不同所得水準之病患對於醫院健保門診部分負擔上升之反應-以就醫場所選擇為例

Patients of different income levels of the copayment of hospital out-patient health care increased reaction -Evidence from site selection for medical treatment

邱瑋婷(Wei-Ting Chiu)

指導教授 ： 陳計良

中原大學/商學院/會計研究所/碩士(2011年)

https://doi.org/10.6840/CYCU.2011.00241

摘要

從民國八十四年全民健康保險開辦以來，民眾就醫的成本大幅下降。但隨著時間的流逝，民眾可能會因為高齡化或者是就醫成本的低廉而導致就醫頻率相對提高，引起道德危機，亦引起中央健康保險局的財務危機。中央健康保險局也多次調整部分負擔的費率，部分負擔之目的是希望調高部分負擔使民眾能分級就醫，不浪費醫療資源。而本研究之目的為部份負擔的調高對於不同所得水準之民眾在一般門診就醫時選擇就醫地點時的影響。

本研究以中央健康保險局委託國家衛生研究院建置的抽樣歸人檔為樣本來源，樣本總筆數為552,249筆。本研究之實證結果指出主要變數（policyi）在低所得水準、中所得水準以及高所得水準之民眾在2005年一般門診部份負擔調整後，其民眾改變至大醫院就醫之機率皆有明顯降低，意指2005年一般門診部份負擔調整後使各所得水準之民眾有達到分級就醫之政策目的，另敏感性分析之結果亦指出相同之結論，故使本研究之結果更臻穩健。

關鍵字

全民健康保險 ； 部份負擔 ； 醫療利用 ； 所得水準

並列摘要

National Health Insurance（NHI）was started from 1995. The cost of medical treatment significantly reduced. But as time goes by, people may seek medical treatment because of aging or low cost medical treatment which led to a corresponding increase in frequency which is called moral crisis. Moral crisis has also caused financial crisis of the Bureau of National Health Insurance. NHI also adjusted the rates of copayment several times some. The purpose of increasing the rates of copayment is making people can be graded for medical treatment, and don’t waste medical resources. The purpose of this study is that the effect of copayment raising on the people with different income levels chooses the site selection for the general outpatient medical treatment.

In this study, the databases derived from the Bureau of National Health Insurance, and maintained by the National Health Research Institutes. Total amount in the sample is 552,249. Empirical results of this study point out after the copayment getting more in 2005, the policyi in the each income levels, people change their site selection for the general outpatient medical treatment, the probility of large hospitals have significantly reduced. It means the policy makes people with different income levels take medical classification. The results of sensitivity analysis is similar to the empirical results.Our result is more steady.

並列關鍵字

NHI ； Copayment Policy ； Medcal Use

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