Analysis of Psychiatrists’ Prescription Pattern Change Upon the Implementation of Hospital Price Regulation and Expenditure Cap by National Health Insurance In Taiwan
Date Issued
2007
Date
2007
Author(s)
Chiu, Hsien-Jane
DOI
en-US
Abstract
English Abstract
Objective: To examine the impact of the implementation of hospital-based global budget programs upon the psychiatrists’ prescribing pattern of Second-Generation Antipsychotics (SGA).
Methods: Data for this study were collected between 2001 and 2004 as part of the NHI database, which included exclusively patients with schizophrenia. For considering lagging effect of hospital-based global budget program upon the prescription behavior, we set a “dividing point” at January 2004, which is 6 months after the starting point of the implementation of global budget. We used general linear regression model to compare the trend of SGA use before and after the dividing point. Two indicators were calculated: proportions of SGA for drug expenditures and use frequency in outpatient and inpatient departments separately. Public sectors versus private sectors and psychiatric centers versus medical centers were examined respectively. The sample of this study consisted of 43386 individuals.
Results: The proportions of SGA in outpatient departments for expenditures and use frequency predominantly increased after Sep, 2002 (starting point of relaxed regulation on SGA use). After the dividing point, SGA proportions in outpatient and inpatient departments did not show obvious growing pattern as they did before the starting point, but appeared to be at a staggering pace lasting for 12 months (p = 0.0004). Compared with medical centers, the SGA expenditures of the psychiatric centers were less affected after the dividing point (p < 0.0001); compared with private sectors, the SGA expenditures of public sectors were less affected after the dividing point (p < 0.019)
Conclusions: We have revealed that psychiatrists’ prescribing pattern of antipsychotics is affected by the implementation of global budget programs; and the extent of influence varies by the types of hospitals, for example, public psychiatric centers are least affected by the implementation of global budget program. Further studies may engage in finding other factors affecting the psychiatrists’ behavior, and applying them on promoting the quality of life and mental-health care for those who are in need of psychiatric service.
Subjects
醫師行為
第二代抗精神病藥物
精神分裂症
hospital-based global budget
physician behavior
second-generation antipsychotics (SGA)
schizophrenia
Type
other
File(s)![Thumbnail Image]()
Loading...
Name
ntu-96-P94743014-1.pdf
Size
23.31 KB
Format
Adobe PDF
Checksum
(MD5):4bd23c319eeea299eb10bec644ce18da