Beyond Universal Health Coverage: Effective Coverage under Taiwan’S National Health Insurance

Project: National Science and Technology CouncilNational Science and Technology Council Academic Grants

Project Details

Abstract

In 2015, UN has proposed 17 Sustainable Development Goals (covering 169 targets) to be accomplished by 2030. Among which, Universal Health Coverage (UHC) is explicitly listed as the 8th target under Goal 3. With the arduous efforts by the international organizations, UHC is globally promoted as an important policy target. WHO has also emphasized the important of tracking UHC and monitoring the implementation progress in two main aspects, health services (prevention and treatment) and financial risk protection (medical impoverishment and incidence of catastrophic payment). It has been 20 years since Taiwan achieved UHC through introducing National Health Insurance scheme. Taiwan NHI not only covers the entire population, but also provides comprehensive benefit coverage; hence, very few researches have touched upon the issue of service effective coverage. Given finite resources under NHI, effective coverage has become a crucial topic for system performance assessment. WHO defines effective coverage as “the fraction of maximum possible health gains, an individual with a health-care need can expect to receive from the health system”. The WHO definition essentially unites intervention need, use and quality into one single summary measure. The focus of effective coverage assessment varies by the level of UHC achieved among countries. For developing countries, more emphasis is placed on maternal and child health and treatment for infectious disease. In contrast, for high-income economies, which already achieved UHC via social insurance or national health services, care for chronic disease is the focus of effective coverage assessment. The proposed three-year study, along the line of the comparative health system research theme, will exploit National Health Interview Survey data along with NHI claim data to assess the effective coverage of diabetes and hypertension treatment and to also explore the issue of avoidable hospitalization.

Project IDs

Project ID:PF10601-0847
External Project ID:MOST105-2410-H182-017-MY2
StatusFinished
Effective start/end date01/08/1731/07/18

Keywords

  • effective coverage
  • avoidable hospitalization
  • diabetes
  • hypertension
  • National Health Insurance

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