本研究主要探討醫院科別在面對恐慌症病患之處方模式差異性的影響因素，藉由隱性知識、經驗累積以及制度環境等概念著手，瞭解醫院科別處方模式背後之管理意涵，並且將其延伸至專業決策者，舉凡會計師、律師、建築師等都與醫師一樣擁有其專業技術與能力，都可應用於本研究之研究成果。
　　本研究以臺灣醫學中心與區域醫院之科別為研究對象，觀察期間為2002年至2009年，並以追蹤資料模型(panel data)作為實證模型。將臨床指引的影響力、整體用藥經驗的多樣性、門診經驗的多樣性、恐慌症病患門診比例以及醫院權屬別等五個可能影響因素分別作為自變數，欲測試其與恐慌症處方模式多樣性之相關性。由資料的整理與比對後，顯示出醫院科別內的隱性知識較臨床指引較具影響力。另外，迴歸分析結果顯示，整體用藥經驗的多樣性以及恐慌症病患門診比例對於恐慌症病患的處方模式多樣性具正向的影響，而門診經驗的多樣性與醫院權屬別則沒有顯著的影響，本研究的實證結果將可提供專業決策者參考。

The main purpose of this study is to determine which factors influence prescription patterns of hospitals, especially in patients with panic disorders. The study will explore the management concepts of hospital’s specialty’s prescription behavior by tacit knowledge, institutional environment and experiential learning and then apply these concepts to professional decision making. For lawyers, accountants and architects as well as doctors, who have professional skills and abilities, all can apply the conclusions of this study on their professional domain.
This study chooses medical centers and local hospitals as the sample and the observational period is from 2002 to 2009. The model is penal data model. The independent variables are the influence of guidelines, the diversity of prescription experience, the diversity of clinical experience, the ratio of panic disorder patients in specialty and the authority ranking of the hospitals. According to the data gathered, the study finds that the influence of tacit knowledge is stronger than that of hospital guidelines. Furthermore, the empirical results strongly support that prescription experience and the ratio of panic disorder patients in specialty have a positive influence on the prescription patterns of hospital specialty in patients with panic disorders. The results of this study can be beneficial not only to medical organizations, but also the professional decision makers.

Alavi, M., & Leidner, D. E. 2001. Review: Knowledge management and knowledge management systems: Conceptual foundations and research issues. MIS Quarterly, 25(1): 107-136.
Brozek, J., Akl, E., Alonso-Coello, P., Lang, D., Jaeschke, R., Williams, J., Phillips, B., Lelgemann, M., Lethaby, A., & Bousquet, J. 2009. Grading quality of evidence and strength of recommendations in clinical practice guidelines. Allergy, 64(5): 669.
Cabana, M. D., Rand, C. S., Powe, N. R., Wu, A. W., Wilson, M. H., Abboud, P.-A. C., & Rubin, H. R. 1999. Why don't physicians follow clinical practice guidelines? The Journal of the American Medical Association, 282(15): 1458-1465.
Chantarujikapong, S. I., Scherrer, J. F., Xian, H., Eisen, S. A., Lyons, M. J., Goldberg, J., Tsuang, M., & True, W. R. 2001. A twin study of generalized anxiety disorder symptoms, panic disorder symptoms and post-traumatic stress disorder in men. Psychiatry Research, 103(2-3): 133.
Chauhan, D., & Mason, A. 2008. Factors affecting the uptake of new medicines in secondary care- A literature review. Journal of Clinical Pharmacy and Therapeutics, 33(4): 339-348.
Erden, Z., von Krogh, G., & Nonaka, I. 2008. The quality of group tacit knowledge. The Journal of Strategic Information Systems, 17(1): 4-18.
Fava, L., & Morton, J. 2009. Causal modeling of panic disorder theories. Clinical Psychology Review, 29(7): 623-637.
Frances, A., Miele, G. M., Widiger, T. A., Pincus, H. A., Manning, D., & Davis, W. W. 1993. The classification of panic disorders: From Freud to DSM-IV. Journal of Psychiatric Research, 27: 3-10.
Freeman, J. K., Barnes, J., Summers, K., & Szeinbach, S. 1993. Modeling physicians' prescribing decisions for patients with panic disorder. Journal of Health Care Marketing, 13(1): 34.
Gorman, J. M. 1997. The use of newer antidepressants for panic disorder. Discussion. The Journal of Clinical Psychiatry. Supplement, 58(14): 54-59.
Jeejeebhoy, F. M., Dorian, P., & Newman, D. M. 2000. Panic disorder and the heart: A cardiology perspective. Journal of Psychosomatic Research, 48(4): 393-403.
Jones, M. I., Greenfield, S. M., & Bradley, C. P. 2001. Prescribing new drugs: Qualitative study of influences on consultants and general practitioners. Bmj, 323(7309): 378.
Kirschenbaum, S. S. 1992. Influence of experience on information- Gathering strategies. Journal of Applied Psychology, 77(3): 343.
Lawrence, T. B., & Phillips, N. 2004. From Moby Dick to Free Willy: Macro-cultural discourse and institutional entrepreneurship in emerging institutional fields. Organization, 11(5): 689-711.
Leidner, D.E. (Ed.), 2000. Knowledge management and knowledge management systems. Journal of Strategic Information Systems Special Issue, vol. 9 (2-3), 101-261.
Leucht, S., Corves, C., Arbter, D., Engel, R. R., Li, C., & Davis, J. M. 2009. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. The Lancet, 373(9657): 31-41.
Lin, S.-J., Jan, K.-A., & Kao, J.-T. 2011. Colleague interactions and new drug prescribing behavior: The case of the initial prescription of antidepressants in Taiwanese medical centers. Social Science & Medicine, 73(8): 1208-1213.
Løwendahl, B. R., Revang, Ø., & Fosstenløkken, S. M. 2001. Knowledge and value creation in professional service firms: A framework for analysis. Human Rrelations, 54(7): 911-931.
Nonaka, I. 1994. A dynamic theory of organizational knowledge creation. Organization Science, 5(1): 14-37.
Reiman, E. M., Raichle, M. E., Butler, F. K., Herscovitch, P., & Robins, E. 1984. A focal brain abnormality in panic disorder, A severe form of anxiety. Nature, 310, 683-685
Schatzberg, A. F., & Ballenger, J. C. 1991. Decisions for the clinician in the treatment of panic disorder: When to treat, Which treatment to use, And how long to treat. Question and answer session. The Journal of Clinical Psychiatry, 52: 26-32.
Scott, W. R. 1987. The adolescence of institutional theory. Administrative Science Quarterly, 32(4): 493-511.
Shaughnessy, A., & d'Amico, F. 1994. Long-term experience with a program to improve prescription-writing skills. Family Medicine, 26(3): 168.
Ting, S., Kwok, S. K., Tsang, A. H., & Lee, W. 2010. Casesian: a knowledge-based system using statistical and experiential perspectives for improving the knowledge sharing in the medical prescription process. Expert Systems with Applications, 37(7): 5336-5346.
Von Nordenflycht, A. 2010. What is a professional service firm? Toward a theory and taxonomy of knowledge-intensive firms. Academy of Management Review, 35(1): 155-174.
Weissman, M. M., Klerman, G. L., Markowitz, J. S., & Ouellette, R. 1989. Suicidal ideation and suicide attempts in panic disorder and attacks. The New England Journal of Medicine, 321(18): 1209-1214
Wittchen, H.-U., & Essau, C. A. 1993. Epidemiology of panic disorder: progress and unresolved issues. Journal of Psychiatric Research, 27: 47-68.
Zaubler, T. S., & Katon, W. 1998. Panic disorder in the general medical setting. Journal of Psychosomatic Research, 44(1): 25-42.
石淦生, 羅紀琼, & 陳國樑. 1996. 公私立綜合醫院服務層面效率差異之探討.中華公共衛生雜誌, 15(5): 469-482.
蔡玉婷. 2003. 臺灣地區公私立醫院全民健保申報狀況分析.