We intend to answer two questions in this paper: 1) What are the key features that characterize the patterns of patient flow over time in Taiwan ﹖ and 2) How does interregion health resource utilization and over-utilized higher level health resources differ according to different regions and different time periods﹖An analysis of the 1981-89 "Morbidity Survey in Public and Private Hospitals/Clinics, Taiwan Area, ROC" collected by the Ministry of Health in Taiwan, four major findings were revealed: 1) Seventeen medical regions in Taiwan can be categorized into four major prototypes, namely close, open, ample, and scarce, in terms of two indecies: localization of health resource utilization and collective market share in local health market. 2).The level of localization of health resource utililization increased over time for most medical regions, however, average regional differences of the localization levels widened from 1981-1988 and narrowed after 1988. 3).Collective market shares in local health markets varied from region to region and between different points of time as well. In addition, average regional differences of the market share widened up until 1986 but never recovered to the level of 1981, indicating keener competition among hospitals of different medical regions. 4).A functional division of labor among different ranks of hospitals and clinics can not be observed over time. In general, hospitals have expanded their market shares at the expense of clinics in the outpatient market while medical centers and area hospitals have done so at the expense of others in the inpatient market. Medical centers have engaged in head-to-head competition with others, especially with area hospitals, in dealing with those diseases which don't require advanced treatments. We discuss the implications of these findings in an assessment of the effectiveness of the health delivery system in Taiwan over time. Issues raised in this descriptive study are outlined for further research.