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Although implementation of the national health insurance (NHI) scheme in Taiwan has ensured that over 97% of all residents are under coverage, inefficient utilization of medical resources and rapid expansion of NHI-related medical expenditures have severely strained governmental and societal resources. This study analyzes the utilization of healthcare resources for first category insured diagnosed with respiratory system diseases in the Northern Region Bureau of National Health Insurance (NRBNHI) in Taiwan. This study adopts two statistical analysis approaches: independent two sample t-test and one-way analysis of variance (one-way ANOVA). Results provide a valuable reference point that age, income and provider type are significantly affects utilization of healthcare resources, but the region does not impact outpatient expenditures.
Introduction
Countries whose health systems are more oriented towards primary care achieve better health levels and higher satisfaction with health services for their residents, as well as lower overall service costs than those not (Starfield, 1994). Primary care is thus widely perceived as the rationale for establishing a healthcare system. After implementing three major health insurance programs, i.e., Labor Insurance, Governmental Employee Insurance and Farmer Health Insurance, the Taiwanese government consolidated those programs under a unified framework and inaugurated the national health insurance (NHI) scheme in March 1995 (Chiang, 1997; Chou, Liu, and Hammitt, 2003; Fu et al., 2004), with the aim of promoting the health of all island residents, administering national health insurance policies and providing healthcare services. Since its implementation, NHI has over 97% of all residents under its coverage (Chou et al, 2003; Fu et ai, 2004). Unfortunately, inefficient utilization of healthcare resources and rapid expansion of NHI-related healthcare expenditures have created a fiscal imbalance in NHI operations and a growing governmental deficit in NHI allocated budget.
Four health care provider types in Taiwan are medical centers, regional hospitals, district hospitals and clinics (Chiang, 1997). The Taiwanese government implemented a hierarchical referral system in July 2005 to counteract the squandering of healthcare resources and control NHI healthcare expenses. However, administering stringent regulations has failed to fully utilize healthcare resources efficiently, necessitating the need to survey the demographics of Taiwanese residents and demonstrate the validity of such a survey method.
Previous studies have focused on utilizing healthcare resources, e. g. Pawar & Smith, 2006; Holl et...