醫師處方決策 -以抗憂鬱劑、抗焦慮劑、安眠鎮靜劑為例

Abstract

根據統計，1997 至2005 年精神疾病總體藥物的使用持續成長，而不只在精神相關疾病也在非精神科之使用量為最大宗且最為廣泛之三大類藥品為「抗抑鬱藥」、「抗焦慮藥」、「安眠與鎮靜劑」，隨著藥品使用人數的增加，也引發了許多副作用問題，導致各國紛紛開始重視精神疾病類藥品問題。本研究主要在探討影響醫師開立處方行為之因素進行實證研究，透過行政院衛生署全民健康保險資料庫(National Health Insurance Research Database)資料檔所提供之資料去探索可能影響之因素，並結合過去文獻所提及但尚未經過證實之特徵進行驗證。本研究以醫院層級、醫師層級、病患層級之變數進行探討，實證結果為，影響醫師用藥決策行為是會受到醫師自身累積下來的門診經驗與對於藥品認知的用藥經驗為主。According to statistics from 1997 to 2005, overall drug use on mental illness continues to grow in Taiwan. The three largest and most widely used drugs on central nervous system are Antidepressants, Anxiolytics, Hypnotics& Sedatives. Interestingly, scholars find that physicians’ medication decisions are different even though the same illness is diagnosed. The study seeks to empirically explore the factors that affect the physicians’ prescription behavior by using the National Health Insurance Research Database provide by Taiwan Government. The study examines variables in hospital level, physician level, and patient level. The empirical results show that physicians’ prescription decisions are influenced by theiraccumulated experiences.