AN AHP MODEL FOR BRINGING EXPERTS TO CONSENSUS ON MEDICAL PAYMENT STANDARDS

1. Introduction Many countries with health insurance systems conduct periodic payment standardsadjustments. The main reasons are to address continually rising health care costs and to ensure an equitable allocation of resources. From the248 JOURNAL OF SYSTEMS SCIENCE AND SYSTEMS ENGINEERING data of the Organization for Economic Co-operation and Development (OECD) countries, the proportion of health care costs as a percentage of Gross Domestic Product (GDP) continues to r…

An AHP model for bringing experts to consensus on medical payment standards

Many countries with health insurance systems conduct periodic payment standards reform. How to reach consensus in setting payment standards among different specialties with different agendas has become a critical issue. The purpose of this study is to construct an analytic hierarchy process (AHP) model to obtain judgments from experts about the importance of “factors related to establishing payment standards in the national health insurance program”. Under this goal, the first tier contains four evaluation aspects, and the second tier contains sixteen evaluation criteria divided into four groups. The AHP model was then used to collect and combine the opinions of experts through an empirical study. The results can be directly used to formulate standard values as the basis for establishing payment standards. The results of our study strongly support that an AHP model is effective in forming a consensus among surgical specialists. This study is deeply indebted to the Taiwan’s Bureau of National Health Insurance, Department of Health, Executive Yuan for providing research funding (BNHI Year 2002 Research and Development Project, Doc. No.:DOH91-NH-1040) Yuan-Huei Huang is a Visiting Staff of Department of Surgery, Hsin-Chu General Hospital. He received his bachelor’s degree in 1987 from the Department of Medicine, College of Medicine at the Chung-Shan Medical University, Taiwan, China. He has also been studying at the Ph.D. Program of Institute of Technology Management, National Chiao Tung University, Taiwan, China, since 1999. His main research interests are health economics, analytic hierarchy process, fuzzy set theory, multiple criteria decision making, and technology management. Pei-Yeh Chang is the Chief of Department of Pediatric Surgery, Chang Gung Children’s Hospital, Taiwan, China. He received his bachelor’s degree in 1978 from the Department of Medicine, College of Medicine at the National Taiwan University, China. He has been also serving as an Associate Professor of School of Medicine, National Cheng Kung University, Taiwan, China at present. Besides medical professional, his main research interests are health policy making, medical resource and workforce allocation, and medical education. Chih-Young Hung serves as the Director and an associate professor of Institute of Technology Management in the Faculty of Management, National Chiao Tung University where he has taught since 1991. His PhD is from the Texas Tech University, U.S.A. He received his bachelor⤐s degree in 1979 from the Department of Electrical and Control Engineering at the National Chiao Tung University, Taiwan, China. His background provided him a special emphasis on the high technology industries in Taiwan, China. He has published a series of papers in studying industry evolution from finance perspective, and also several professional books on financial related areas. Kuei-Ing Wang serves as the lecturer of Department of Information Management, Ming Hsin University of Science and Technology where she has taught since 1998. She received her MBA degree in 1998 from the Department of Business Administration at the National Chengchi University, Taiwan, China. She has also been studying at the Ph.D. Program of Institute of Technology Management, National Chiao Tung University since 2001. Her main research interests are health economics, the analytic hierarchy process, hi-tech industry analysis, multiple criteria decision making, and information management. King-Jen Chang is the President of the Foundation of Breast Cancer Prevention and Treatment in Taiwan, China. He has been also serving as a professor of School of Medicine at National Taiwan University, Taiwan, China, since 1991. His PhD is from the College of Medicine at the National Taiwan University, Taiwan, China, in 1982. Besides medical professional, his main research interests are health economics, health policy making, and medical resource allocation.