Testing Taiwan's National Health Insurance Reforms in Internal Cost Control: From Providers' Aspect

Tein-Cheng Chien ； Hsiu-Li Chen

《Asian Journal of Health and Information Sciences》 3卷1-4期 (2008/12) Pp. 69-87

https://doi.org/10.6412/AJHIS.200812.0069

並列摘要

Implementation of National Health Insurance (NHI) in 1995 was a significant milestone in the Taiwan healthcare scenario. However, the NHI system also has some problems. As physician providers play a major role in health care, the main purpose of this research is to explore the views of providers on NHI policy reforms relating to demand side and supply side of the health care service.
Multiple regression and logistic regression are used to analyze the acceptability of sixteen NHI reforms and to compare the internal cost control by different hospital ownerships and grades. The conclusions of this study are: (1) the evidence supports that both hospital ownership and hospital grade differed significantly on acceptability of demand-side and supply-side policies, but most of them are on supply side policy. (2) Public hospitals, private for profit hospital, and private non-profit hospital have higher probabilities of controlling their internal cost when compared with local clinics. (3) A higher grade of hospital (e.g., medical center, regional center and district hospital) has higher internal cost control pressure than local clinics.
The findings strongly suggest that future NHI reform efforts in Taiwan should focus on provider behavior. Supply-side policies should be the preferred instruments for cost control. In designing optimal contract policies, the Bureau of NHI should use a combination of economic incentives and monitoring to better influence provider practices and finally improve the effectiveness of the NHI system.

並列關鍵字

NHI ； supply-side ； cost control ； health policy ； physician provider