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

何瑛(Ying Ho) ； 黃偉堯(Wei-Yao Huang)

《台灣公共衛生雜誌》 24卷5期 (2005/10) Pp. 394-401

https://doi.org/10.6288/TJPH2005-24-05-03

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.

關鍵字

醫療行為 ； 總額預算 ； 所得最大化

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

陳琇玲、溫信財、楊志良、黃文駿、黃意婷、徐慧娟(2002)。健保支付標準與醫師執業耗用資源對牙科服務量之影響。21，17-26。

陳琇玲、溫信財、楊志良、黃文駿、黃意婷、徐慧娟(2002)。健保支付標準與醫師執業耗用資源對牙科服務量之影響。台灣衛誌。21，17-26。

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