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牙醫總額預算制度對牙醫服務量與價格的影響

The Influence of Global Dental Budgets on Dental Service Volume and Price

摘要


Objectives: This study aims to examine how dentists responded in service volume and price with a focus on the effect of the global budget according to the income-maximizing concept. Method: By measuring the change in fees over time in townships to study the dentists' behavior pre and post introduction of the global budget and follow the effects between township from 1996 to 2001. 291 townships with complete claim data from 1996 to 2001 in Taiwan were examined. We used the number of visits and the average price per claim to analyze dentists' behavior response with t-test and regression. Results: Between 1997 and 1999, the number of visits per township increased from 73,702 to 80,332 (t=9.3, p<0.001); the average price per claim per township increased from 863 to 948 NT. dollars (t=19.4, p<0.001). The results of multiple regressions showed that dental global budget had a positive relationship with the number of visits and the average price per claim (β=6,629.23, p<0.0l; β=84.41, p<0.001) after controlling for urbanization, population, dependency ratio and dentist-population ratio. Conclusions: In response to the introduction of global budget, dentists would increase the volume or price of services, especially price.

並列摘要


Objectives: This study aims to examine how dentists responded in service volume and price with a focus on the effect of the global budget according to the income-maximizing concept. Method: By measuring the change in fees over time in townships to study the dentists' behavior pre and post introduction of the global budget and follow the effects between township from 1996 to 2001. 291 townships with complete claim data from 1996 to 2001 in Taiwan were examined. We used the number of visits and the average price per claim to analyze dentists' behavior response with t-test and regression. Results: Between 1997 and 1999, the number of visits per township increased from 73,702 to 80,332 (t=9.3, p<0.001); the average price per claim per township increased from 863 to 948 NT. dollars (t=19.4, p<0.001). The results of multiple regressions showed that dental global budget had a positive relationship with the number of visits and the average price per claim (β=6,629.23, p<0.0l; β=84.41, p<0.001) after controlling for urbanization, population, dependency ratio and dentist-population ratio. Conclusions: In response to the introduction of global budget, dentists would increase the volume or price of services, especially price.

並列關鍵字

behavior global budget income-maximizing

參考文獻


Walton I(1996).Markets, Maximizers, and Efficiency.(Tregarthen Teds. Economics).
Eisenberg JM(1985).(Physician utilization-the state of research about physicians` practice patterns).
Hickson GB, Altemeier WA, Perrin JM(1987).Physician reimbursement by salary or fee-for-service: effect on physician behavior in a randomized prospective study..(Physician reimbursement by salary or fee-for-service: effect on physician behavior in a randomized prospective study.).
Murray JP, Greenfield S, Kaplan S, Yano EM(1992).(Ambulatory testing for capitation and fee-for-service patients in the same practice setting: relationship to outcomes).
Kinder K(2001).Assessing the impact of payment method and practice setting on German physicians` practice patterns.(Assessing the impact of payment method and practice setting on German physicians` practice patterns).

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