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The effects of Taiwan's National Health Insurance on access and health status of the elderly

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Author Info

  • Likwang Chen

    (Center for Health Policy Research and Development, National Health Research Institutes, Taiwan)

  • Winnie Yip

    (School of Public Health, Harvard University, Cambridge, MA, USA)

  • Ming-Cheng Chang

    (Graduate Institute of Healthcare Administration, Taichung Healthcare and Management University, Taiwan)

  • Hui-Sheng Lin

    (Department of Public Health, Chung Shan Medical University, Taiwan)

  • Shyh-Dye Lee

    (Graduate Institute of Long-Term Care, National Taipei College of Nursing, National Taiwan University Hospital, Bei Hu Branch, Taiwan)

  • Ya-Ling Chiu

    (Center for Health Policy Research and Development, National Health Research Institutes, Taiwan)

  • Yu-Hsuan Lin

    (Center for Population and Health Survey Research, Bureau of Health Promotion, Department of Health, Taiwan)

Abstract

The primary objective of this paper is to evaluate the impact of Taiwan's National Health Insurance program (NHI), established in 1995, on improving elderly access to care and health status. Further, we estimate the extent to which NHI reduces gaps in access and health across income groups. Using data from a longitudinal survey, we adopt a difference-in-difference methodology to estimate the causal effect of Taiwan's NHI. Our results show that Taiwan's NHI has significantly increased utilization of both outpatient and inpatient care among the elderly, and such effects were more salient for people in the low- or middle-income groups. Our findings also reveal that although Taiwan's NHI greatly increased the utilization of both outpatient and inpatient services, this increased utilization of health services did not reduce mortality or lead to better self-perceived general health status for Taiwanese elderly. Measures more sensitive than mortality and self-perceived general health may be necessary for discerning the health effects of NHI. Alternatively, the lack of NHI effects on health may reflect other quality and efficiency problems inherent in the system not yet addressed by NHI. Copyright © 2006 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1160
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 16 (2007)
Issue (Month): 3 ()
Pages: 223-242

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Handle: RePEc:wly:hlthec:v:16:y:2007:i:3:p:223-242

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Goldman D. P. & Bhattacharya J. & McCaffrey D. F. & Duan N. & Leibowitz A. A. & Joyce G. F. & Morton S. C., 2001. "Effect of Insurance on Mortality in an HIV-Positive Population in Care," Journal of the American Statistical Association, American Statistical Association, American Statistical Association, vol. 96, pages 883-894, September.
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  7. Janet Currie & Jonathan Gruber, 1995. "Health Insurance Eligibility, Utilization of Medical care, and Child Health," NBER Working Papers 5052, National Bureau of Economic Research, Inc.
  8. Pannarunothai, Supasit & Mills, Anne, 1997. "The poor pay more: Health-related inequality in Thailand," Social Science & Medicine, Elsevier, Elsevier, vol. 44(12), pages 1781-1790, June.
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  10. Denton, Margaret & Prus, Steven & Walters, Vivienne, 2004. "Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health," Social Science & Medicine, Elsevier, Elsevier, vol. 58(12), pages 2585-2600, June.
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Cited by:
  1. Sheu, Ji-Tian & Lu, Jui-fen Rachel, 2014. "The spillover effect of National Health Insurance on household consumption patterns: Evidence from a natural experiment in Taiwan," Social Science & Medicine, Elsevier, Elsevier, vol. 111(C), pages 41-49.
  2. Shu-Hsi Ho & Wen-Shai Hung, 2013. "A study of the Health of Children Born to Foreign- and Native-Born Mothers in Taiwan," Journal of Family and Economic Issues, Springer, Springer, vol. 34(3), pages 355-368, September.
  3. Sujin Kim & Soonman Kwon, 2014. "The effect of extension of benefit coverage for cancer patients on health care utilization across different income groups in South Korea," International Journal of Health Care Finance and Economics, Springer, Springer, vol. 14(2), pages 161-177, June.
  4. Chang, Hung-Hao, 2013. "Functional food consumption and depression among the elderly — What can we learn from a longitudinal survey?," Economic Modelling, Elsevier, Elsevier, vol. 33(C), pages 187-193.
  5. Chang, Hung-Hao & Yen, Steven T., 2011. "Full-time, part-time employment and life satisfaction of the elderly," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, Elsevier, vol. 40(6), pages 815-823.
  6. Chu, Xueling & Chen, Qihui & Fang, Xiangming, 2013. "Can National Health Insurance Programs Improve Health Outcomes?—Re-Examining the Case of the New Cooperative Medical Scheme in Rural China," 2013 Annual Meeting, August 4-6, 2013, Washington, D.C., Agricultural and Applied Economics Association 150488, Agricultural and Applied Economics Association.
  7. Hong Wang & Winnie Yip & Licheng Zhang & William C. Hsiao, 2009. "The impact of rural mutual health care on health status: evaluation of a social experiment in rural China," Health Economics, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 18(S2), pages S65-S82, July.
  8. Liu, Li-Fan & Tian, Wei-Hua & Yao, Hui-Ping, 2012. "Utilization of health care services by elderly people with National Health Insurance in Taiwan: The heterogeneous health profile approach," Health Policy, Elsevier, Elsevier, vol. 108(2), pages 246-255.
  9. Tian, Wei-Hua & Liu, Tsai-Ching & Chen, Chin-Shyan & Liu, Li-Fan & Tien, Joseph J., 2012. "The relationship between depressive symptoms and health service utilization for elderly people in Taiwan," Health Policy, Elsevier, Elsevier, vol. 108(2), pages 256-267.

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