醫師服務量對極低出生體重新生兒醫療費用的影響分析

Impact of Physician Volume on Medical Expenditures: Empirical Study of Very Low Birth Weight InfantsImpact of Physician Volume on Medical Expenditures: Empirical Study of Very Low Birth Weight Infants

黃昱瞳(Yu-Tung Huang) ； 翁新惠(Shin-Huey Wung) ； 楊長興(Chiang-Hsing Yang) ； 許玉君(Yu-Jung Hsu)

《台灣公共衛生雜誌》 23卷6期 (2004/12) Pp. 462-468

https://doi.org/10.6288/TJPH2004-23-06-06

摘要

本研究旨在探討在照護極低出生體重新生兒時，其出生後首次住院所花費之醫療費用是否因醫師服務量的多寡而有差異。方法：以國家衛生研究院全民健保資料庫2000年出生體重介於500~1499 公克的極低出生體重新生兒為研究對象，串連照護醫師及機構特性資料，進行迴歸分析。結果：符合研究定義之樣本共1191個新生兒，在控制新生兒特性、醫院特性及疾病嚴重度後，醫師服務量與其所照護新生兒的醫療花費呈負相關。結論：由較有經驗的醫師照護極低出生體重新生兒時，其花費的醫療費用相對較低，但是影響微小。

關鍵字

醫師服務量 ； 極低出生體重新生兒 ； 醫療費用

並列摘要

To empirically evaluate the impact of physician volume on medical expenditures with very low birth weight infants who were initally haspitalized. Method: NHI claim record data from 1191 cases of very low birth weight (500g-1499g) infants were obtained from the NHI research database. The regression model was employed to evaluate the relationship between physician volume and medical expenditures. Results: After adjusting for hospital characteristics, patient characteristics and outcome, we found a negative correlation between physician volume and medical expenditures. Conclusion: Medical expenditures may be lower for very low birth weight infant when cared for by a high volume physician, but the effect was limited.

並列關鍵字

physician volume ； very low birth weight infants ； medical expenditures

參考文獻

簡麗年、朱慧凡、劉見祥(2003)。醫院、醫師手術量與醫療品質之關連性探討－以全股（髖）關節置換為例。台灣衛誌。22，118-126。

翁新惠、楊長興(2002)。低體重早產兒的住院醫療資源耗用分析。台灣衛誌。21，397-402。

Adams DF,Fraser DB,Abrams HL(1973).(The complications of coronary arteriography).

Arndt M,Bradbury RC,Golec JH(1995).(Surgeon volume and hospital resource utilization).

Becker ER,Teutsch SM(2000).(State maternal and child expenditures and low birthweith infants: a descriptive analysis).