Does pediatric specialty training matter?

• Main Authors: Chiao-Lin Lee, 李巧玲
• Other Authors: Tung-Liang Chiang
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/90017708737189664023

碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 103 === Aim: Asthma is one of the most common diseases of children, but it is difficult to be diagnosed. Previous researches found that the recognition and care of asthma were different between physicians. The quality of care was affected though. Because some healthcare providers of children are not pediatrics, so we would like to know if the care quality of pediatrics is different with other physicians since they had complete training of pediatrics. Methods: The data was provided by the Ministry of Health and Welfare. We extraced the cliam data of respiratory diseases of children aged 1-11 years in 2010 to compare the differences of diagnosis quality between pediatrics and non-pediatrics. Results: 1.77 percent of children aged 1-11 years were new patients in 2010. The sensitivity of asthma diagnosis of pediatrics was 0.5127, non-pediatrics was 0.2655. Pediatrics had higher false positive rate than non-pediatrics. Asthma was difficult to be diagnosed for children with more healthcare usage and lower continuity of care. Physicians with more outpatient services, more asthma patients, and more patients of pay-for-performance program of asthma, both the sensitivity and fale positive rate of diagnosis of asthma increased. Pediatrics intended to join the pay-for-performance program. The difference of the ratio of enrolled patients of pediatrics and non-deiatrics was not significant. Pediatarics were intended to include the patients with high continuity of care to the pay-for-performance program. Conclusions: The asthma diagnosis quality was influenced by many factors with different level of influences among physicians with different speciality tranings. Pediatrics had higher sensitivity of asthma diagnosis. They intended to make the asthma diagnosis, therefore had higher false positive rate than non-pediatrics. Higher amount of service of physicians was helpful to the asthma diagnosis quality, so did the continuity of care. Physicians joined the program of pay-for-performance had better diagnosis quality.