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題名:基層醫師釋出慢性病連續處方箋之意願及相關因素
書刊名:臺灣公共衛生雜誌
作者:龔佩珍呂嘉欣蔡文正
作者(外文):Kung, Pei-tsengLu, Chia-hsinTsai, Wen-chen
出版日期:2007
卷期:26:1
頁次:頁26-37
主題關鍵詞:連續處方箋處方箋釋出慢性病滿意度Refilled prescriptionsPrescription releaseChronic diseaseSatisfaction
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(4) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:4
  • 共同引用共同引用:18
  • 點閱點閱:49
目標:醫師意願為影響慢箋釋出之首要因素,故本研究希望了解影響基層診所醫師釋出慢性病連續處方箋之意願及相關因素。 方法:依健保局特約醫事機構名冊篩選符合研究條件之8,830位西醫基層醫師為研究對象,從中隨機抽取4,000位,以郵寄結構式問卷的方式進行問卷調查,共計回收有效問卷813份。除描述性分析外,並以複迴歸分析探討影響基層醫師釋出慢箋意願之相關因素。 結果:50.5%的基層醫師表示願意或非常願意釋出慢箋,但也有32.7%醫師表示不願意或非常不願意;不願意理由前三項主因為「醫療糾紛責任區分不明」、「領藥流程造成民眾不便」、「藥師可能私自更換藥品」。五成以上基層醫師表達對於慢箋釋出制度不滿意。在控制其他變項下,影響基層醫師釋出慢箋意願之因素為「醫師認為無法即時掌握病情」、「增加醫師用藥困擾」、「對社區藥師協助用藥安全之認知」及「是否應制定社區藥局處方箋獨立總額之看法」、「對處方交付費滿意度」、「是否自聘藥師協助調劑」、「執業年資」、「平均每週病患人數」及「醫師主要診治之疾病」。 結論:約一半基層醫師願意釋出慢性病連續處方箋,但仍有不少醫師不願釋出,若能針對研究中提出之不願意釋出因素加以改善,將能提升慢性病連續處方箋之釋出。
Objectives: Physicians willingness is the main factor determining the approval of prescription refills for chronic diseases. The aim of the current study was to investigate the factors influencing the willingness of clinic physicians to approve prescription refills. Methods: Of 8, 830 clinic physicians in the National Health Insurance database, 4,000 physicians were randomly surveyed with structured questionnaires. Of the 4,000 questionnaires mailed to the physicians, 813 were returned. Descriptive and multiple regression analyses were performed to identify those factors determining clinic physicians' willingness to approve prescription refills. Results: Of the physician respondents, 50.5% were willing, or very willing, to approve prescription refills for chronic diseases, whereas 32.7% of clinic physicians were unwilling, or very unwilling, to do so. The three major reasons determining a physician's unwillingness to approve prescription refills were: 1) concerns related to medical malpractice, 2) inconvenience associated with the process, and 3) the possibility of the prescription being changed. One-half of physicians were not satisfied with the policy pertaining to the approval of prescription refills. After controlling for other factors, the factors significantly associated with the physicians' willingness to approve prescription refills included: 1) empathy for the patient's medical condition, 2) increased medication problems, 3) the pharmacist's competence in safely dispensing medications, 4) establishing a separate global budget payment schedule for prescription refills, 5) satisfaction with the reimbursement for prescription refills, 5) hiring the pharmacist, 6) years of practice, 7) weekly patient volume, and 8) a physician’s speciality. Conclusions: One-half of the clinic physicians sampled in the current study were willing to approve prescription refills for chronic diseases. By focusing on the factors associated with the physicians' unwillingness to approve prescription refills and working to overcome them, the rate of approving prescription refills may be increased.
期刊論文
1.黃光華、李玉春、黃昱瞳(20041200)。醫藥分業對西醫診所門診處方釋出率及影響因素之分析。臺灣公共衛生雜誌,23(6),469-478。new window  延伸查詢new window
2.吳銘斌、楊盛玉、林易煌、顏裕庭(19990400)。執業醫師對將來醫藥分業實施的看法。臺灣醫界,42(4),57-60。  延伸查詢new window
3.吳敬堂、鍾國彪、苗迺芳、王佳惠、許怡欣、張金堅、郭乃文(20050600)。影響醫師實施臨床指引意願之因素探討--針對臨床指引本身之特性。醫務管理期刊,6(2),153-172。new window  延伸查詢new window
4.邱瓊萱、鍾國彪、陳端容、魏中仁、楊志良(20010800)。主治醫師價值觀契合度與組織承諾關係的探討--以六家醫學中心為例。臺灣公共衛生雜誌,20(4),275-290。new window  延伸查詢new window
5.王嘉明(2002)。「趨勢報告」日本醫藥分業近況與未來趨勢--2002年亞洲藥學會日本論文報告。中華民國藥師公會全國聯合會藥師週刊,1299,3。  延伸查詢new window
6.王嘉明(2002)。「趨勢報告」日本醫藥分業近況與未來趨勢--2002年亞洲藥學會日本論文報告。中華民國藥師公會全國聯合會藥師週刊,1300,3。  延伸查詢new window
7.中華景康藥學基金會圓桌論壇(2005)。醫藥分業系列--台日經驗交流。藥學雜誌,21,155-160。  延伸查詢new window
8.連瑞猛(2004)。台北市藥師公會慢性病連續處方箋釋出計劃。台北市藥師公會會刊,12。  延伸查詢new window
9.陳本源(2004)。台中市推動慢性病連續處方箋釋出之經驗分享。台中總藥訊,11,1。  延伸查詢new window
10.劉宏志(2001)。韓國能!為什麼我們不能!。臺北市藥師公會會刊,17,3-7。  延伸查詢new window
11.劉宏志(20010100)。韓國醫藥分業現況。臺北市藥師公會會刊,17(3)=128,3-7。  延伸查詢new window
12.許芳瑾、鄭萬祥(19990300)。臺灣省醫藥分業推動之研究。藥學雜誌,15(1)=58,151-156。  延伸查詢new window
13.林惠雯、薛亞聖(20030200)。醫療消費者及醫療提供者對全民健保新制門診藥品部分負擔的認知、態度及行為之研究。臺灣公共衛生雜誌,22(1),33-42。new window  延伸查詢new window
會議論文
1.林淑梅(2003)。推動處方箋釋出--東京經驗談及我國推動措施。行政院衛生署藥政處主辦之推動慢性病連續處方箋釋出研討會。臺北。  延伸查詢new window
研究報告
1.白璐(2000)。醫師、藥師、民眾對實施醫藥分業之認知、態度與經驗及其對民眾用藥認知、行為之影響。台北。  延伸查詢new window
2.龔佩珍(2005)。慢性病連續處方箋釋出相關因素及建立可行性機制之研究。台北。  延伸查詢new window
3.何蘊芳(2004)。慢性病連續處方箋釋出成效之探討與推廣。台北。  延伸查詢new window
4.蔡貞慧(2001)。醫藥分業政策影響評估--診所藥局之互動及用藥質量變化。台北。  延伸查詢new window
圖書
1.中央健康保險局(2005)。全民健康保險總額支付制度協商參考指標要覽。臺北:中央健康保險局。  延伸查詢new window
 
 
 
 
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