醫藥分業對西醫診所門診處方釋出率與影響因素之分析

This study aimed to investigate the trend and related factors of the release rate of prescriptions (RRP) to the pharmacies of primary care clinics with reference to the implementation of separation of drug prescribing (SDP) policy in Taiwan. Methods: Secondary data analysis was applied to the claim data of primary care clinics under the National Health Insurance scheme from 1996 to 2000. The database was obtained from the National Health Research Institutes. Results: The implementation of SDP was found to be related to the RRP. The greater the population covered by SDP, the higher the RRP, despite the low rate of RRP nationally. Clinics in the most and least urbanized areas, with fewer physician numbers and a lower patient volume, registered as specialist unit, and claiming the visits as special services rather than chronic diseases had higher RRP. Compared with E.N.T., those practicing family medicine, general practice, internal medicine, and pediatrics had higher RRP than those practicing gynecology, surgery, dermatology and ophthalmic. Regarding patients＇ characteristics, the younger, and the less severe (type A diseases) the patients were, the higher the RRP. Conclusion: Although this study found that environmental, institutional and patient factors, as well as SDP, all had significant impact on RRP, the financial incentives, still played the most important role. For the purpose of reinforcing the SDP policy and promoting the total RRP, it is recommended that NHI should increase financial incentives and reduce the profit gained from drugs.