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Disparity of medical care utilization among different health insurance schemes in Taiwan

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  • Cheng, Shou-Hsia
  • Chiang, Tung-Liang

Abstract

Potential excess use of health care services caused by insurance has been a major concern for almost every industrialized county. Moral hazard problems and fee-for-service payment methods are considered to be important factors for higher medical care utilization among those insured. Health care availability is another feature reportedly associated with health care use. Using the data from a National Health Interview Survey in Taiwan in 1990, this study examined differences in medical care utilization by beneficiaries under three major social insurance plans (i.e. Labor Insurance-LI, Government Employees' Insurance-GEI, and Farmers' Insurance-FI) which covered about half the population at that time. Logistic and Poisson regression models were applied to examine the effects of relevant factors on the probability and volume of physician visits. Results from the analyses revealed that (1) persons with different insurance plans had a similar higher probability of seeing a doctor than the uninsured, with the odds ratios ranged from 1.8 to 2.0. Also (2) the LI/FI participants consumed 60-73% more physician services than the uninsured, while the GEI enrollees utilized only 30% more physician services. Findings from our study concerning the access and use of physician services in different insurance plans provide some useful information for reforming a health care delivery system.

Suggested Citation

  • 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.
    • Handle: RePEc:eee:socmed:v:47:y:1998:i:5:p:613-620
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    Citations

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    Cited by:

    1. Yanhong Gong & Xiaoxv Yin & Yunxia Wang & Yongbin Li & Geng Qin & Liqun Liu & Wei Zhou & Fujian Song & Xiaoxin Dong & Shiyi Cao & Chen Yang & Huajie Yang & Jun Xie & Junan Liu & Zuxun Lu, 2014. "Social Determinants of Community Health Services Utilization among the Users in China: A 4-Year Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-7, May.
    2. Patrick Opiyo Owili & Miriam Adoyo Muga & Ya-Ting Yang & Yi-Hsin Elsa Hsu, 2019. "Perceived Impact of Taiwan’s National Health Insurance Allocation Strategy: Health Professionals’ Perspective," IJERPH, MDPI, vol. 16(3), pages 1-12, February.
    3. Lee, Miaw-Chwen & Jones, Andrew Michael, 2007. "Understanding differences in income-related health inequality between geographic regions in Taiwan using the SF-36," Health Policy, Elsevier, vol. 83(2-3), pages 186-195, October.
    4. Chiao, Chi, 2019. "Beyond health care: Volunteer work, social participation, and late-life general cognitive status in Taiwan," Social Science & Medicine, Elsevier, vol. 229(C), pages 154-160.
    5. 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.
    6. Wong, Irene Oi Ling & Chan, Wai-Sum & Choi, Sarah & Lo, Su-Vui & Leung, Gabriel Matthew, 2006. "Moral hazard or realised access to care?: Empirical observations in Hong Kong," Health Policy, Elsevier, vol. 75(3), pages 251-261, February.
    7. Fuhmei Wang & Jung-Der Wang & Yu-Wen Hung, 2018. "Universal health insurance, health inequality and oral cancer in Taiwan," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-13, October.

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