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題名:臺灣全民健康保險的減貧效果
書刊名:臺灣公共衛生雜誌
作者:江宛霖江東亮
作者(外文):Chiang, Wan-linChiang, Tung-liang
出版日期:2016
卷期:35:2
頁次:頁164-172
主題關鍵詞:臺灣全民健保貧窮率醫療財務災難Taiwan's national health insurancePoverty rateCatastrophic health spending
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:30
  • 點閱點閱:112
目標:全民健保的首要目標就是保障公平就醫的權利,並減少因病而貧的狀況。本研究從收入面及支出面探討全民健保的減貧效果。方法:資料來源為1993年至2012年家庭收支調查。我們以全國家戶均等可支配所得中位數的一半作為貧窮線,計算家戶、兒童與老人貧窮率,並以醫療支出佔扣除生存所需的家戶消費的25%與40%為閾值,估計家戶、兒童與老人的醫療財務災難率。結果:1995年,台灣家戶貧窮率在加計社會移轉收支後由13.7%降為7.5%,減貧效果達6.2%,其中1.1%的效果為全民健保的貢獻,到了2012年全民健保貢獻則提高為3.7%。至於對兒童貧窮率及老人貧窮率,全民健保的貢獻在同一期間亦分別由0.5%及3.3%提高為2.0%及8.0%。其次,全民健保開辦後,家戶醫療財務災難率由1993年的7.0%驟降為1998年的1.3%,而兒童與老人的醫療財務災難率,亦分別由2.3%及17.7%降為0.3%及3.7%,但是進入21世紀以後,無論家戶、兒童或老人的醫療財務災難率,皆微幅上升。結論:自從開辦以來,全民健保對於減輕台灣的貧窮現象有重要的貢獻。
Objectives: In 1995 National Health Insurance (NHI) was launched in Taiwan to provide equal access to adequate health care for all, and to protect people from financial hardship. This study determined the effect of the NHI on poverty reduction. Methods: Data were obtained from the Family Income and Expenditure Survey (1993-2012). First, we computed the household, child, and elderly poverty rates using 50% of the national median equivalized disposable income as the poverty line. We then defined catastrophic health spending as household health expenditures exceeding a specific fraction (25% or 40%) of household consumption remaining after subsistence needs. Results: In 1995 the household poverty rate fell from 13.7% to 7.5% after social taxes and transfers (a decrease of 6.2%), of which 1.1% was contributed by the NHI transfers. In 2012 the NHI contribution increased to 3.7%. With respect to child and elderly poverty rates, the NHI contribution also increased from 0.5% and 3.3% to 2.0% and 8.0%, respectively, during the same time period. After implementation of the NHI, catastrophic health spending fell from 7.0% in 1993 to 1.3% in 1998 for households, 2.3% to 0.3% for children, and 17.7% to 3.7% for the elderly. Since the beginning of the 21st century, all three types of catastrophic health spending have increased slightly. Conclusions: The NHI in Taiwan has made a significant contribution to poverty reduction since its implementation.
期刊論文
1.李妙純、沈茂庭(20080600)。全民健保下不同所得群體醫療利用不均因素分析。臺灣公共衛生雜誌,27(3),223-231。new window  延伸查詢new window
2.文羽苹、黃旭明、江東亮(20120200)。臺灣醫療保健支出成長率的分析:醫療通膨,質量與公平性。臺灣公共衛生雜誌,31(1),1-10。new window  延伸查詢new window
3.蔡貞慧、周穎政(20021000)。臺灣全民健康保險的醫療支出重分配效果,1995∼2000。臺灣公共衛生雜誌,21(5),373-379。new window  延伸查詢new window
4.Chu, T. B.、Liu, T. C.、Chen, C. S.、Tsai, Y. W.、Chiu, W. T.(2005)。Household Out-of-Pocket Medical Expenditures and National Health Insurance in Taiwan: Income and Regional Inequality。BMC Health Services Research,5(60),1-9。  new window
5.Chiang, T. L.(1997)。Taiwan's 1995 health care reform。Health Policy,39,225-239。  new window
6.O'Donnell, O.、van Doorslaer, E.、Rannan-Eliya, R. P.(2008)。Who pays for health care in Asia?。J Health Econ,27,460-475。  new window
7.van Doorslaer, E.、O'Donnell, O.、Rannan-Eliya, R. E.(2007)。Catastrophic payments for health care in Asia。Health Econ,16,1159-1184。  new window
8.Habicht, J.、Xu, K.、Couffinhal, A.、Kutzin, J.(2006)。Detecting changes in financial protection: creating evidence for policy in Estonia。Health Policy Plan,21,421-431。  new window
9.Lee, Y. C.、Yang, M. C.、Huang, Y. T.、Liu, C. H.、Chen, S. B.(2006)。Impacts of cost containment strategies on pharmaceutical expenditures of the National Health Insurance in Taiwan, 1996-2003。Pharmacoeconomics,24,891-902。  new window
10.Cheng, S. H.、Chiang, T. L.(1997)。The effect of universal health insurance on health care utilization in Taiwan: Results from a natural experiment。The Journal of the American Medical Association,278(2),89-93。  new window
11.Xu, K.、Evans, D. B.、Kawabata, K.、Zeramdini, R.、Klavus, J.、Murray, C. J. L.(2003)。Household Catastrophic Health Expenditure: A Multicountry Analysis。The Lancet,362(9378),111-117。  new window
12.Chen, Li-Chia、Schafheutle, Ellen I.、Noyce, Peter R.(2009)。The impact of nonreferral outpatient co-payment on medical care utilization and expenditures in Taiwan。RESEARCH IN SOCIAL AND ADMINISTRATIVE PHARMACY,5,211-224。  new window
13.許績天、韓幸紋、連賢明、羅光達(20110800)。部分負擔調整對醫療利用的衝擊:以2005年政策調整為例。臺灣公共衛生雜誌,30(4),326-336。new window  延伸查詢new window
研究報告
1.United Nations Children's Fund(2005)。Child poverty in rich countries, 2005。  new window
圖書
1.衛生福利部中央健康保險署(2014)。2014-2015全民健康保險年報。台北:衛生福利部中央健康保險署。  延伸查詢new window
2.Saksena, P.、Antunes, A. F.、Xu, K.、Musango, L.、Carrin, G.(2010)。Impact of Mutual Health Insurance on Access to Health Care and Financial Risk Protection in Rwanda。Geneve:WHO。  new window
3.Etienne, C.、Asamoa-Baah, A.、Evans, D. B.(2010)。Health Systems Financing: The Path to Universal Coverage。Geneve:WHO。  new window
4.衛生福利部(2013)。101年國民醫療保健支出。台北:衛生福利部。  延伸查詢new window
5.行政院主計處(2013)。101年家庭收支調查報告。台北:行政院主計處。  延伸查詢new window
其他
1.The Organisation for Economic Co-operation and Development。What are equivalence scales,http://www.oecd.org/eco/growth/latestdocuments/28/, 2011/02/23。  new window
 
 
 
 
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