Preprinted Physician's Order and

Case Payment System

(For Reference)


OBS & GYN --

Spontaneous delivery
Cesarean section
Cesarean section (of p't own will)
Myomectomy
Ectopic pregnancy op.
Total hysterectomy
Subtotal hysterectomy
Salpingo-oophorectomy
Laparoscopic total hysterectomy
Laparoscopic salpingo-oophorectomy
Laparoscopic ectopic pregnancy op.

G-S --

Appendectomy
Laparoscopic cholecystectomy
Hemorrhoidectomy w/wo  fistulectomy
Herniorrhaphy, unilateral, >1yr
Herniorrhaphy, >1yr, OPD
Herniorrhaphy, bilateral, >1yr
Thyroidectomy
Mastectomy, with complications
Mastectomy
Partial mastectomy

Urology --

Transurethral prostatectomy
ESWL, OPD
Renal transplantation

Orthopedics --

Total hip replacement, unilateral
Total knee replacement, unilateral
Total hip replacement, bilateral
Open reduction, tarsal, metatarsal, toe
Open reduction, carpal, metacarpal, finger
Open reduction, radius or ulna
Open reduction, humerus, >17yrs
Open reduction, femoral shaft or neck, >17yrs
Open reduction, tibia or fibula >17yrs


Oph --

Phacoemulsification & IOL implantation
Phacoemulsification & IOL implantation, OPD

ENT --

Resection of palatine tonsil
Septomeatal plasty
Laryngomicrosurgery
Laryngomicrosurgery, OPD

C-V --

C-V Surgery --

Due to economic pressures, The Bureau of National Health Insurance (BNHI) in Taiwan has gradually implemented the case payment system beginning in October 1997, to attempt to control resource utilization while maintaining or improving the quality of medical care. Under the case payment system, 65% of minimal requirements for preoperative preparations and tests should be performed during the patient’s admission. While patients discharge from the hospital, the discharge status recommended by BNHI should be checked to ensure the care quality.  If patients are rehospitalization with the same diagnosis of disease within 2 weeks of hospital discharge, the admission charges will not be paid by BNHI. Untill now, 50 procedures have been covered by the case payment system.

In this site, we have created preprinted physician's orders for these procedures to try to reduce the length of hospital stay, admission charges, practice variations, and to improve the quality of medical care. Preprinted physician's orders include admission order, preoperative (preprocedure) order, postoperative (postprocedure) order, discharge order, and discharge status.

                                                         -----  Henry Chang, M.D.