Assessing the effects of drug price reduction policies on older people in Taiwan.

This study investigates the initial effects of the government's prescription drug price reduction policies on outpatient hypertension treatment for the elderly in Taiwan. The National Health Insurance scheme has taken a number of steps in recent years to reduce drug prices. The data used in the study comprises the medical records of approximately 137,000 hypertension patients aged 65 and above.

Changes in prescribing behaviors after implementing drug reimbursement rate reduction policy in Taiwan: implications for the medicare system.

Prescription drug costs are the fastest rising component of health care spending worldwide. To control drug costs, the Bureau of the National Health Insurance in Taiwan has taken a series of actions over the years to reduce drug reimbursement rates. The purpose of this study is to investigate changes in physicians' prescribing behaviors after initial implementation of drug reimbursement rate reduction policy in Taiwan.

Genetics of body mass stability and risk for chronic disease: a 28-year longitudinal study.

We examined the contributions of genetic and environmental factors to body mass index (BMI) over approximately 28 years. Participants were 693 male, predominantly middle-class, twins (355 monozygotic, 338 dizygotic) from the Vietnam Era Twin Registry. The phenotypic correlation between age 20 and age 48 BMI was 0.

Sensation seeking and HIV serodiscordant couples.

Studies have shown that a modest percentage of HIV serodiscordant couples continue to practice unprotected sex. This study examined sensation seeking and unprotected sex practices among this group. Objectives of the study were to describe unprotected sex practices among HIV serodiscordant couples and assess sensation seeking and unprotected sex with other psychosocial covariates.

Major issues in quality assessment and improvement of clinical hyperbaric services: an international perspective.

The continued rapid worldwide diffusion of clinical hyperbaric facilities has substantially increased interest in clinical quality assessment and service improvement. This paper examines major issues, perspectives, and methods integral to the measurement and improvement of the quality of care provided to hyperbaric patients and their relevance and applicability across different societies. Special focus is directed toward the importance of quality assessment and improvement of clinical hyperbaric care, multiple stakeholder perspectives on improved clinical quality, measurement of clinical outcomes of hyperbaric care, importance of facility accreditation, process improvement methods, and the future importance of quality management in clinical hyperbaric facilities.

Heritability of SF-36 among middle-age, middle-class, male-male twins.

Objective: We sought to examine the relative importance of genetic and environmental factors for the MOS SF-36; a widely used, valid, and reliable measure of health-related quality of life and to discuss incorporating genetic influences into health services research.

Data Sources: Data are from a nationally distributed, nonclinical cohort of 2928 middle age, middle-class, male-male twin members of the Vietnam Era Twin Registry.

Study Design: This was a secondary data analysis, classic twin heritability analysis.

The genetics of middle-age spread in middle-class males.

This study provides findings to assist in identifying factors that contribute to the current clinical and public health debate of the obesity epidemic. The study examined the genetics of adult-onset weight change in middle-aged male-male twins controlling for weight in early adulthood, lifetime history of tobacco use and alcohol dependence, and aimed to estimate the proportion of genetic factors that influence weight change between early adulthood and middle age in white middle-class males. The study was a classic longitudinal twin design and used Body Mass Index (BMI) for three waves of data collection from the Vietnam Era Twin Registry--induction physicals (approximately 1968), 1987 and 1990--or periods corresponding between young adulthood and middle age.

Does capitated contracting improve efficiency? Evidence from California hospitals.

This study examines the effect of capitated contracting on hospital efficiency to better understand strategies related to the recent financial crisis in the California health care market. Our findings indicate that less efficient hospitals are more likely to participate in capitated contracting. As a result, hospitals with capitated contracts are, on average, less efficient than hospitals without capitated contracts.

Changes in drug utilization following the outpatient prescription drug cost-sharing program--evidence from Taiwan's elderly.

This paper examines changes in drug utilization following Taiwan's newly implemented National Health Insurance (NHI) outpatient prescription drug cost-sharing program for persons over 65 years old. The study is a hospital outpatient prescription level analysis that adopts a pretest-posttest control group experiment design. Selected measures of outpatient prescription drug utilization are examined for cost-sharing and non cost-sharing groups in cost-sharing periods and pre cost-sharing periods.

Assessing the effect of Taiwan's outpatient prescription drug copayment policy in the elderly.

Objectives: This study uses variance cost analysis and regression analysis as tools for investigating the initial effects of Taiwan's outpatient prescription drug copayment program in the elderly. Under its new National Health Insurance program, Taiwan implemented a prescription drug cost-sharing program August 1, 1999. We compare an elderly population's prescription drug use after the policy was implemented with an elderly population's prescription drug use before the policy change to describe initial and general consequences of the drug cost-sharing program.

Hyperbaric oxygen technology: an overview of its applications, efficacy, and cost-effectiveness.

Objectives: To examine the growing evidence and the consensus in the medical community concerning the efficacy and cost-effectiveness of hyperbaric oxygen therapy (HBO2T) and to suggest future research areas to ensure the appropriate use of this technology.

Methods: A literature search of articles published between 1985 and 2000 was conducted using PubMed to describe the growth of HBO2T-related articles published over the past fifteen years. In addition, articles involving the qualitative synthesis of the efficacy and cost-effectiveness of HBO2T in thirteen major application areas were identified and compared with the changing view of the medical community toward the evidence of HBO2T.

The initial effects of Physician Compensation Programs in Taiwan hospitals: implications for staff model HMOs.

This paper examines whether a Physician Compensation Program (PCP), which was based on the responsibility centers system, improved departmental efficiency in a large Taiwan teaching hospital. PCPs in Taiwan may have implications for staff-model HMOs. Monthly financial data and related information for 58 departments in the 5 months following the introduction of the program (the PCP period) and the corresponding 5 months before the introduction of the program (the pre-PCP period) were provided by the case hospital.

Does the implementation of responsibility centers, total quality management, and physician fee programs improve hospital efficiency? Evidence from Taiwan hospitals.

Objectives: This study evaluates whether the implementation of various types of hospital-physician integration strategies, such as the responsibility centers system, total quality management, and physician fee programs, enhance efficiency for Taiwan hospitals. Because hospitals in Taiwan are structurally similar to staff-model HMOs, the study has implications beyond Taiwan.

Research Design: The Data Envelopment Analysis model is applied to measure hospital efficiency.