影響精神科醫師用藥決策之因素

Abstract

本研究以WHO頒布之每日定義劑量（DDD）為用藥標準，針對醫生處方之劑量是否符合標準進行研究。使用資料庫2011年1月至2011年12月之資料，以量化的方式探究19家醫學中心精神科醫師之處方行為影響因素。迴歸結果顯示，醫生年紀、醫生所處科別、醫院同事、醫院權屬別及醫生看診多樣性為影響醫生處方行為之因素。精神科醫師相較於內科、神經科、心臟血管內科醫師而言，較常出現用藥超標的行為，劑量超標程度也較高。醫生年紀及病患平均年紀對醫生用藥超標行為有顯著負向影響；醫院同事用藥超標比例則有正向的影響。若醫生處在用藥超標較嚴重之科別，則會導致其較常出現用藥超標的行為，劑量超標程度也較高。

This study was conducted to examine the compliance of physician-prescribed doses with the WHO Defined Daily Dose (DDD) as a medication standard. Data from January 2011 to December 2011 were used to quantify the factors influencing the prescribing behavior of psychiatrists at 19 medical centers.The regression results showed that physician age, physician specialty, hospital colleagues, hospital ownership, and experience diversity are factors that influence physician prescribing behaviors.Psychiatrists were more likely to overdose than physicians in internal medicine, neurology, and cardiovascular medicine, and the degree of overdose was also higher. Physician age and average patient age had a significant negative effect on physician overdose behavior; the percentage of overdose by hospital colleagues had a positive effect. If a physician is in a department with more severe overdose, he or she will have a higher incidence of overdose behavior and a higher degree of overdose.