國人對全民健康保險部分負擔之意見調查

A Kap Study on Cost Sharing

楊志良(Chih-Liang Yaung) ； 蘇春蘭(Cheng-Lan Su) ； 傅千芬(Chien-Fen Fu)

《中華民國公共衛生學會雜誌》 9卷4期 (1989/12) Pp. 184-197

https://doi.org/10.6288/JNPHARC1989-09-04-02

摘要

本調查之目的在瞭解民眾對全民健康保險實施部分負擔之態度、對保險費及部分負擔之負擔能力以及「若實施部分負擔，參與健康保險之意願」，並探討其影響因素，以為規畫全民健康保險之參考。
本調查除以分層三段等機率抽樣法抽取2500名設籍在台灣地區（不含離島及山地）之成人樣本外，另由公保處及勞保局抽取822名及500名公、農保被保險人，以獲得足夠之公、農保樣本。本調查採郵寄結構式問卷收集資料，有效問卷回收率為36.2%(1383/3822)，各險別回收樣本與其該險別母羣體在性別及年齡別之分佈無顯著差異。
其結果摘要如下：
1.公、勞保樣本自認交保險費金額較實際繳納額高出甚多，而農保樣本則較相近。可能的原因是公勞保被保險人自己負擔的保險費係由政府或雇主自薪資中扣除，而非自行籌款繳交，故造成認知上的差距。
2.為使家戶內尚未投保者都能加入健康保險而同意每戶每月再繳1100元保險費者佔83.5%。
3.每次門診可負擔20%（60元）者佔89.7%；每次住院可部分負擔5%（1,100元）醫療費者佔86.1%；家戶每月部分負擔上限可為3000元者佔76.5%。
4.依所定之部分負擔條件，有78.8%的人贊成實施部分負擔方式為定率制。而若實施部分負擔，仍然願意參加全民保健者達84.1%，由此可見，全民健康保險採行部分負擔制度是為大多數民眾所接受。
5.年紀較輕者，教育程度較高者，在政府機關工作或為雇主者，家庭收入較高者、參加公保和有參加民間壽險者比非具上述特性者，其繳納保險費及部分負擔之能力亦較強。
6.教育程度較高者、在政府機關工作或為雇主者、家庭收入較高者、參加公保、有參加民間壽險者、繳納保險費及部分負擔能力較高者比非具上述特性者，其較贊成實施部分負擔，且參與健康保險之意願亦較強。

並列摘要

In order to understand the attitude of adults in Taiwan toward cost sharing, the affordability of premium and the intention to join national insurance even with cost sharing, a sample of 3822 adults were randomly selected among residents of Taiwan area those insured by Government Employees' Insurance (GEI) and Farmers Insurance (FI), who received a questionnaire survey by mail. After sending three mailings, the response rate is 36.2% (1383 among 3822). There were no significant differences in sex and age distribution between the respondents of GEI, FI and Labor Insurance (LI) and their populations.
Main results are as followings:
1. The reported insurance premium paid by GET and LI insured is much higher than what they acturally pay, but this is not so for farmers. The reason is the insured of GEI and LI pay their premium by a deduction on salary payment. On the other hand, farmers must pay their prmium out of pocket directly.
2. 83.5% of respondents agree to pay an additional monthly premium of NT$ 1,100 in order to allow their still uninsured family members to be covered by health insurance.
3. Regarding cost sharing, 89.7% of respondents reply that they are able to pay NT$60 per OPD (equal to 20% of the average cost of OPD's), 86.1% are able to pay NT$ 1,100 per hospitalization (equal to 5% of the average cost of hospitalizations) and 76.5% agree to set the ceiling of cost sharing at NT$ 3,000 per household per month.
4. 78.8% of respondents agree cost sharing of national health insurance, 68.6% of them regard coinsurance as the best method of cost sharing. Even with cost sharing, 84.1% of respondents still intend to join NHI.
5. Respondents of younger age, higher education, government employment, being an employer, having higher income and subscribing to life insurance axe reporting to be able to pay higher premium than their counterparts.
6. Those who are younger, more educated, and subscribe to life insurance are reporting to be able to pay larger shares of medical costs and more willing to join NHI even with cost sharing than their counterparts.

並列關鍵字

Health Insurance ； Cost Sharing Insurance