制度環境與經驗對專業決策之影響
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2013
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本研究主要探討醫院科別在面對恐慌症病患之處方模式差異性的影響因素，藉由隱性知識、經驗累積以及制度環境等概念著手，瞭解醫院科別處方模式背後之管理意涵，並且將其延伸至專業決策者，舉凡會計師、律師、建築師等都與醫師一樣擁有其專業技術與能力，都可應用於本研究之研究成果。
本研究以臺灣醫學中心與區域醫院之科別為研究對象，觀察期間為2002年至2009年，並以追蹤資料模型(panel data)作為實證模型。將臨床指引的影響力、整體用藥經驗的多樣性、門診經驗的多樣性、恐慌症病患門診比例以及醫院權屬別等五個可能影響因素分別作為自變數，欲測試其與恐慌症處方模式多樣性之相關性。由資料的整理與比對後，顯示出醫院科別內的隱性知識較臨床指引較具影響力。另外，迴歸分析結果顯示，整體用藥經驗的多樣性以及恐慌症病患門診比例對於恐慌症病患的處方模式多樣性具正向的影響，而門診經驗的多樣性與醫院權屬別則沒有顯著的影響，本研究的實證結果將可提供專業決策者參考。
The main purpose of this study is to determine which factors influence prescription patterns of hospitals, especially in patients with panic disorders. The study will explore the management concepts of hospital’s specialty’s prescription behavior by tacit knowledge, institutional environment and experiential learning and then apply these concepts to professional decision making. For lawyers, accountants and architects as well as doctors, who have professional skills and abilities, all can apply the conclusions of this study on their professional domain. This study chooses medical centers and local hospitals as the sample and the observational period is from 2002 to 2009. The model is penal data model. The independent variables are the influence of guidelines, the diversity of prescription experience, the diversity of clinical experience, the ratio of panic disorder patients in specialty and the authority ranking of the hospitals. According to the data gathered, the study finds that the influence of tacit knowledge is stronger than that of hospital guidelines. Furthermore, the empirical results strongly support that prescription experience and the ratio of panic disorder patients in specialty have a positive influence on the prescription patterns of hospital specialty in patients with panic disorders. The results of this study can be beneficial not only to medical organizations, but also the professional decision makers.
The main purpose of this study is to determine which factors influence prescription patterns of hospitals, especially in patients with panic disorders. The study will explore the management concepts of hospital’s specialty’s prescription behavior by tacit knowledge, institutional environment and experiential learning and then apply these concepts to professional decision making. For lawyers, accountants and architects as well as doctors, who have professional skills and abilities, all can apply the conclusions of this study on their professional domain. This study chooses medical centers and local hospitals as the sample and the observational period is from 2002 to 2009. The model is penal data model. The independent variables are the influence of guidelines, the diversity of prescription experience, the diversity of clinical experience, the ratio of panic disorder patients in specialty and the authority ranking of the hospitals. According to the data gathered, the study finds that the influence of tacit knowledge is stronger than that of hospital guidelines. Furthermore, the empirical results strongly support that prescription experience and the ratio of panic disorder patients in specialty have a positive influence on the prescription patterns of hospital specialty in patients with panic disorders. The results of this study can be beneficial not only to medical organizations, but also the professional decision makers.
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恐慌症處方模式, 專業決策, 制度環境, 經驗, panic disorder, the prescription patterns, professional decision makers, Institutional environment, experiential learning