特約藥局申報處方箋與釋出處方箋之比較

The Comparison between Claimed Prescriptions and Released Prescriptions

10.7023/TJFM.200409.0142

莊明憲(Mieng-Hsian Chuang)；柯景馨(Ching-Hsing Ke)；高東煒(Tung-Wei Kao)；游翁斌(Weng-Ping Yu)；陳永煌(Yeong-Hwang Chen)；周稚傑(Chih-Chieh Chou)；羅慶徽(Ching-Hui Loh)

national health insurance ； medication cost ； prescription ； separation of pharmacy dispensing from physician services

台灣家庭醫學雜誌

14卷3期（2004 / 09 / 01）

142 - 149

繁體中文

台灣地區在西元1990年全國衛生行政會議結論中，首度確定全民健康保險之實施，將以醫藥分業為基礎，並於1997年3月1日起實施醫藥分業。本研究之目地在探討釋出處方箋與特約藥局申報處方箋藥物種類、藥物粒數、藥物費用和給藥天數之差異，以做為醫藥分業執行的參考。我們以國家衛生研究院所提供之健保資料檔案為研究對象，時程為1997年至2000年，進行橫斷式、二變項迴歸分析之二次資料分析。 我們發現特約藥局申報處方箋數由1997年之2,329,812件顯著的增加至2000年之12,481,682件，其申報金額亦由1997年四億六千萬元上升至2000年之二十三億五千萬元(佔健保費用比例0.3%至1.18%)。在藥物種類、藥物粒數、藥物費用和給藥天數上，都呈現減少的情況。另外特約藥局申報之平均藥費用(約0.7)。由這些結果可以發現，迴歸係數之走向逐年提高，顯示釋出處方箋與申報處方箋之一致性有提昇之現象。

In 1990, the Committee of Taiwanese National Health Administration suggested that national health insurance should be based on a separation policy of pharmacy and medical practice (SPMP). This notion resulted in the enactment of SPMP on March 1, 1997. This study aimed to facilitate the separation of the pharmacy from physician services and has analyzed the determinative variables of implementing this SPMP policy. It contrasted the different kinds of medication, numbers of tablets, expenditures, and lengths of prescriptions between ”released prescriptions for medical practice” and ”claimed prescriptions for contracted pharmacies”. Empirical data based on four year insurance records (1997 to 2000) were collected from the National Health Research Institute. This study was a cross-sectional and bivariate regression model of secondary data analysis. The number of claimed prescriptions by contracted pharmacies has increased remarkably from 2,329,812 in 1 997 to 1 2,481,682 in 2000. The expenditure has also increased from $ 0.464 billion NT (0.3% of total NHI expenditure) in 1997 to $2.35 billion NT (1.18%) in 2000. On the contrary, different kinds of medication, numbers of tablets, expenditures, and lengths of prescriptions declined gradually. The average of medical expenditures released and claimed decreased from 222 vs. 251 in 1997 to 133 vs. 123 in 2000. The bivariate regression test was performed to measure the interrelations of variables between released and claimed prescriptions. It concluded the highest regressional coefficient (the length of prescriptions above 0.95) and the lowest regressional coefficient (expenditures around 0.7). This analysis revealed an increasing inclination of r-squares. The implication is that the consistency of released and claimed prescriptions was enhanced.

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