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The Impacts of the Hierarchical Medical System on National Health Insurance on the Resident’s Health Seeking Behavior in Taiwan: A Case Study on the Policy to Reduce Hospital Visits

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  • Yu-Hua Yan

    (Department of Medical Research, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), No. 670, Chung Te Road, Tainan City 701, Taiwan
    Department of Hospital and Health Care Administration, Chang Jung Christian University, No.60, Sec. 1, Erren Rd., Rende District, Tainan City 71710, Taiwan
    Department of Health Care Administration, Chia Nan University of Pharmacy and Science, No.1, Changda Rd., Gueiren District, Tainan City 71101, Taiwan)

  • Chih-Ming Kung

    (Department of Information Technology and Communication, Shih Chien University Kaohsiung Campus, No. 200 University Road Neimen, Kaohsiung 84550, Taiwan)

  • Horng-Ming Yeh

    (Department of Internal Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), No. 670, Chung Te Road, Tainan City 701, Taiwan)

Abstract

Objective : This study investigated the impacts of the hierarchical medical system under the national health insurance program on residents’ healthcare-seeking behavior in Taiwan. Background : Healthcare authorities in Taiwan initiated an allowance reduction for outpatient visits at regional hospitals and higher hierarchical hospitals in 2018. The ultimate goal is to implement a hierarchical medical system to provide residents accessible as well as consistent medical services. Methods : This research was conducted through a questionnaire survey, and data were collected between August and December 2018 from the records of subjects who had recently sought medical attention. A total of 1340 valid questionnaires were returned. Results : A principal finding was that there were significant differences in the knowledge of new policies by age, marital status, annual income, education level, and occupation ( p < 0.001). Regarding the effects on healthcare-seeking behavior, there were significant differences from persons aged 40–49 years ( p < 0.1), in junior high school ( p < 0.05), not aware of the policy ( p < 0.001), and awareness of both the hierarchical medical system and the policy to reduce outpatient visits to large hospitals ( p < 0.001). Conclusion : The health administration authorities should devote more effort into promoting knowledge of the policy in order to better inform the public about the hierarchical medical system.

Suggested Citation

  • Yu-Hua Yan & Chih-Ming Kung & Horng-Ming Yeh, 2019. "The Impacts of the Hierarchical Medical System on National Health Insurance on the Resident’s Health Seeking Behavior in Taiwan: A Case Study on the Policy to Reduce Hospital Visits," IJERPH, MDPI, vol. 16(17), pages 1-10, August.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:17:p:3167-:d:262401
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    References listed on IDEAS

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    1. Christopher B. Forrest & Paul A. Nutting & Sarah von Schrader & Charles Rohde & Barbara Starfield, 2006. "Primary Care Physician Specialty Referral Decision Making: Patient, Physician, and Health Care System Determinants," Medical Decision Making, , vol. 26(1), pages 76-85, January.
    2. Wang, Ming-Jye & Lin, Shu-Ping, 2010. "Study on doctor shopping behavior: Insight from patients with upper respiratory tract infection in Taiwan," Health Policy, Elsevier, vol. 94(1), pages 61-67, January.
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    Cited by:

    1. Shuduo Zhou & Jin Xu & Xiaochen Ma & Beibei Yuan & Xiaoyun Liu & Hai Fang & Qingyue Meng, 2020. "How Can One Strengthen a Tiered Healthcare System through Health System Reform? Lessons Learnt from Beijing, China," IJERPH, MDPI, vol. 17(21), pages 1-14, October.

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