摘要:医生的处方行为在医疗过程扮演着至关重要的角色,但在处方开具过程中,经常会发生医生多重用药、开药种类过多等问题,这类处方行为会导致用药多样性的增加,可能会导致诸如抗生素药物滥用等负面影响。如何降低上述处方开具行为的负面影响是医疗管理中的一个重要议题。医疗智慧化技术的发展,尤其是辅助诊疗系统在医疗系统的应用,为缓解上述负面效应提供了一个有希望的途径。然而,辅助诊疗系统能否降低医生开具处方时的用药多样性,从而缓解医生多重用药等负面效应,这一问题尚未得到系统的实证考察。本文利用从我国某省会城市卫健委获取的相关数据,通过构建多期DID模型,实证探讨了辅助诊疗系统采用对医生处方用药多样性与患者医疗成本的影响。研究发现,辅助诊疗系统的采用减少了医生处方的用药多样性,医疗机构等次在辅助诊疗系统对医生处方行为的影响中起调节作用。研究结果从专业服务提供者的视角为智慧化技术的实施效果提供了解释,弥补了现有文献中对医生处方行为研究的不足。
Abstract: Physicians' prescribing behavior plays a crucial role in the medical process. However, during the prescription process, issues such as polypharmacy and excessive drug variety often occur. These prescribing behaviors lead to increased medication diversity, which may result in negative consequences such as antibiotic misuse. Reducing the negative impact of such prescribing behaviors is an important issue in healthcare management. The development of smart healthcare technologies, particularly the application of Clinical Decision Support Systems(CDSS) in healthcare systems, provides a promising approach to alleviate these negative effects. However, whether CDSS can reduce medication diversity in prescriptions and thus mitigate the negative effects of polypharmacy has not been systematically empirically investigated. This study uses data obtained from the Health Commission of a provincial capital city in China, constructing a multi-period DID model to empirically explore the impact of CDSS adoption on physicians' prescription medication diversity and patients' medical costs. The study finds that the adoption of CDSS reduces the diversity of physicians' prescriptions. The level of medical institutions moderates the impact of CDSS on physicians' prescribing behavior. The research results provide an explanation for the implementation effects of smart technology from the perspective of professional service providers, filling gaps in the existing literature on physicians' prescribing behavior.