政大機構典藏-National Chengchi University Institutional Repository(NCCUR):Item 140.119/59108
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    Please use this identifier to cite or link to this item: https://nccur.lib.nccu.edu.tw/handle/140.119/59108


    Title: 加倍自然產支付能否降低剖腹產比例？
    Other Titles: Can Doubling the Payment for Vaginal Delivery Lower the Cesarean Section Rate in Taiwan?
    Authors: 韓幸紋;連賢明
    Contributors: 政大財政系
    Keywords: 剖腹產;支付標準;誘發性需求
    Cesarean section;Medical payment;Induced demand
    Date: 2010-09
    Issue Date: 2013-08-26 11:39:19 (UTC+8)
    Abstract: 目標：基於台灣居高不下的剖腹產率，健保局於2005年5月將自然產支付點數加倍和剖腹產點數一致，期望藉由加倍自然產給付來降低剖腹產率。本研究分析該給付調整是否達成其政策目的。方法：本文利用2003至2007年健保資料庫頭胎生產案件，估計上使用邏輯機率模型(logistic model)、固定效果(fixed-effect)和多層次(multi-level model)模型來分析給付調整對降低剖腹產利用的影響，並觀察長(2003-4 v.s 2006-7)、短(2004 v.s 2006)期有無不同效果。此外，本文將剖腹產進一步依原因區分為一般性剖腹(scheduled cesarean sections)及緊急剖腹(emergency
    cesarean sections)兩種，觀察政策效果是否依剖腹緊急程度而有不同。結果：在控制產婦年紀、醫師接生時點，和醫師特性的考量等因素下，各種模型均顯示提高自然產給付對頭胎樣本不論是短期或長期時，一般性和緊急剖腹產率上皆無顯著變化。結論：這結果隱含醫師接生所得可能不是決定生產方式的主要因素，健保局需考慮其他方法來降低剖腹產。
    Relation: 臺灣公共衛生雜誌, 29(3), 213-225
    Data Type: article
    Appears in Collections:[Department of Public Finance] Periodical Articles

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