title: Effects of increased payment for ventilation tube insertion on decision making for paediatric otitis media with effusion.
abstract: OBJECTIVE
  The National Health Insurance (NHI) in Taiwan raised the physician fee for myringotomy with ventilation tube insertion (VTI) from $61.5 to $117.6 in July 2004. This study aimed to evaluate if the increased payment affected the decision making of physicians.
  
  
  METHODS
  This study is a retrospective analysis by using NHI databank in Taiwan. All children less than 12 years old who underwent VTI from 1 July 2003 to 30 June 2006 were included. Waiting time and case numbers before and after the increased VTI payment were compared. The waiting time between public and private hospitals was also examined.
  
  
  RESULTS
  From the 7408 cases evaluated, there was no difference in waiting time before and after the raise of VTI payment, and no difference within each year group. The case number of VTI increased significantly after the increase in VTI payment (P < 0.05). The waiting time of VTI performed in private hospitals was shorter than that in public hospitals (P = 0.0001).
  
  
  CONCLUSIONS
  The waiting time of VTI for children with otitis media with effusion (OME) has not been shortened after the increase in VTI payment. Waiting time in private hospitals is shorter than that in public hospitals. Increased payment for VTI has no effect on the physicians' decision making regarding to waiting time for children with OME in Taiwan.
authors: Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Mao-Che
authors: MC
authors: Wang
authors: Chung-Kai
authors: CK
authors: Huang
authors: Ying-Piao
authors: YP
authors: Wang
authors: Ching-Wen
authors: CW
authors: Chien
mesh_terms: D002648:Child; D016208:Databases, Factual; D003657:Decision Making; D005251:Fees, Medical; D006779:Hospitals, Public; D006788:Hospitals, Voluntary; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008876:Middle Ear Ventilation / Q000191:economics*; D009313:National Health Programs / Q000191:economics; D010034:Otitis Media with Effusion / Q000601:surgery*; D012189:Retrospective Studies; D013624:Taiwan