Chu Kuan-Yu, Huang Chunmin
BMC Health Serv Res. 2013 Jun 13;13:215. doi: 10.1186/1472-6963-13-215.
A smartcard is an integrated circuit card that provides identification, authentication, data storage, and application processing. Among other functions, smartcards can serve as credit and ATM cards and can be used to pay various invoices using a 'reader'. This study looks at the unit cost and activity time of both a traditional cash billing service and a newly introduced smartcard billing service in an outpatient department in a hospital in Taipei, Taiwan.
The activity time required in using the cash billing service was determined via a time and motion study. A cost analysis was used to compare the unit costs of the two services. A sensitivity analysis was also performed to determine the effect of smartcard use and number of cashier windows on incremental cost and waiting time.
Overall, the smartcard system had a higher unit cost because of the additional service fees and business tax, but it reduced patient waiting time by at least 8 minutes. Thus, it is a convenient service for patients. In addition, if half of all outpatients used smartcards to pay their invoices, along with four cashier windows for cash payments, then the waiting time of cash service users could be reduced by approximately 3 minutes and the incremental cost would be close to breaking even (even though it has a higher overall unit cost that the traditional service).
Traditional cash billing services are time consuming and require patients to carry large sums of money. Smartcard services enable patients to pay their bill immediately in the outpatient clinic and offer greater security and convenience. The idle time of nurses could also be reduced as they help to process smartcard payments. A reduction in idle time reduces hospital costs. However, the cost of the smartcard service is higher than the cash service and, as such, hospital administrators must weigh the costs and benefits of introducing a smartcard service. In addition to the obvious benefits of the smartcard service, there is also scope to extend its use in a hospital setting to include the notification of patient arrival and use in other departments.
智能卡是一种集成电路卡，可提供身份识别、认证、数据存储和应用处理功能。除其他功能外，智能卡可用作信用卡和自动取款机卡，并可使用“读卡器”支付各种发票。本研究考察了台湾台北一家医院门诊部传统现金计费服务和新推出的智能卡计费服务的单位成本和活动时间。
通过时间与动作研究确定使用现金计费服务所需的活动时间。采用成本分析比较两种服务的单位成本。还进行了敏感性分析，以确定智能卡使用情况和收银窗口数量对增量成本和等待时间的影响。
总体而言，由于额外的服务费和营业税，智能卡系统的单位成本较高，但它将患者等待时间至少缩短了8分钟。因此，它对患者来说是一项便捷的服务。此外，如果所有门诊患者中有一半使用智能卡支付发票，同时设置四个现金支付收银窗口，那么现金服务用户的等待时间可减少约3分钟，增量成本将接近收支平衡（尽管其总体单位成本高于传统服务）。
传统现金计费服务耗时且要求患者携带大量现金。智能卡服务使患者能够在门诊部立即支付账单，并提供更高的安全性和便利性。护士的空闲时间也可减少，因为他们可协助处理智能卡支付。空闲时间的减少降低了医院成本。然而，智能卡服务的成本高于现金服务，因此医院管理人员必须权衡引入智能卡服务的成本和收益。除了智能卡服务的明显好处外，在医院环境中扩大其使用范围以包括患者到达通知和在其他科室的使用也有空间。
