Redistributive effects of the National Health Insurance on physicians in Taiwan: a natural experiment time series study

International Journal for Equity in Health

Research

Ya-Seng A Hsueh¹  Yu-Tung A Huang²  Chiang-Hsing Yang³ 

[1] Centre for Health Policy, Programs and Economics, Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, 3053 Victoria, Australia;Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan;Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan;

关键词: National Health Insurance;    Medicine Physician;    Gini Coefficient;    Lorenz Curve;    Universal Health Coverage;   

DOI  :  10.1186/1475-9276-12-13

 received in 2012-08-14, accepted in 2013-01-27,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundPrevious studies have evaluated the effects of various health manpower policies but did not include full consideration of the effect of universal health insurance on physician re-distribution. This study examines the effects of implementing National Health Insurance (NHI) on the problem of geographic mal-distribution of health providers in Taiwan.MethodsData on health providers and population between 1971 and 2001 are obtained from relevant governmental publications in Taiwan. Gini coefficients derived from the Lorenz curve are used under a spline regression model to examine the impact of the NHI on the geographic distribution of health providers.ResultsThe geographic distribution equality of the three key health providers has improved significantly after the implementation of NHI program. After accounting for the influences of other confounding factors, Gini coefficients of the three key providers have a net reduction of 1.248% for dentists, 0.365% for western medicine physicians, and 0.311% for Chinese medicine physicians. Overall, the absolute values of the three key providers’ Gini coefficients also become close to one another.ConclusionsThis study found that NHI’s offering universal health coverage to all citizens and with proper financial incentives have resulted in more equal geographic distributions among the key health care providers in Taiwan.

【 授权许可】

Unknown   
© Yang et al; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.