The Study of Effects on Medication Expenses Trend for Primary Care Clinics of Central Taiwan under the National Health Insurance

• Main Author: 顏志偉
• Other Authors: Jiunn-Wen Wang
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/70736612613889095685

碩士 === 中山醫學大學 === 醫學研究所 === 93 === After implementation of national health insurance (NHI) from 1995, the fee-for-service payment method was adopted and caused high utilization rate and medical expenditure growing, therefore, the financial deficit has appeared since 1998 as medication cost increasing rapidly. Medicine cost has taken up 25% of the total medical expense in the NHI in Taiwan, much higher than that the other countries. As a result, Department of Health (DOH) and Bureau of National Health Insurance (BNHI) have adopted various policies to control drug expenditures. The purpose of this study is aimed at analyzing drug policies and the growing medication expenditures. The outpatient medical expenditure data file was employed to compare the changes in medical claims among western primary clinics of central Taiwan from January 2000 to December 2002. The adjustment of medication price, global budget payment system in western primary clinics and reducing the proportion of cost on daily medication was analyzed in this study. The result shows that the total medication expenditure claimed from western primary clinics of central Taiwan dropped sharply. The area of cities is a significant factor influencing the results of medication expenditure. At the type of specialist, medication expenditure claimed from general practitioner mostly. According to the trend of expenditure claims, we know that the adjustment of medication price is significantly influencing the results of the medication expenses trend for primary care clinics, the reducing the proportion of cost on daily medication is significantly influencing the results of medication expenditure controls. Average visits per physician, days of each prescription, medication fee per day and medication per visit are significantly influencing the reducing the proportion of cost on daily medication. At the initial impacts of the global budget payment system, average of medication expenditure per physician decreased. At the area of cities, medication expenditure also decreased. The control of medication expenditure was indeed influenced by the implementation of the global budget payment system. This study suggests that DOH and BNHI need to watch about primary care medication expenditure shifting, analyzing the drugs reimbursing content and modifying the payment prices of drugs. Hopefully to control the medication expenditure and reduce the waste of medical resources.