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• Main Authors: Han-Chou Huang, 黃漢洲
• Other Authors: Ming-Zhang Chen
• Format: Others
• Language: zh-TW
• Published: 2006
• Online Access: http://ndltd.ncl.edu.tw/handle/86382027344312671259

碩士 === 高雄醫學大學 === 藥學研究所碩士在職專班 === 94 === Abstract A new agreement between NHI, the National Unit of Pharmacist Associations and the National Unit of Physician Associations was consent to the definition and regulation strategy of physician-ownership pharmacy in 2005. This agreement has announced by NHI since 2006/1/1, which reimbursed pharmaceutical-care fee of clinics that run physician-ownership pharmacy at the same level of clinic pharmacy. It is estimated; the cost of this reimbursement reduction, by this agreement, will be more than two billion dollars in a year. In this study, we found, there are in the same level of pharmacist-practice conditions and legitimating position between physician-ownership pharmacies and NHI-contracted community pharmacies, which is also known as the pharmacist-ownership pharmacy. The pharmaceutical-care fee will not be reimbursed until the owner of pharmacy is a pharmacist, and also it will not be reimbursed until the certification of the ownership is complete. The goal of this study was exploring the cognition of the environmental change after SDMP policy and NHI’s regulation strategies of physician-ownership pharmacy. We included the methodologies of survey and qualitative study to investigated the manner of pharmacist of NHI-contracted community pharmacies in Taichung City. One hundred and seventy-three responded from 227 questionnaires, the response rate was 72.6 percent. The valid 126 questionnaires were analyzed in cross tabulation and chi-square test with SPSS ver. 12.0. We expected our study could evaluate the effectiveness of these implements launched by NHI. Through the pattern of irrational prescription-distribution, we can predict the outcome of equality and rationality of the reimbursement policy. This study focused on investigation and analysis the understanding of legislation responsibility in community primary-care pharmacist after the implements of “no reimbursement on irrational prescription distribution” and “certification of pharmacist ownership“, which were the associated implements of SDMP policy launched by NHI since 2005. The result showed, there was 67.6 percent of pharmacy certificated as pharmacist-ownership, and the pharmacy that we suspected as physician-ownership but still claimed pharmacist-ownership was 58 percent. This result suggested no advanced analysis before launching implement by NHI but a pressure response attitude to SDMP policy. This attitude was outward manipulated and far away from the core issue of public benefit. It is a dilemma between self-interest and rationality. We suggested initiating the capitation of pharmaceutical–care service to promote the quality of pharmacy service, by this implement, pharmacists would have their profession exploration. And this will be the cornerstone of health policies such as SDMP. Key words: physician-ownership pharmacy, irrational prescription distribution, prescription-releasing fee, daily medication-package fee, pharmaceutical-care fee