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Effects of financing smoking cessation outpatient services in Taiwan

机译：台湾资助戒烟门诊服务的效果

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Objective: This study assesses the effects of a 2005 increase in funding for smoking cessation services on provider participation, patient utilisation of smoking cessation services and cessation outcome at a six-month follow-up. Methods: Analyses are based on existing databases and on a follow-up study among smokers participating in the smoking cessation service. The effect of the policy is evaluated by comparing year 2004 (old policy) with year 2005 (new policy). The generalised estimating equations (GEE) method was conducted to examine the effects of increasing funding for smoking cessation services on monthly smoking cessation services provided per physician and yearly consultations received per patient. Logistic regression was used to examine the effects of increasing funding on smoking cessation outcome. Results: The study found the increased reimbursement rates and medication subsidies for smoking cessation to be positively related to the number of physicians enrolling in the programme (1841 in 2004 vs 3466 in 2005), the number of cessation consultations per month per physician (5.1 vs 14.6) and the number of cessation visits per year per patient (2.0 vs 2.5). Male providers and providers belonging to the private sector were found to offer more cessation consultations. The number of subjects receiving this counselling increased from 22 167 in 2004 to 109 508 in 2005. After adjusting for consumer and provider factors the likelihood of successful quitting among those counselled did not change. Overall, smokers who were older, had attempted to quit in the past year, had lower nicotine dependence, had gone to more smoking cessation service visits, had received consultations in the public sector and were seen by physicians delivering fewer consultations were more likely to have quit smoking at the six-month follow-up. Conclusions: Based on increases in physician enrolment and consultations and the increase in number of subjects receiving counselling and number of visits, the policy of increasing provider incentives and medication subsidies appears to have successfully promoted smoking cessation services.
机译：目的：这项研究评估了2005年增加的戒烟服务资金对提供者参与，患者对戒烟服务的利用以及戒烟结局的效果，为期六个月。方法：分析基于现有数据库和参与戒烟服务的吸烟者的后续研究。通过比较2004年（旧策略）和2005年（新策略）来评估该策略的效果。进行了广义估计方程（GEE）方法，以检查增加戒烟服务经费对每位医生每月提供的戒烟服务和每位患者每年接受咨询的影响。 Logistic回归用于检验增加资助对戒烟结果的影响。结果：该研究发现，戒烟的报销率和药物补贴的增加与该计划中注册的医生人数（2004年为1841名，2005年为3466名），每位医生每月戒烟咨询次数（5.1比14.6）和每年每位患者的戒烟就诊次数（2.0比2.5）。发现男性提供者和属于私营部门的提供者提供了更多的戒烟咨询。接受该咨询的受试者人数从2004年的22167增加到2005年的109508。在调整了消费者和提供者因素之后，被咨询者成功戒烟的可能性没有改变。总体而言，吸烟者年龄较大，在过去一年中曾尝试戒烟，对尼古丁的依赖程度较低，去戒烟服务的次数增加，在公共部门接受过咨询，并且看医生的咨询减少的可能性更大在六个月的随访中戒烟。结论：基于医师入学和咨询的增加以及接受咨询和就诊的人数的增加，增加提供者激励和药物补贴的政策似乎已成功地促进了戒烟服务。

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