https://scholars.lib.ntu.edu.tw/handle/123456789/493749
標題: | Changes in the prescription pattern of antipsychotics for schizophrenic outpatients after the implementation of a global budgeting program | 作者: | Chiu, Hsien-Jane Chou, Po-Han Loh, El-Wui Lan, Tzuo-Yun Wu, Bo-Jian Chang, Yung-Yan Liu, Shuen-Zen Lan, Tsuo-Hung |
關鍵字: | Global budgeting; National Health Insurance; Schizophrenia | 公開日期: | 2014 | 卷: | 77 | 期: | 6 | 起(迄)頁: | 325-332 | 來源出版物: | Journal of the Chinese Medical Association | 摘要: | Background: A hospital-based global budget (GB) program was implemented by the Taiwan Bureau of National Health Insurance (TBNHI) to control the rising costs of medical care. We investigated whether the introduction of the GB program affected prescriptions for second-generation antipsychotics (SGAs) for schizophrenic outpatients in public and private medical and psychiatric centers. Methods: The prescription data of schizophrenic outpatients treated between 2001 and 2004 were retrieved from the TBNHI database, which included outpatients who were diagnosed as having schizophrenia during the period from 1996 to 2001. Because the new health insurance policy may have had a lag effect on physicians' decision regarding SGA prescription, we used January 2004 as the timepoint to divide the data, which was 6 months after GB implementation. Thus, data from the 6-month period immediately after the GB implementation were included in the pre-GB period. Second-generation antipsychotics included in the study were clozapine, risperidone, olanzapine, quetiapine, ziprasidone, zotepin, and amisulpride. Results: After January 2004, the proportion of SGA use in outpatient departments did not show an upward trend, as had been observed in the pre-GB period, which appeared at a staggering pace lasting for 12 months ( p=0.0004). Compared with medical centers, SGA expenditures in the psychiatric centers were less affected in the GB period ( p<0.0001). Compared to the private sector, the SGA expenditures in the public sector were less affected in the GB period ( p<0.019). Conclusion: We concluded that the GB implementation reduced SGA expenditures significantly. The extent of influence varied among hospitals (i.e., public versus private, medical versus psychiatric centers), which was most likely caused by financial factors. ? 2014. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/493749 | ISSN: | 1726-4901 | DOI: | 10.1016/j.jcma.2014.03.004 | SDG/關鍵字: | amisulpride; clozapine; neuroleptic agent; olanzapine; quetiapine; risperidone; ziprasidone; zotepine; neuroleptic agent; article; budget; comparative study; drug cost; female; health insurance; health program; human; major clinical study; male; mental health center; national health insurance; outpatient; outpatient department; prescription; private hospital; public hospital; schizophrenia; clinical practice; legislation and jurisprudence; public health; schizophrenia; trends; Antipsychotic Agents; Female; Humans; Male; National Health Programs; Outpatients; Practice Patterns, Physicians'; Schizophrenia |
顯示於: | 會計學系 |
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