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頁籤選單縮合
題名 | Reduction of Laboratory Expenditure by Periodic Peer Comparison Feedback to Physicians: Cost-Benefit and Durability of Effect=醫師藉由周期性的同儕比較回饋而減少檢驗醫療花費--經濟效益與效果持久度之研究 |
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作者 | 黃淑蜂; 喻小珠; 王士叡; 黃凱琳; 趙坤郁; | 書刊名 | 臺灣家庭醫學雜誌 |
卷期 | 12:4 2002.12[民91.12] |
頁次 | 頁168-178 |
分類號 | 419.45 |
關鍵詞 | 同儕比較; 回饋; 醫療花費; 檢驗項次; Feedback; Diagnostic tests; Health expenditures; Intervention studies; Cost-benefit analysis; |
語文 | 英文(English) |
中文摘要 | 日益上升的醫療花費已經成為許多國家的沉重負擔,而節省檢驗費用是我們可以努力的方向。本研究要評估醫師藉由同儕的比較回饋,是否可以減少不必要的檢驗項次與醫療花費。我們蒐集臺灣某醫學中心由1998年一月到2000年十二月共計三年的時間,13位家庭醫師共225,675個病人門診數為實驗組,在1999年一月至十二月接受同儕的比較與回饋,43位內科醫師共1464,748個病人門診數為對照組。結果顯示兩組每張處方的平均檢驗項次在1999年均比1998年少(p<0.01),但實驗組有更顯著的差異(p<0.0001)。1999年平均每張處方的醫療花費在接受回饋的實驗組為下降(p<0.01),但在對照組卻是增加(p<0.01)。若將2000年每張處方的檢驗項次及醫療花費與1999年作比較,兩組均有下降(p<0.01),但是實驗組有更為顯著的下降(p<0.0001)。回饋的費用為US$1,588.6元,藉由減少開立檢驗項次可以省下US$184,669.5元。 本研究結果顯示,周期性的同儕比較回饋可以改變醫師開立檢驗的行為並且符合經濟效益,而其效力至少可以維持一年。 |
英文摘要 | To investigate the cost-benefit and durability of feedback strategy to physicians for reducing unnecessary laboratory tests and expenditure. A prospective quasi-experimental trial with concurrent comparison group and historical comparison. A medical center in Taiwan. A total of 225,675 patient-visits for 13 family physicians and 1,464,748 patient-visits for the 43 enrolled internists, conducted from January 1998 to December 2000. Family physicians received monthly feedback in year 1999 on their use of laboratory tests of the preceding month. Internists (comparison group) received no intervention. Mean number of tests and laboratory expenditure per prescription from 1998 to 2000. When compared with prescriptions in year 1998, mean number of tests per prescription in 1999 decreased in both groups (p<0.01) with a more marked decrease in the intervention group (p<0.0001), and mean laboratory expenditure per prescription in 1999 decreased in the feedback group (p<0.01), but increased in the comparison group (p<0.01). When compared with prescriptions in year 1999, mean number of tests and laboratory expenditure per prescription in 2000 decreased in both groups (p<0.01) with a more marked decrease in the intervention group (p<0.0001). The cost of feedback was US$1,588.6. Total saving from reduced tests was US$184,669.5. Periodic peer comparison feedback to physicians on their test-ordering behavior to reduce laboratory expenditure is cost-effective. The effectiveness can persist for at least 1 year after the end of feedback intervention. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。