Whether the hospital joining the Center of the Excellence or not actually impacts the practice, the amount of medical services provided.
To resolve the ?Quarter-End Effect? phenomenon, this research suggests that all hospitals prepare quarterly closing at different month.
