全民健保實施對社經狀況不同地區的國民死亡率影響之研究－以時間數列分析

王頌華; 楊長興; 鍾信成; 陳巧珊

doi:10.30156/CCMJ.200704.0004

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P32 - 45

Health & Medical Care > Medical Sciences
Health & Medical Care > Hospital Administration & Medical Affair Management
Health & Medical Care > Social Medicine

DOI： 10.30156/CCMJ

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全民健保實施對社經狀況不同地區的國民死亡率影響之研究－以時間數列分析

Socioeconomic Status Differences in 'Avoidabl' Mortality under National Health Insurance in Taiwan: Time Series Analysis

王頌華(Song-Hua Wang) ；楊長興(Chiang-Hsing Yang) ；鍾信成(Hsin-Cheng Chung) ；陳巧珊(Chiao-Shan Chen)

澄清醫護管理雜誌； 3卷2期 (2007 / 04 / 01) ， P32 - 45

繁體中文 DOI： 10.30156/CCMJ.200704.0004

全民健康保險；社經狀況；可避免死因死亡率；介入分析模式； National Health Insurance ； socio-economic status ； avoidable mortality ； intervention analysis model

Abstract │ Times Cited (9)

Abstract 〈TOP〉

Parallel Abstract 〈TOP〉

Context: The implementation of the National Health Insurance (NHI) in Taiwan on March 1,1995 has profound impact on our health care system. Many studies have pointed out that the NHI tremendously increases our compatriots' accessibility to medical services, particularly those who did not being insured before. In addition, many other researches, focusing on the assessment of satisfaction with the NHI's services. Although, findings of those studies are interesting, there were few studies addressed the potential influence of the increasing access resulted from the NHI on people's health status. The NHI's potential and differential impacts on the health status of our compatriots deserve an investigation.
Purpose: To compare the changes of health status (using mortality and avoid mortality as measures) for people who live in different geographical areas, with different socio-economic status before and after the implementation of the NHI. By examining the changes, the potential and differential impacts can be attributed to the NHI.
Method：The all-cause mortality and avoidable mortality were used as the indicators to measure the health status. Mortalities for people lived in different geographical areas and of different socio-economic status as well as age groups were standardized for comparison. The event intervention analysis was employed to assess the movement of monthly data of all-cause and avoidable mortality rate from January 1992 to December 2001. Because the data includes the mortality before and after the implementation of NHI, patterns of change in mortality could reflex the effects result from NHI.
Results：The findings of this study reveal that all-caused mortality declined significantly after the implementation of NHI; regardless of the geographical areas, socioeconomic status, and age groups. Additionally, compared to people with higher income, the magnitude of the reduction in all-cause mortality tend to be higher for those with lower income. On the other hand, decline of avoidable mortality for people lived in different geographical areas, with different socio-economic status, and of different age groups are found to be statistically insignificant after the implementation of NHI.
Conclusion: Change in mortality indicates that the implementation of NHI tend to have a stronger positive impact on the health status for people with lower income level. It possibly because of the accessibility for people with low income has better improved. The implications suggest that there are for further improvement can be aimed at some vulnerable groups.

Times Cited ( 9 ) 〈TOP〉

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