在初级保健中提供财务激励和处方行为
Olivia Bodnar1, Hugh Gravelle2, Nils Gutacker2
1DICE, Heinrich-Heine-University, Düsseldorf, Germany.
英格兰国家卫生服务部门的医生处方增加了3.1%的药物成本,这是由于更多的处方. 然而,配药实践规定了较小的包装,减轻了一些成本上.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 初级医疗保健的研究.
背景情况:
- 医疗保健系统经常限制医生开处方药.
- 担忧包括可能增加的,无效的或过于昂贵的处方.
- 了解医生开药的经济影响对于政策至关重要.
研究的目的:
- 估计医生发行权利对处方行为的影响.
- 分析对广泛 (分发与非分发实践) 和密集 (分发的患者比例) 边际的影响.
- 量化医生开销药品成本的财务后果.
主要方法:
- 利用了英国国家卫生服务 (NHS) 2011-2018年间的数据.
- 采用了计量经济学技术,包括普通最小平方 (OLS),平衡和两阶段最小平方 (2SLS).
- 对可观测和不可观测的实践特征进行控制,影响到分配的选择.
主要成果:
- 医生处方与每名患者药物成本增加3.1%有关.
- 这一增长是由于处方量更高,药物价格更昂贵而导致的.
- 处方实践倾向于处方较小的药物包,受补偿结构的影响.
结论:
- 医生发行药品的权利可能会导致药品总体支出增加.
- 报销模式可能会影响处方模式,例如包装大小.
- 随着在实践中开放的流行率的增加,处方行为转向非开放实践.
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