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標題: 從SID模式探討台灣某外國藥廠供給活動對中部醫學中心與區域醫院的醫師處方行為影響之研究
A Study of The Impacts of A Foreign Pharmaceutical Corporation's Supply Activities on The Physicians' Prescribing Behavior of Central Taiwan Medical Centers and Regional Hospitals From Supplier-Induced Demand Model
作者: 周銘正
Chou, Ming-Cheng
出版社: 高階經理人碩士在職專班
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本文旨在探討醫療市場中供給誘發需求(Supplier Induced Demand 以下簡稱SID)的現象。根據文獻發現,醫師與病患之間存在著代理理論關係,由於醫師本身具有醫療的決策權力,當醫療市場屬於高度競爭市場時,供給誘導需求情況更為明顯。國內隨著全民健康保險的開辦,在全民健保制度下醫師處方行為受全民健保財務的平衡以及藥廠供給的活動的影響。本文從SID模式及透過個案研究方式探討外國藥廠針對醫師進行的供給活動是否會產生誘發醫師處方需求增加的情況。並以醫院的管理政策為干擾變數探討醫師處方行為的干擾現象。結果發現在正常醫療環境下,病人健康狀態對醫師處方行為有輕度誘導現象,在醫師所得方面產生較明顯的誘導醫師處方行為現象,加入健保制度的卓越計畫則對醫師處方行為影響最大,其他的影響因素以休閒性學術活動參與及與業務代表關係最會影響醫師處方行為,訪談結論證明SID模式存在於外國藥廠供給活動和醫師處方行為之間係。而當醫院管理政策連結獎金制度時,醫師的處方態度相對變得保守。

The study explores the phenomenon of Supplier Induce Demand(SID) in medicine market. According to prior studies, physicians play the role of agency prescribing medicines for patients. Due to physicians have the power to prescribe, the situation of SID tend to be more significant when medical market under highly competitive tension. Since the National Health Insurance policy has been deployed in Taiwan, prescription behaviors by physicians were affected in terms of financial control by the policy as well as the supply activity by foreign pharmaceutical companies. A case study was taken to explore whether pharmaceutical company's supply activities indeed induces SID. Hospital management strategy is the moderating variable. The result shows that under normal medical environment, patient's real health condition slightly induces physicians' prescription behavior. Physicians' incomes affect prescription behavior more significantly. However, hospitals attend “hospital excellence program” brings the most significant influence in prescription behavior. The interviews conclusion demonstrates that SID model exists in the promotion activities which are held by foreign pharmaceutical corporations. Furthermore, when hospital management strategy links physician's prescription behavior with their incentives, physicians tend to be more conservative on prescriptions.
其他識別: U0005-2206200914472600
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