目標:瞭解民國88年實施新制門診藥品部分負擔之後,民眾及醫師對此制度之認知、態度及行為,並比較民眾與醫師兩者意見之差異。方法:分別以台灣地區就醫民眾及有執業之西醫師(不含牙醫)為研究對象,經隨機抽樣分別進行電訪及郵寄問卷調查。就醫民眾電訪完成有效問卷946份,醫師部分隨機抽取4,113位醫師為樣本,最後得有效問卷688份(回收率16.7%)。經適合度檢定,就醫民眾問卷與健保局投保人口分佈無顯著差異,樣本具代表性。結果:就醫民眾調查結果,新制部份負擔實施近1年半,尚部分負擔;約七成的就醫民眾可以接受看門診拿藥要付藥品的民眾只有4.6%。醫師調查結果,多數醫師(85.5%)對門診藥品部分負擔表示支持的能度;有89.4%認為藥品浪費嚴重;61.1%醫師會受門診藥品部分負擔的影響而建議病人減少用藥。結論:就醫民眾普遍認為藥品浪費嚴重,並能接受新制藥品項部分負擔制度。雖然就醫民眾在認知、態度上支持新制部分負擔,但是對減少就醫、拿藥的效果卻不高,反而是醫師自認愛影響的比率較高,可見部分負擔雖然是作用在民眾身上,但是影響較深的卻是醫師。
Objectives: The purpose of this research is to understand the perception, attitude and behavior of patients and health care providers under the new Outpatient Prescription Drugs Co-payment policy of the National Health Insurance (NHI) Program. Methods: This research uses two sources of data. One is a nation-wide random sampling telephone interview with CA TI (Computer aided telephone interview) system for the patients. The other set of data is from a random sampling survey with self-administered questionnaire. We got 946 valid respondents by telephone interview. The response rate is 16.7% for the physicians. Results: There is still one-fifth of patients who don't know this new policy. There are about 70% of patients who can accept this policy. 60%patients consider that waste of drug is serious. Only 4.56% patients have asked physicians to prescribe fewer drugs, and 11.57% reported they have made fewer visits to the doctors. Regarding whether physicians will change prescriptions pattern because of the new outpatient prescription co-payment policy, 61.1 % physicians reported they tended to suggest fewer drugs. Conclusion: Most patients can accept this policy but few of them will reduce visiting doctors and buy less drugs. Therefore, outpatient prescription co-payment policy influences physicians more than patients.