國家衛生研究院 NHRI:Item 3990099045/5037
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/5037


    Title: The impact of universal National Health Insurance on population health: the experience of Taiwan
    Authors: Lee, YC;Huang, YT;Tsai, YW;Huang, SM;Kuo, KN;McKee, M;Nolte, E
    Contributors: Division of Health Policy Research and Development
    Abstract: BACKGROUND: Taiwan established a system of universal National Health Insurance (NHI) in March, 1995. Today, the NHI covers more than 98% of Taiwan's population and enrollees enjoy almost free access to healthcare with small co-payment by most clinics and hospitals. Yet while this expansion of coverage will almost inevitably have improved access to health care, however, it cannot be assumed that it will necessarily have improved the health of the population. The aim of this study was to determine whether the introduction of National Health Insurance (NHI) in Taiwan in 1995 was associated with a change in deaths from causes amenable to health care. METHODS: Identification of discontinuities in trends in mortality considered amenable to health care and all other conditions (non-amenable mortality) using joinpoint regression analysis from 1981 to 2005. RESULTS: Deaths from amenable causes declined between 1981 and 1993 but slowed between 1993 and 1996. Once NHI was implemented, the decline accelerated significantly, falling at 5.83% per year between 1996 and 1999. In contrast, there was little change in non-amenable causes (0.64% per year between 1981 and 1999). The effect of NHI was highest among the young and old, and lowest among those of working age, consistent with changes in the pattern of coverage. NHI was associated with substantial reductions in deaths from circulatory disorders and, for men, infections, whilst an earlier upward trend in female cancer deaths was reversed. CONCLUSIONS: NHI was associated in a reduction in deaths considered amenable to health care; particularly among those age groups least likely to have been insured previously.
    Date: 2010-08
    Relation: BMC Health Services Research. 2010 Aug;10:Article number 225.
    Link to: http://dx.doi.org/10.1186/1472-6963-10-225
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1472-6963&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000282802100001
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=77955105224
    Appears in Collections:[Ken-Nan Kuo] Periodical Articles
    [Yi-Wen Tsai(1999-2010)] Periodical Articles

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