Equity in Health Care Use Reexamined---The Effects of Service Intensity and Supply-Side Factors

Acknowledging that education and health care are two essential factors in enhancing human capital quality, governments around the world have been dedicated to improving the efficiency and equity aspects of the health systems, better population health and human capital. As health care systems around the world undergo financial stress, studies have focused primarily on efficiency and cost containment, consequently, tend to offer incomplete diagnosis. Taiwan』s National Health Insurance (NHI) program, introduced in 1995, has been well recognized as one of the most important social policies in the recent history of Taiwan. A key objective of Taiwan』s NHI is to provide people with financial risk protection and equal access to health care, regardless of their socioeconomic status. In particular, in the midst of immense calls for NHI reform, assuring an equitable distribution of health care uses will be an undeniable policy object of NHI. The literature to date has offered an overall picture in the equity distribution of health utilization at aggregate level, but did not tackle details in the service scope/intensity rendered to people of different social economic classes. In addition, supply-side factors have not been explored in the construction of the index of horizontal inequity. Hence, this 3-year study is set forth to further explore the research theme of equity in health utilization by levels of provider institutions with emphases in the effects of service intensity and supply-side factors. The estimation model should be improved upon with research variables profoundly constructed from exploiting 1994, 2001 and 2005 National Health Interview Surveys, supplemented with NHI Research Database, Survey on Facilities and Service Volumes of the Medical Institutions and official statistics. The empirical research results aim to both address the gap in academic literature and provide valuable policy references for policy making in implementing NHI and global budget.

Project ID:PF9801-1417
External Project ID:NSC96-2416-H182-001-MY3