“呼吸道診療概況表”實施對基層醫師之影響

Translated title of the contribution: The Impact of the Implementation of "Tables of Diagnosis and Treatment of Respiratory Tract" on Primary Care Physicians

陳家榆, 林恆慶

Research output: Contribution to journalArticle

Abstract

This study aims to explore the attitudes of primary care physicians toward the implementation of Tables of Diagnosis & Treatment of Respiratory Tract (TDTRT) and its impact on physician behaviors. This study used a structured self-administered survey to collect data. The study subjects were 2040 primary care physicians registered at the Bureau of Affairs, Department of Health as the general practitioners, ENT, pediatricians, internal medicine, and family practitioners under the Taipei Branch of the Bureau of the National Health Insurance (BNHI). A total of 496 questionnaires were returned, yielding a response rate of 24.8%. The goodness-of-fitness tests found that there were significant differences between population physicians and the respondents in terms of age and gender. A logistic regression analysis was performed to examine the impact of the implementation of TDTRT on physician behaviors. The results showed that 42.8% of respondents had the negative attitudes toward the implementation of TDTRT. The logistic regression analysis showed that controlling for other factors, those aged less than 40 years and those agreed the BNHI can use TDTRT as a basis for reimbursement were less likely to change their behavior pattern for patient care. Those who agreed that healthcare environment is suitable for the implementation of TDTRT, those agreed to continue to use the TDTRT, those agreed the TDTRT can be a basis for peer comparison, and those who agreed the BNHI can use TDTRT as a basis for the analysis of resource utilization were more likely to change their behavior pattern for patient care. Based on our study results, we suggest that the health authority (1) use the TDTRT as an educational tool instead of a punishment basis; (2) select the appropriate indicators and ICD codes; and (3) provide timely feedback.
Translated title of the contributionThe Impact of the Implementation of "Tables of Diagnosis and Treatment of Respiratory Tract" on Primary Care Physicians
Original languageTraditional Chinese
Pages (from-to)27-40
Number of pages14
Journal台灣家庭醫學雜誌
Volume16
Issue number1
DOIs
Publication statusPublished - Mar 2006

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