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    題名: 同儕效果對醫師處方行為之影響—以精神分裂症為例
    Is doctor`s prescribing behavior affected by peer effect? Evidence from Schizophrenia treatment.
    作者: 龔芳玉
    Kung, Fangyu
    貢獻者: 連賢明
    龔芳玉
    Kung, Fangyu
    關鍵詞: 同儕效果
    處方行為
    精神分裂症
    peer effect
    prescribing behavior
    schizophrenia
    日期: 2007
    上傳時間: 2009-09-18 11:01:02 (UTC+8)
    摘要: 本文透過健保資料精神疾病歸人檔,擷取1997~2004年門診中之精神分裂症患者,針對其中701位精神科專科醫師對患者的精神分裂症一、二代藥物之處方行為進行研究。迴歸結果顯示醫師性別對處方選擇沒有特別的影響,同儕效果在相當程度上對醫師產生蠻大的改變。藥價調整前,教學醫院的醫師會受到周遭醫師開藥行為影響,其受影響程度大於非教學醫院。藥價調整後,教學醫院醫師幾乎不受同儕影響,相對的,非教學醫院比起藥價變動前,更易受到同僚行為而改變其行為。不過大體而言當周遭醫師容易開新藥(舊藥)時,醫師本身也會較容易開第二代(第一代)藥物。
    參考文獻: 英文部分
    Arcidiacono and Nicholson S. (2005), “Peer effects in medical school”, Journal of Public Economics, 89 (2) :327–350.
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    Bordley, W.C., Chelminski, A., Margolis, P.A., Kraus, R., Szilagyi, P.G.., Vann, J.J. (2000), “The effect of audit and feedback on immunization delivery: A systematic review “, American Journal of Preventive Medicine, 18(4) : 343-350.
    Coleman, J.S., Campbell, E.Q., Hobson, C., McPartland, J., Mood, A., Weinfield, F.D., York, R.(1966),《Equality of educational opportunity》Government Printing Office, Washington, DC.
    Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.(1995), American Psychiatric Association, Washington, D.C.
    Epple, D., Romano, R.(1998), “Competition between private and public schools, vouchers, and peer group effects”, American Economic Review, 88:33–62.
    Fidler, H., Lockyer, J.M., Toews J., Violato, C. (1999), “Changing physicians’ practices: The effect of individual feedback”, Academic Medicine,74:702-714.
    Gaviria, A., and Raphael, S. (2001), “School-based peer effects and juvenile behavior”, Review of Economics and Statistics, 83:257–268.
    Goodpastor, W. A., & Montoya, I. D.(1996), “ Motivating physician behavior change: social influence versus financial contingencies”, International Journal of Health Care Quality Assurance, 9(6): 4-9.
    Hillman, A.L, Ripley, K., Goldfard, N., Nuamah, I., Weiner, J., Lusk, E. (1998) , “Physician financial incentives and feedback:Failure to increase cancer screening in Medicaid managed care”, American Journal of Public Health, 88:1699-1701.
    Kang, C.(2007), “Classroom peer effects and academic achievement: Quasi-randomization evidence from South Korea” , Journal of Urban Economics, 61:458-495.
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    McEwan, P.J. (2003), “Peer effect on student achievement: Evidence from
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    中文書目
    蕭文主編,Linda Seligman 原著(1995),《心理異常診斷與治療》,台北:五南圖書,頁334-335。
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    周勵志審訂,主婦友社編著,保崎秀夫監修(2005),《精神疾病檢測百科》,台北:三采文化,頁179-183。
    林式穀(2005),《精神藥物手冊》,台北:合記,頁34-37。
    莊明敏主持(1995),《精神病患醫療服務體系之檢討》,行政院研究發展考核委員會編印,頁7-13。
    曾文星、徐靜(1994),《現代精神醫學》,台北:水牛,頁245-248。
    張明永主持(2003),《全民健康保險精神分裂症病患用藥型態分析》,行政院衛署九十二年度委託研究計畫,計畫編號DOH92-NH-1025。
    中文期刊及論文
    Huang et al.(2002), “Reduction of Laboratory Expenditure by Periodic Peer Comparison Feedback to Physicians:Cost-benefit and Durability of Effect”, 臺灣家庭醫學雜誌,12卷,4期,頁168-178。
    吳培滋(2006),影響醫學中心醫師開立慢性病連續處方箋之因素探討,長榮大學醫務管理學研究所碩士論文。
    林寶鳳(1995),提供藥價及醫師檔案分析資訊對醫師處方行為影響之類實驗性研究,國立陽明大學衛生福利研究所碩士論文。
    陳端容、鍾國彪、吳麗竹、曾靜瑤、張金堅(2006),「同儕資訊回饋與內科醫師開立TG檢驗次數之關係:一個探索性研究」,臺灣公共衛生雜誌,25卷,1期,頁26-36。
    喻小珠、黃凱琳、王世叡、趙坤郁、陳富滿、黃靜宜(2000),「同儕間藥品處方的回饋對多重用藥的影響,四個月的觀察」,The Changhua Journal of Medicine,6卷,1期,頁37-44。
    董旭英、王文玲(2007),「國高中生依附父母、接觸偏差同儕、傳統價值觀念與偏差行爲的關聯性之差異性研究」,犯罪學期刊,10卷,2期,頁29-48。
    楊雪華、陳端榮、李蘭、柯姍如(2003),「雙親和同儕團體對高中生吸菸行為的影響」,醫學教育,7卷,2期,頁128-139。
    劉育昇、于若蓉(2007),「工作團隊內的同儕效果:台灣房屋仲介經紀人的分析」,經濟論文叢刊,35卷,2期,頁183-212。
    描述: 碩士
    國立政治大學
    財政研究所
    95255022
    96
    資料來源: http://thesis.lib.nccu.edu.tw/record/#G0095255022
    資料類型: thesis
    顯示於類別:[財政學系] 學位論文

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