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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
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    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 431-466.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    10. Hanratty, Maria J, 1996. "Canadian National Health Insurance and Infant Health," American Economic Review, American Economic Association, vol. 86(1), pages 276-284, March.
    11. 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.
    12. 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.
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    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.
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