摘要
最近幾年以來台灣的人口平均壽命因為醫療進步及環境衛生的改善等因素大幅延長，主要的死因轉變為老年疾病或是慢性病，需要長期的追蹤與治療，造成醫療費用也將隨人口老化而逐步上升，將來有可能對我國全民健康保險的財務產生重大影響。因為人口結構的老化、經濟的發展、健康保險的擴張，醫療資源耗用的成長，以及醫藥科技創新等因素，造成醫療保健支出費用逐年攀升。全民健康保險( National Health Insurance ，NHI )在性質上屬於社會保險之一，目的是為了促進民眾就醫之可近性、減輕民眾就醫的財務障礙，但是目前我國的全民健保卻面臨了與其他OECD(Organization for Economic Cooperation and Development)國家相同的難題，即醫療支出費用高漲的問題。目前健保局實施「總額管制」來控制醫療服務費用給付總金額，逐步實施論病例計酬制度，期望能藉由加強醫院成本的意識，來達成抑制醫療費用上漲的目的。本研究利用的資料來源為國民健康局「全民健康保險研究資料庫」，期間為1996 年至2007年住院與門診DRGs（Diagnosis Related Groups）費用申報資料。而研究重點主要在於探討人口老化對於DRGs醫療支付的影響，及2008年至2033年DRGs醫療費用的推估，並討論推估結果代表的意義。研究發現與人口老化相關的DRGs醫療費用將隨時間直線上升，與我國人口老化的趨勢頗為一致，如此醫療費用的上升必定對我國的全民健康保險財務造成重大影響。
並列摘要
Recently, according to information from Taiwan’s National Health Insurance database, the medical expenditure on illness of elderly and chronic diseases has increased significantly because of an aging population. Because of the aging population structure、the economical development、the expansion of health insurance、the consumption increases of medical resources and the innovation of medical technology cause the healthcare disbursement to climb year by year.National health insurance (NHI) is one of social security in the nature，the purpose is to promote the populace to see a doctor the accessibility and to reduce the financial barrier which the populace to see a doctor.The present our country's National health insurance (NHI) has faced with the OECD (Organization for Economic Cooperation and Development) country the same as difficult problem－the medical expenditure upward question.Currently,the BNHI (the Bureau of NHI ) implements “total amount control"to control the total medical claimed payments of each medical healthcare provider.In this research we attempt to use Taiwan National Health Insurance database from 1996 to 2007 to investigate the medical expenditure for DRGs（Diagnosis Related Groups.In this research we are interested in investigating the impact of aging on DRGs expenditures and estimation of DRGs expenditure in the future. The estimation showsthat the result of the DRGs expenditure due to illness of elderly and chronic diseases grows linearly with time. This effect is consistent with the trend of an increase of numbers in elderly. It implies that an aging population will lead to a significant financial impact on Taiwan’s national health insurance program.