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Characteristics of Clinics without National Health Insurance Contracts: A Nationwide Survey in Taiwan

Author

Listed:
  • Pei-Jyun Lu

    (Department of Medical Education, Taipei Veterans General Hospital, Taipei 112, Taiwan)

  • Jui-Yao Liu

    (Department of Family Medicine, National Yang Ming Chiao Tung University Hospital, Yilan 260, Taiwan
    School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan)

  • Hsin Ma

    (Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan)

  • Tzeng-Ji Chen

    (School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
    Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
    Institute of Hospital and Health Care Administration, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
    Big Data Center, Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan)

  • Li-Fang Chou

    (Department of Public Finance, National Chengchi University, Taipei 116, Taiwan)

  • Shinn-Jang Hwang

    (School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
    Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan)

Abstract

Based on the 1978 Alma-Ata Declaration, the key to achieving health for all is primary health care, and many countries have established various comprehensive health care systems. Because of the financial toll of a public health care system, government-sponsored public health insurance is not universally accepted. This study used Taiwan as the backdrop to understand why many health clinics have chosen not to accept the National Health Insurance (NHI), despite it covering 99.93% of the country’s population. The clinics’ operational details were garnered from the datasets of Taiwan’s open government data platforms and checked against the list of contracting clinics within the NHI. Of 10,907 Western medicine primary care clinics in 2016, as many as 9846 (90.3%) clinics had signed contracts with the NHI. The remaining 1061 noncontracting clinics were distributed in urban (94.5%, n = 1003), suburban (4.9%, n = 52), and rural/remote areas (0.6%, n = 6). The NHI did not have contracts with 183 plastic surgery, 88 internal medicine, and 85 surgery clinics. In conclusion, nearly one-tenth of clinics practiced independently of the NHI in Taiwan. Their reasons for declining the contract and practices for delivering their services deserve further studies.

Suggested Citation

  • Pei-Jyun Lu & Jui-Yao Liu & Hsin Ma & Tzeng-Ji Chen & Li-Fang Chou & Shinn-Jang Hwang, 2022. "Characteristics of Clinics without National Health Insurance Contracts: A Nationwide Survey in Taiwan," IJERPH, MDPI, vol. 19(3), pages 1-10, January.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:3:p:1517-:d:737258
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    References listed on IDEAS

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