Characteristics of Clinics without National Health Insurance Contracts: A Nationwide Survey in Taiwan

International Journal of Environmental Research and Public Health

Jui-Yao Liu¹  Hsin Ma²  Pei-Jyun Lu³  Li-Fang Chou⁴  Tzeng-Ji Chen⁵  Shinn-Jang Hwang⁵ 

[1] Department of Family Medicine, National Yang Ming Chiao Tung University Hospital, Yilan 260, Taiwan;Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;Department of Medical Education, Taipei Veterans General Hospital, Taipei 112, Taiwan;Department of Public Finance, National Chengchi University, Taipei 116, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan;

关键词: ambulatory care facilities;    national health programs;    private practice;    Taiwan;   

DOI  :  10.3390/ijerph19031517

来源: DOAJ

【 摘 要 】

Based on the 1978 Alma-Ata Declaration, the key to achieving health for all is primary health care, and many countries have established various comprehensive health care systems. Because of the financial toll of a public health care system, government-sponsored public health insurance is not universally accepted. This study used Taiwan as the backdrop to understand why many health clinics have chosen not to accept the National Health Insurance (NHI), despite it covering 99.93% of the country’s population. The clinics’ operational details were garnered from the datasets of Taiwan’s open government data platforms and checked against the list of contracting clinics within the NHI. Of 10,907 Western medicine primary care clinics in 2016, as many as 9846 (90.3%) clinics had signed contracts with the NHI. The remaining 1061 noncontracting clinics were distributed in urban (94.5%, n = 1003), suburban (4.9%, n = 52), and rural/remote areas (0.6%, n = 6). The NHI did not have contracts with 183 plastic surgery, 88 internal medicine, and 85 surgery clinics. In conclusion, nearly one-tenth of clinics practiced independently of the NHI in Taiwan. Their reasons for declining the contract and practices for delivering their services deserve further studies.

【 授权许可】

Unknown