The impact of global budgeting in Taiwan on inpatients with unexplained fever

Liu, Keh-Sen; Yu, Tsung-Fu; Wu, Hsing-Ju; Lin, Chun-Yi

Risk of re-admission within 14 days CT. However, this could be offset by earlier definitive treatment due to higher diagnostic sensitivity, which could reduce LOS with an average of £400 per day. [49] Therefore, FDG-PET/CT can aid in diagnosing FUO, particularly when diagnostic clues are absent. Diagnostic, therapy, and total costs incurred for treating patients with unexplained fever significantly increased after GB system implementation. After adjustments for other covariates, the GB system and Charlson comorbidity index was found to be positively correlated with increased diagnostic, therapy, and total costs. The increase in health care expenditures from 25.4% to 426.6% significantly exceeded the 2.2% growth in consumer price index for the same period in Taiwan (Table S2 , http://links. lww.com/MD/D225). The possible reasons for the higher costs include longer LOSs, additional comorbidities, and higher proportion of older individuals in the study population after GB system implementation (Table 7) . Moreover, salaries of physicians in Taiwan are calculated more or less on the basis of FFS. Therefore, physicians demonstrate a natural proclivity to maximize medical services to maximize their income; and the GB system does not provide an incentive for physicians to reduce the volume of medical care. Health care expenditures incurred by patients with unexplained fever did not differ between hospitals with different accreditation levels or in different geographic areas in Taiwan.