IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v16y2007i3p223-242.html
   My bibliography  Save this article

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

* This paper has been replicated

Author

Listed:
  • Likwang Chen
  • Winnie Yip
  • Ming‐Cheng Chang
  • Hui‐Sheng Lin
  • Shyh‐Dye Lee
  • Ya‐Ling Chiu
  • Yu‐Hsuan Lin

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.

Suggested Citation

  • Likwang Chen & Winnie Yip & Ming‐Cheng Chang & Hui‐Sheng Lin & Shyh‐Dye Lee & Ya‐Ling Chiu & Yu‐Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242, March.
    • Handle: RePEc:wly:hlthec:v:16:y:2007:i:3:p:223-242
    DOI: 10.1002/hec.1160
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.1160
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.1160?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    2. Adamson, Joy & Ben-Shlomo, Yoav & Chaturvedi, Nish & Donovan, Jenny, 2003. "Ethnicity, socio-economic position and gender--do they affect reported health--care seeking behaviour?," Social Science & Medicine, Elsevier, vol. 57(5), pages 895-904, September.
    3. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    4. 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, vol. 96, pages 883-894, September.
    5. Pannarunothai, Supasit & Mills, Anne, 1997. "The poor pay more: Health-related inequality in Thailand," Social Science & Medicine, Elsevier, vol. 44(12), pages 1781-1790, June.
    6. 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, vol. 58(12), pages 2585-2600, June.
    7. Janet Currie & Jonathan Gruber, 1997. "The Technology of Birth: Health Insurance, Medical Interventions, and Infant Health," NBER Working Papers 5985, National Bureau of Economic Research, Inc.
    8. Hanratty, Maria J, 1996. "Canadian National Health Insurance and Infant Health," American Economic Review, American Economic Association, vol. 86(1), pages 276-284, March.
    9. Hugh R. Waters, 1999. "Measuring the impact of health insurance with a correction for selection bias-a case study of Ecuador," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 473-483.
    10. Roetzheim, R.G. & Pal, N. & Gonzalez, E.C. & Ferrante, J.M. & Van Durme, D.J. & Krischer, J.P., 2000. "Effects of health insurance and race on colorectal cancer treatments and outcomes," American Journal of Public Health, American Public Health Association, vol. 90(11), pages 1746-1754.
    11. Winnie Yip & Karen Eggleston, 2001. "Provider payment reform in China: the case of hospital reimbursement in Hainan province," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 325-339, June.
    12. Cheng, Shou-Hsia & Chiang, Tung-Liang, 1998. "Disparity of medical care utilization among different health insurance schemes in Taiwan," Social Science & Medicine, Elsevier, vol. 47(5), pages 613-620, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Wagstaff, Adam & Pradhan, Menno, 2005. "Health insurance impacts on health and nonmedical consumption in a developing country," Policy Research Working Paper Series 3563, The World Bank.
    2. Yingying Meng & Junqiang Han & Siqi Qin, 2018. "The Impact of Health Insurance Policy on the Health of the Senior Floating Population—Evidence from China," IJERPH, MDPI, vol. 15(10), pages 1-17, October.
    3. Hua Chen & Jianing Xing & Xiaoxu Yang & Kai Zhan, 2021. "Heterogeneous Effects of Health Insurance on Rural Children’s Health in China: A Causal Machine Learning Approach," IJERPH, MDPI, vol. 18(18), pages 1-14, September.
    4. Alejandro Gaviria & Carlos Medina & Carolina Mejía, 2006. "Evaluating The Impact Of Health Care Reform In Colombia: From Theory To Practice," Documentos CEDE 2647, Universidad de los Andes, Facultad de Economía, CEDE.
    5. Manan Roy, 2011. "How Well Does the U.S. Government Provide Health Insurance?," Departmental Working Papers 1102, Southern Methodist University, Department of Economics.
    6. Feiyan Yang & Li Wei, 2023. "The impact of tax-subsidized health insurance on health and out-of-pocket burden in China," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 194-246, January.
    7. Ellen Meara, 2001. "Why is Health Related to Socioeconomic Status?," NBER Working Papers 8231, National Bureau of Economic Research, Inc.
    8. Mary Eschelbach Hansen & Paul Jacobs, 2007. "Valuing Substitute Families:Financial Support for Foster and Adoptive Families," Working Papers 2007-04, American University, Department of Economics.
    9. Manan Roy, 2014. "How well does the U.S. Government provide health insurance for infants?," Empirical Economics, Springer, vol. 46(1), pages 253-284, February.
    10. Santosh Kumar & Fidel Gonzalez, 2018. "Effects of health insurance on birth weight in Mexico," Health Economics, John Wiley & Sons, Ltd., vol. 27(8), pages 1149-1159, August.
    11. Leemore Dafny & Jonathan Gruber, 2000. "Does Public Insurance Improve the Efficiency of Medical Care? Medicaid Expansions and Child Hospitalizations," NBER Working Papers 7555, National Bureau of Economic Research, Inc.
    12. Lin, Lin & Zai, Xianhua, 2022. "The Power of Public Insurance With Limited Benefits: Evidence from China's New Cooperative Medical Scheme," GLO Discussion Paper Series 1180, Global Labor Organization (GLO).
    13. Freedman, Seth & Lin, Haizhen & Simon, Kosali, 2015. "Public health insurance expansions and hospital technology adoption," Journal of Public Economics, Elsevier, vol. 121(C), pages 117-131.
    14. Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.
    15. Hoke, Omer & Dunn, Richard, 2016. "The Effect of Early ACA Medicaid Expansion on Mental Health," Working Paper series 290123, University of Connecticut, Charles J. Zwick Center for Food and Resource Policy.
    16. Liu, Hong & Zhao, Zhong, 2014. "Does health insurance matter? Evidence from China’s urban resident basic medical insurance," Journal of Comparative Economics, Elsevier, vol. 42(4), pages 1007-1020.
    17. Jonathan Gruber, 1997. "Health Insurance for Poor Women and Children in the US: Lessons from the Past Decade," NBER Chapters, in: Tax Policy and the Economy, Volume 11, pages 169-211, National Bureau of Economic Research, Inc.
    18. Philip Oreopoulos & Mark Stabile & Randy Walld & Leslie L. Roos, 2008. "Short-, Medium-, and Long-Term Consequences of Poor Infant Health: An Analysis Using Siblings and Twins," Journal of Human Resources, University of Wisconsin Press, vol. 43(1).
    19. Sarah Miller & Laura Wherry & Gloria Aldana, 2022. "Covering Undocumented Immigrants: The Effects of a Large-Scale Prenatal Care Intervention," NBER Working Papers 30299, National Bureau of Economic Research, Inc.
    20. Lingguo Cheng & Hong Liu & Ye Zhang & Ke Shen & Yi Zeng, 2015. "The Impact of Health Insurance on Health Outcomes and Spending of the Elderly: Evidence from China's New Cooperative Medical Scheme," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 672-691, June.

    Replication

    This item has been replicated by:
  • Simon Chang, 2012. "The Effect Of Taiwan'S National Health Insurance On Mortality Of The Elderly: Revisited," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1257-1270, November.

    • More about this item

    Lists

    This item is featured on the following reading lists, Wikipedia, or ReplicationWiki pages:
    1. The effects of Taiwan's National Health Insurance on access and health status of the elderly (Health Economics 2007) in ReplicationWiki

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:16:y:2007:i:3:p:223-242. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.