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Please use this identifier to cite or link to this item:
http://hdl.handle.net/2069/200
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| Title: | A Study of Factors Impacting the Expenditures for National Health Insurance Program in Taiwan |
| Authors: | Lin, Yen-Kuang |
| Keywords: | None provided |
| Issue Date: | 24-Sep-2009 |
| Abstract: | After the implementation of National Health Insurance (NHI) program in 1995, all
residents in Taiwan became universally insured and had the right of access to the health care
system. Nevertheless, according to statistics from Bureau of National Health Insurance
(2004), the expenditures of the NHI have exceeded its revenue since 1998. Despite the
persistent public debate on the fiscal conditions of NHI, little analysis has been done to
identify the individual factors that cause rising expenditures. A key component of many
recent health reform efforts is a system of risk-adjusted payments among health plans
(Newhouse, 1998; Iezzoni, 2003). To provide a complete and balanced assessment of the NHI,
it is necessary and pertinent to assess the consumers’ medical utilizations in the NHI program.
The purpose of this study is to identify the factors (i.e. demographic factors, diagnostic
factors, etc.) that may explain rising expenditures in NHI program. Furthermore, this study
will try to develop a risk adjustment model based on diagnostic and demographic information
from NHI dataset. The risk adjusters will then be evaluated for their predictability.
This study was conducted as a secondary data analysis. All of the data used in this study
were obtained from the National Health Insurance Research Database (NHIRD) provided by
National Health Research Institutes in Taiwan. All of the individuals in the NHIRD are
re-coded therefore they are anonymous. This study will first develop a Taiwanese version diagnostic base risk adjustment model by using one of the most popular risk adjustment
software on the market-diagnostic cost groups (DxCG) (Ellis & Ash, 1995; Iezzoni, 2003;
Richardson, 2006). Second, by utilizing multiple regression and logistic regression, risk
factors will be identified. Finally, ROC (receiver operating characteristic) curve analysis then
will be used to evaluate the predictability of the risk factors. The results of this study may
help produce health care reform for Taiwan toward a better system, as well as provide
knowledge of Taiwan’s health sector achievements and NHI experience for scholars and
policy experts in the United States. Taiwan’s Bureau of National Health Insurance (BNHI)
may utilize this information to formulate a new payment system, with a focus on efforts to
control health cost inflation. |
| URI: | http://hdl.handle.net/2069/200 |
| Appears in Collections: | Electronic Dissertation
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Files in This Item:
| File |
Description |
Size | Format |
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| Yen-Kuang Lin Cover & Abstract.pdf | | 16Kb | Adobe PDF | View/Open |
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