台灣人口結構與健保醫療費用變化情形

Change in Population Structure and Health Insurance Medical Expenditures in Taiwan

劉瑞卿(Liu Rui Qing)

指導教授 ： 張明正

亞洲大學/健康學院/健康管理研究所/碩士(2007年)

摘要

本研究係以1996、2000、 2005年間全民健保資料庫，並配合「直接標準化」探討人口結構對健保醫療費用變化的影響，同時對未來人口成長及其結構變化，加以探討。
分析結果顯示，人口老化對台灣醫療費用之增加，扮演重要的角色，尤其對未來人口負成長階時期有極深遠的影響。在另一方面，台灣老年性別比例仍然是男性多於女性的不正常情況.'到了2015年，女性多於男性將漸漸變成正常。同時，目前的65歲和65歲以上老人的醫療費用平均值，男性高於女性。然而，到了2025年，可推估出女性醫療費用超過男性，因此，未來性別結構的改變，會對醫療費用之增加產生衝擊。
未來台灣人口負成長，醫療費用卻快速膨脹，因此健保局對健保資源應妥善規劃，有效利用;並應加強人民的健康知識及健康促進，減少就醫人數，使健保財務不至於陷入窘境。

關鍵字

人口結構 ； 人口老化 ； 直接標準化

並列摘要

Using Taiwan' National Health Insurance research data base in 1996,2000,and 2005,this study applies "Direct Standardization Method" to examine the impact of change in population structure on the increase in medical expenditures. In the meantime, such an influence is also extended to future situation in Taiwan.
The analytical results show that aging of population has played an important role in the increase of medical expenditures in Taiwan and will have much more influence in the future, especially in the stage of negative population growth. On the other hand, the sex ratio of elderly in Taiwan is still abnormal (more males than females) and will be becoming normal in 2015 (more females than males).Also, the average medical expenditures for the elderly 65 and older is higher for males than females at the current situation. However, it is estimated that females' average medical expenditures will exceed males' in 2025. Therefore, change in sex structure in the future will also have an impact on the increase in medical expenditures.
Due to negative population growth in Taiwan and the continuos rising of medical expenditures in the future,Bureau of Taiwan National Health Insurance should prepare itself for Health Insurance resources and make the most efficient use of the medical expenditures. Also,the Bureau should emphasize both the knowledge of health and strengthen health promotion." So,lessening curing population will make it possible to avoid lack of Health Insurance finances.

並列關鍵字

population structure ； aging population ； direct standardization method

參考文獻

江宏哲、楊志良、錢慶文、王俊文、葉德豐 (2005)總額支付制度協商醫療費用成長率之實證研究。中華民國醫師公會全國聯合會委託研究計劃。

Barreto, S. M., A. Kalache, and L. Giatti. (2006). Does health status explain gender dissimilarity in health care use among older adults?. Cadernos de Saude Publica, 22(2), 347-355.

Coale, A. J. (1974). The history of the human population.

Scientific American. 23 1(3), 40-51.

Cox C. (1986). Physician utilization by three groups of ethnic elderly. Medical Care, 24, 667-676.