Effects of Doctors’ Selection of Patients Under Quality Incentives －A case Study of Diabetes Payments

• Main Authors: Hsuan-Ching Wang, 王暄晴
• Other Authors: Peng- Teng Chang
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/91768373513191873287

碩士 === 東海大學 === 工業工程與經營資訊學系 === 96 === In order to correct medical behaviors and improve the efficiency of diabetes care health service, the Taiwan Bureau of National Health Insurance (BNHI) has introduced the disease management since 2001. Until 2007,to strength the clinical outcome, the Bureau of National Health Insurance (BNHI) introduced a pay for performance. In Taiwan, there has been no study about patient selection for specific disease yet. we need more studies to understand the patient selection of hospital behaviors . Therefore, the objectives of this study are to evaluate effects of Doctors’ selection of patients under quality incentives, to analyze factors influencing patient selection. The study applied “before-after comparison design” for secondary data analysis based on claim data and web-site patient registry data provided by BNHI (2006,2007). Patients who have registry data in 2006 will be considered as control group. We analyzed the data by Structural Equation Modeling (SEM,for path analysis). The results showed that there were quality incentives implementation, hospital characteristics, and doctor characteristics all significantly related to patient selection. In 2006, patient’s clinical indicators were age, HbA1C, LDL. In 2007, patient’s clinical indicators were SBP, EBP, HbA1C, LDL and TG.