[Appropriation of time for professional staff and appropriation of costs for services, education and research at a major teaching hospital].
Cost analysis of hospital graduate medical education (GME) cannot follow standard accounting procedure because most of the services, teaching and research activities involved are performed simultaneously. This paper surveys work time allocation and analyzes the budgetary appropriation of a major teaching hospital in Taiwan, ROC based on answers given in a specially designed questionnaire. Percentages of working time used for services, teaching, research by the 2206 professionals at the hospital were 84.0%, 10.3% and 5.7% respectively; for the 776 physicians the figures were 64.1%, 22.7% and 13.2% respectively; GME represented a 12.22% share of the operation budget. In view of the fact that the IRB (Intern-Resident/Bed) ratio of the hospital reaches a high of 45%, GME investment is apparently insufficient. To obtain a reasonable ratio of teaching activities, hospital physicians expressed the opinion that the GME expenditure rate should be at least 18.95%. The Labor Insurance Plan, currently the biggest of its kind in this country, pays 3% of GME expenses to all hospitals. This payment neglects the different teaching load in different hospitals.
Han
K
K
College of Public Health, National Taiwan University.
D003361:Cost Allocation; D004503:Education, Medical, Graduate / Q000191:economics*; D006784:Hospitals, Teaching / Q000191:economics*; D006801:Humans; D013997:Time Factors