期刊论文详细信息
BMC Public Health
Illness, medical expenditure and household consumption: observations from Taiwan
Shuangge Ma3  Benchang Shia1  Linglong Ye2  Yefei Jiang2  Chi Ma4  Kuangnan Fang2 
[1] Department of Statistics and Information Science, FuJen Catholic University, New Taipei, Taiwan;Department of Statistics, Xiamen University, Xiamen, China;School of Public Health, Yale University, 60 College ST, New Haven, CT 06520, USA;Beijing Institute of Petrochemical Technology, Beijing, China
关键词: Taiwan;    Household consumption;    Medical expenditure;    Illness;   
Others  :  1161939
DOI  :  10.1186/1471-2458-13-743
 received in 2013-04-03, accepted in 2013-08-07,  发布年份 2013
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【 摘 要 】

Background

Illness conditions lead to medical expenditure. Even with various types of medical insurance, there can still be considerable out-of-pocket costs. Medical expenditure can affect other categories of household consumptions. The goal of this study is to provide an updated empirical description of the distributions of illness conditions and medical expenditure and their associations with other categories of household consumptions.

Methods

A phone-call survey was conducted in June and July of 2012. The study was approved by ethics review committees at Xiamen University and FuJen Catholic University. Data was collected using a Computer-Assisted Telephone Survey System (CATSS). “Household” was the unit for data collection and analysis. Univariate and multivariate analyses were conducted, examining the distributions of illness conditions and the associations of illness and medical expenditure with other household consumptions.

Results

The presence of chronic disease and inpatient treatment was not significantly associated with household characteristics. The level of per capita medical expenditure was significantly associated with household size, income, and household head occupation. The presence of chronic disease was significantly associated with levels of education, insurance and durable goods consumption. After adjusting for confounders, the associations with education and durable goods consumption remained significant. The presence of inpatient treatment was not associated with consumption levels. In the univariate analysis, medical expenditure was significantly associated with all other consumption categories. After adjusting for confounding effects, the associations between medical expenditure and the actual amount of entertainment expenses and percentages of basic consumption, savings, and insurance (as of total consumption) remained significant.

Conclusion

This study provided an updated description of the distributions of illness conditions and medical expenditure in Taiwan. The findings were mostly positive in that illness and medical expenditure were not observed to be significantly associated with other consumption categories. This observation differed from those made in some other Asian countries and could be explained by the higher economic status and universal basic health insurance coverage of Taiwan.

【 授权许可】

   
2013 Fang et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Flores G, Krishnakumar J, O’Donnell O, Van Doorslaer E: Coping with health-care costs: implications for the measurement of catastrophic expenditures and poverty. Health Econ 2008, 17:1393-1412.
  • [2]Foster A: Poverty and illness in low-income rural areas. Am Econ Rev 1994, 84:216-220.
  • [3]Kabir MA, Rahman A, Salway S, Pryer J: Sickness among the urban poor: a barrier to livelihood security. J Int Dev 2000, 12:707-722.
  • [4]Wagstaff A: The economic consequences of health shocks: evidence from Vietnam. J Health Econ 2007, 26:82-100.
  • [5]Wang H, Zhang L, Hsiao W: Ill health and its potential influence on household consumptions in rural China. Health Policy 2006, 78:167-177.
  • [6]Setboonsarng S, Lavado RF: Does organic agriculture lead to better health among organic and conventional farmers in Thailand? An investigation of health expenditure among organic and conventional farmers in Thailand. ADB Institute Working Paper No129; 2008.
  • [7]Lu JR, Hisao WC: Does Universal health insurance make health care unaffordable? Lessons from Taiwan. Universal Coverage 2003, 22(3):77-88.
  • [8]Lee S, Chun C, Lee Y, Seo NK: The national health insurance system as one type of new typology: the case of South Korea and Taiwan. Health Policy 2008, 85(1):105-113.
  • [9]Fang K, Shia BC, Ma S: Health insurance coverage, medical expenditure and coping strategy: evidence from Taiwan. BMC Health Serv Res 2012, 12:442. BioMed Central Full Text
  • [10]Shih S, Ting C, Chang H, Kuo K: Insurance covered and non-covered complementary and alternative medicine utilization among adults in Taiwan. Soc Sci Med 2008, 67(7):1183-1189.
  • [11]Kreng V, Yang C: The equality of resource allocation in health care under the national health insurance system in Taiwan. Health Policy 2011, 100:203-210.
  • [12]Liu TC, Chen CS: An analysis of private health insurance purchasing decisions with national health insurance in Taiwan. Soc Sci Med 2002, 55:755-774.
  • [13]Nguyen K, Khuat OTH, Ma S, Pham DC, Khuat GTH, Ruger JP: Effect of health expenses on household capabilities and resource allocation in Vietnam. PLoS One 2012, 7(10):e47423.
  • [14]Waksberg J: Sampling methods for random digit dialing. J Am Stat Assoc 1978, 361:40-46.
  • [15]Hosmer DW, Lemeshow S: Applied logistic regression. New York: Wiley; 2000.
  • [16]Fang K, Jiang Y, Shia BC, Ma S: Impact of illness and medical expenditure on household consumptions: a survey in western China. PLoS One 2012, 7(12):e52928.
  • [17]Fang K, Shia BC, Ma S: Health insurance coverage and impact: a survey in three cities in China. PLoS One 2012, 7(6):e39157.
  • [18]Kopecky KA, Koreshkova T: The impact of medical and nursing home expenses and social insurance policies on savings and inequality. Federal Reserve Bank of Atlanta; 2010. Working paper 2010-19
  • [19]van Doorslaer E, O’Donnell O, Rannan-Eliya RP, Somanathan A, Adhikari SR, Garg CC, Harbianto D, Herrin AN, Huq MN, Ibragimova S, Karan A, Lee TJ, Leung GM, Lu JF, Ng CW, Pande BR, Racelis R, Tao S, Tin K, Tisayaticom K, Trisnantoro L, Vasavid C, Zhao Y: Catastrophic payments for health care in Asia. Health Econ 2007, 16:1159-1184.
  • [20]Lu C, Chin B, Li G, Murray CJL: Limitations of methods for measuring out of pocket and catastrophic private health expenditures. Bull World Health Org 2009, 87:238-244.
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