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題名:醫藥分業對西醫診所門診處方釋出率及影響因素之分析
書刊名:臺灣公共衛生雜誌
作者:黃光華 引用關係李玉春黃昱瞳
作者(外文):Huang, Kuang-huaLee, Yue-chuneHuang, Yu-tung
出版日期:2004
卷期:23:6
頁次:頁469-478
主題關鍵詞:醫藥分業處方釋出率影響因素Separation of drug prescribing and dispensingRelease rate of prescriptionsInfluence factors
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(6) 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:6
  • 共同引用共同引用:24
  • 點閱點閱:136
     目標:本研究目的在瞭解臺灣醫藥分業政策實施前後處方箋釋出比例之趨勢,及影響診所釋出門診處方箋之因素。方法:本研究採次級資料分析,研究對象為全民健保西醫診所,資料來源為國家衛生研究院1996∼2000年全民健康保險學術研究資料庫中之全民健保西醫基層門診申報資料。結果:醫藥分業政策顯著影響處方釋出率,隨著實施地區人口比率增加,整體的處方釋出率雖仍相當低,但有顯著成長;都市化程度較高或較低地區、診所執業醫師數較少、每日服務量較低、專案案件相對於慢性病,一般診所相對於專科診所,處方釋出可能性顯著較高;相對於耳鼻喉科,眼科、皮膚科、外科及婦產科釋出處方率顯著較低,而家醫或不分科、內科及兒科則顯著較高;病患年齡愈輕,疾病嚴重度愈低(A類疾病)處方釋出可能性顯著較高。結論:雖然本研究發現除醫藥分業外,環境因素、機構特性及病患特性皆顯著影響處方釋出率,但財務誘因可能才是最重要之因素。為落實醫藥分業政策,建議提高健保釋出處方誘因並降低藥品利潤,俾利整體處方釋出率之提升。
     Objectives: This study aimed to investigate the trend and related factors of the release rate of prescriptions (RRP) to the pharmacies of primary care clinics with reference to the implementation of separation of drug prescribing (SDP) policy in Taiwan. Methods: Secondary data analysis was applied to the claim data of primary care clinics under the National Health Insurance scheme from 1996 to 2000. The database was obtained from the National Health Research Institutes. Results: The implementation of SDP was found to be related to the RRP. The greater the population covered by SDP, the higher the RRP, despite the low rate of RRP nationally. Clinics in the most and least urbanized areas, with fewer physician numbers and a lower patient volume, registered as specialist unit, and claiming the visits as special services rather than chronic diseases had higher RRP. Compared with E.N.T., those practicing family medicine, general practice, internal medicine, and pediatrics had higher RRP than those practicing gynecology, surgery, dermatology and ophthalmic. Regarding patients' characteristics, the younger, and the less severe (type A diseases) the patients were, the higher the RRP. Conclusion: Although this study found that environmental, institutional and patient factors, as well as SDP, all had significant impact on RRP, the financial incentives, still played the most important role. For the purpose of reinforcing the SDP policy and promoting the total RRP, it is recommended that NHI should increase financial incentives and reduce the profit gained from drugs.
期刊論文
1.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
2.楊文惠、黃松共、楊宜璋(20010100)。醫藥分業後民眾選擇藥局調劑之決策因素研究--以臺北市為例。公共衛生,27(4),227-244。  延伸查詢new window
3.季瑋珠、陳善音、陳建煒(19980200)。民眾對醫藥分業執行方案意見調查。中華公共衛生雜誌,17(1),10-18。new window  延伸查詢new window
4.曾國雄、吳水源(19860300)。臺灣地區市鎮鄉都市化程度特性之研究。國立臺灣師範大學地理研究報告,12,287-323。new window  延伸查詢new window
5.林金龍(20030300)。考察日本醫藥分業暨相關健康保險給付現況。藥學雜誌,19(1)=74,154-160。  延伸查詢new window
6.洪章榮(20020600)。日本東京都醫藥分業考察報告。藥學雜誌,18(2)=71,139-158。  延伸查詢new window
7.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
8.周稚傑、葉明功、游翁斌、白璐(19991200)。用藥趨勢分析:以醫藥分業實施前後臺北縣市健保特約藥局接獲之釋出處方箋為例。醫學研究,20(3),142-151。  延伸查詢new window
9.周稚傑、葉明功、游翁斌(19990600)。醫藥分業實施後大臺北地區診所釋出處方箋之用藥分析。中華民國家庭醫學雜誌,9(2),84-93。  延伸查詢new window
10.蕭美玲(19910900)。醫藥分業之規劃及展望--當前醫藥分業概況。藥學雜誌,7(3)=28,3-6。  延伸查詢new window
11.王運昌、邱尚志、葉明功、周稚傑、白璐(19991200)。全民健保特約藥局執業藥師(生)對醫藥分業認知、態度及相關經驗之初探。醫學研究,20(3),133-141。  延伸查詢new window
12.葉明功、周稚傑、王運昌、白璐(20000300)。執業藥師對醫藥分業態度及相關經驗之探討。醫院藥學,17(1/2),1-11。  延伸查詢new window
13.謝文紘、陳美霞(20011000)。醫藥分業政策推行對藥師專業的影響。臺灣公共衛生雜誌,20(5),395-411。new window  延伸查詢new window
14.葉明功、王運昌、周稚傑、白璐(20010400)。執業藥師對醫藥分業政策之認知。臺灣臨床藥學雜誌,8(3/4),16-30。new window  延伸查詢new window
15.白佳昇、白佳原、張錦文、譚開元(1997)。醫藥分業對皮膚專科醫療預期之影響。醫院:中華民國醫院協會雜誌,30,1-7。  延伸查詢new window
16.張永源、彭美熒(1995)。實施醫藥分業對國內醫療環境的影響。醫院:中華民國醫院協會雜誌,28,5-11。  延伸查詢new window
17.Chou, Y. J.、Yip, W. C.、Lee, C. H.、Huang, N.、Sun, Y. P.、Chang, H. J.(2003)。Impact of Separating Drug Prescribing and Dispensing on Provider Behaviour: Taiwan's Experience。Health Policy Plan,18,316-329。  new window
18.謝曉菱(1997)。醫藥分業開步走-醫療院所、特約藥局須知。全民健康保險,7,20-21。  延伸查詢new window
19.張倫馨(1997)。他山之石-簡介日本醫藥分業制度。全民健康保險,5,2-5。  延伸查詢new window
20.Ryan, M.、Bond, C.(1994)。Dispensing Physicians and Prescribing Pharmacists: Economic Considerations for the UK。Pharmacoeconomics,5,8-17。  new window
研究報告
1.黃文鴻、高雅慧(1997)。全民健保特約醫療機構門診處方釋出情形之探討。沒有紀錄。  延伸查詢new window
2.呂碧鴻、王英偉(1990)。家庭醫師在全民健康保險及醫療網中的角色-現在與未來之探討。沒有紀錄。  延伸查詢new window
圖書
1.莊永明(1998)。臺灣醫療史:以臺大醫院為主軸。臺北:遠流。  延伸查詢new window
2.楊漢湶(1997)。醫療管理常用名詞彙編。臺北:行政院衛生署。  延伸查詢new window
其他
1.行政院衛生署(1998)。藥政管理,0。  延伸查詢new window
2.行政院衛生署(2001)。藥政管理-醫藥分業,沒有紀錄。  延伸查詢new window
 
 
 
 
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