- 期刊
醫師特質與低價值處方的相關性探討－以抗生素、抗精神病藥物、鎮靜安眠藥為例
The association between physician characteristics and low-value medication use: Using antibiotics, antipsychotics, and benzodiazepine as an example
摘要
目的：隨著醫療科技進步與人口高齡化的現象，各國醫療費用成長快速。台灣健保門診藥費從1998年至2016年成長了178.7%，且藥品佔近五分之一國民醫療保健支出。本研究欲探討醫療提供者特性與低價值處方開立的相關因素。方法：本研究為橫斷性研究，使用2010－2014年健保全人口資料庫。研究對象分別為罹患急性鼻竇炎或上呼吸道感染、失智症的成年患者，以及有失眠躁動或譫妄症狀之老年患者。結果：整體而言，當醫師有開立抗生素／抗精神病藥物習慣、藥費佔總門診費用比率相對高、平均開立藥品品項數多，較有可能給予患者低價值處方。然而，當醫師有開立鎮靜安眠藥物習慣時，給予失眠老年人低價值處方的情形則較少。結論：本研究納入的四項低價值處方在臺灣十分普遍，並且與醫師特質息息相關。醫師特質與低價值處方之間有顯著相關性，但可能會根據處方而有所差異。
並列摘要
Objectives: In Taiwan, there was a 178.7% increase in fees paid by the health insurance system for outpatient drugs between 1998 and 2016. Our objective in the current study is to explore the relationship between physician characteristics and use of low-value medication. Methods: This is a cross-sectional study using data from the Health Insurance Population Database of Taiwan for the period 2010-2014. The sample comprised adult patients with acute sinusitis, upper respiratory tract infection, or dementia as well as elderly patients with insomnia, agitation, or symptoms of delirium. Results: When physicians have the habit of prescribing antibiotics/antipsychotics drugs/ benzodiazepines, high prescribing fees of the total outpatient expenses and high average number of drug items are more likely to prescribe low-value medication. Conclusions: The four types of low-value care addressed in this study are common in Taiwan. We observed correlations between physician characteristics and prescribing of low-value medication; however, the patterns varied as a function of drug type.