Degrees of Shortage and Uncovered Ratios for Long-Term Care in Taiwan's Regions: Evidence from Dynamic DEA.

Kuo-Feng Wu,Hawjeng Chiou,Jin-Li Hu

doi:10.3390/ijerph18020605

Abstract

The government is facing the country’s aging population and low birth rate have led to a severe shortage of its healthcare workforce in Taiwan after 2003. In order to explore the status of the country’s degree of long-term care shortage and uncovered ratio, this research uses the Push-Pull-Mooring (PPM) theory to explain long-term care efficiency during 2010–2019 in each city and county. We collect longitudinal-sectional data for 2010–2019 from the Ministry of Health and Welfare’s Department of Statistics for 22 administrative regions in Taiwan in each year and employ dynamic data envelopment analysis (DEA) to evaluate the overall technical efficiency and the disaggregate output insufficiency to explain the research results. The main findings are as follows: (1) Cities near the capital Taipei have the highest degree of shortages in long-term caregivers and high uncovered ratios of people who need long-term care. (2) Presently, there is no demand to increase the number of long-term care institutions in Taiwan. (3) The government should introduce new long-term care certificates through national examinations in order to develop a stronger professional workforce in this field.

Highlights

Taiwan and other parts of East Asia experienced the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, which led to a sudden and widespread break-out that severely strained health systems
(1) Municipalities in Taiwan are generally rich in resources and has a large population, but can experience a severe shortage like its long-term care efficiency score
The government should increase the cultivation of a long-term care workforce to reduce the burden on doctors and nurses

Summary

Introduction

Taiwan and other parts of East Asia experienced the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, which led to a sudden and widespread break-out that severely strained health systems. As a result of this epidemic, the medical staff workforce in Taiwan has become strained and insufficient due to a shortage of health care workers and an aging society after 2003. As the elderly population continues to increase in number, countries are investing significantly in long-term care resources. The United States has provided insurance since 1965 under the government-run Medicaid and Medicare programs, which cover home and nursing care (mainly medical care), but strictly speaking, there are no complete or separate long-term care systems in the United States. The U.S government even reduced Medicare, Medicaid, Children’s Health Insurance Program (CHIP), and marketplace subsidies by about 25%, or $1.1 trillion, in its 2019 budget. Three-fifths of the budget relates to Medicare, which covers 61 million people over the age of 65 or disabled, while the other two-fifths go to Medicaid and CHIP.

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