The Equity and Efficiency of Health Resource Allocation in Taiwan's National Health Insurance System
| Autor: | Shao-WeiYang, 楊劭為 |
|---|---|
| Rok vydání: | 2014 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 102 From a health policy perspective, ideal resource allocation in health care should be concerned with the combination of inputs required to produce these services at the lowest costs, given that resources are limited. To accomplish this goal, procedural equity must accurately assess the fairness of health care services delivery. Taiwan implemented a National Health Insurance (NHI) program in 1995 so as to reduce financial barriers for all citizens using a universal health care system. Horizontal equity, an explicit goal of the NHI system, is to guarantee equal opportunity of access to health care. However, due to a severe financial deficit, a global budget was introduced to replace the original payment system in 2002. At the macro level, measuring equity and efficiency of resource allocation in hospital-based health care services is a complex issue concerning multi-criteria decision making (MCDM). Two methods of MCDM are illustrated and analyzed in this study:grey Incidence Analysis (GIA) is used to measure the static resource allocation in NHI system to address the equity in health care services between urban and rural in Taiwan; and data envelopment analysis (DEA) is applied to measure the efficiency of health care resource allocation and further to explore the impacts of global budgeting scheme in Taiwan’s NHI system. From the findings of this empirical study, health care resources tend to be clustered in the metropolitan areas, like New Taipei City, Taipei City, Taichung City, Tainan City and Kaohsiung City. Not only equity but also efficiency in Taipei City has the highest ranking, which implies that health care resources in Taipei City are well utilized without wasting health care resources. Although Penghu County has a lower ranking in regards to equity, it has better resource allocation in overall efficiency and allocative efficiency. Due to supply exceeding demand, Hsinchu County and Hsinchu City have excess supply in hospital-based health care services. DMUs Yilan County, Changhua County, Nantou County and Chiayi City, where demand exceeds supply (excess demand) in hospital-based health care services, it is advisable that a better system of location-selection for new hospitals be implemented in the future. Hence, policy maker should draw attention to improving resource allocation of health care services for the equity in areas such as Yilan County, Hsinchu County, Changhua County, Nantou County, Hsinchu City and Chiayi City. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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