[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-113-2-psychiatric-community-042":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":62},"精神科與社區衛生護理學","psychiatric-community",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":26},"nurse-113-2-精神科與社區衛生護理學-042","nurse-113-2-psychiatric-community-042",113,2,42,"全民健康保險中，為避免被保險人醫療資源不當使用，所導致的道德危害（moral hazard），採用下列何項措施？",{"A":14,"B":15,"C":16,"D":17},"論量計酬（fee-for-service）","診斷關聯群（diagnosis-related groups）","部分負擔（copayment）","總額支付制度（global budget）","C",null,[],"本題考點在於健康保險中抑制「道德危害(moral hazard)」的財務誘因機制。道德危害指被保險人因不需自付全部費用而過度使用醫療資源;部分負擔(copayment)讓民眾就醫時自付一部分費用,直接提高使用者的價格感受、抑制不必要就醫,正對應防範道德危害的目的,故選 C。選項 A 論量計酬是「按服務量給付醫方」的支付制度,反而可能誘導供給端衝量;選項 B 診斷關聯群(DRGs)是按診斷分類包裹給付、控制醫方成本的制度,屬供給端;選項 D 總額支付制度是設定年度醫療總額上限的宏觀控管,亦針對供給端與整體費用。三者都作用於「供給方(醫療提供者)」,唯部分負擔直接作用於「需求方(被保險人)」的使用行為。判斷關鍵在於道德危害源自需求端,對策就要作用在需求端。","供需兩端費用控制對照:需求端(抑制民眾過度利用)→部分負擔、自負額、就醫層級轉診;供給端(抑制醫方誘導需求)→論量計酬易衝量,故改採論病例計酬 DRGs、論人計酬、總額支付制度。道德危害的經濟本質是「價格為零時需求膨脹」,部分負擔透過恢復部分價格訊號來矯正,是健保財務題的核心考點。",[24,27,29,31],{"term":25,"count":26},"道德危害 moral hazard",1,{"term":28,"count":26},"部分負擔 copayment",{"term":30,"count":26},"醫療費用需求端控制",{"term":32,"count":26},"DRGs 與總額支付對比",[34,38,43,48,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-2-psychiatric-community-043","有關兒童事故傷害的敘述，下列何者最不適當？",43,{"webId":39,"stem":40,"number":41,"year":42,"session":26},"nurse-114-1-psychiatric-community-039","有關紫外線防護之護理指導，下列何者最不適當？",39,114,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-114-3-psychiatric-community-033","調查社區民眾自費支付 SARS-COV-2 病毒核酸檢驗的能力，是評估服務資源的那一項屬性？",33,3,{"webId":49,"stem":50,"number":26,"year":51,"session":10},"nurse-106-2-psychiatric-community-001","關於精神病人轉日間住院，對病人的幫助，下列何者正確？",106,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-107-2-psychiatric-community-045","王先生外出用餐食用生鮮魚貝類，返家後開始出現下痢、腹痛、噁心、嘔吐、頭痛、腹瀉等急性腸胃不適，依此症狀判斷，最有可能由何種細菌引起？",45,107,{"webId":58,"stem":59,"number":60,"year":61,"session":26},"nurse-109-1-psychiatric-community-079","李老先生是 82 歲的糖尿病個案，血糖控制不好，也不願就醫，他向社區護理師說：「我已經活夠了，現在都沒不舒服，如果怎樣，死了就算了，無須再就醫吃藥」。根據健康信念模式，社區護理師應加強何項認知的對話？",79,109,"2026-09-04",1788510756119]