Abstract
IntroductionTo test the hypothesis that the distribution of healthcare services is according to health need can be achieved under a rather open access system.MethodsThe 2001 National Health Interview Survey of Taiwan and National Health Insurance claims data were linked in the study. Health need was defined by self-perceived health status. We used Concentration index to measure need-related inequality in healthcare utilization and expenditure.ResultsPeople with greater health need received more healthcare services, indicating a pro-need character of healthcare distribution, conforming to the meaning of vertical equity. For outpatient service, subjects with the highest health need had higher proportion of ever use in a year than those who had the least health need and consumed more outpatient visits and expenditures per person per year. Similar patterns were observed for emergency services and hospitalization. The concentration indices of utilization for outpatient, emergency services, and hospitalization suggest that the distribution of utilization was related to health need, whereas the preventive service was less related to need.ConclusionsThe universal coverage plus healthcare networking system makes it possible for healthcare to be utilized according to need. Taiwan’s experience can serve as a reference for health reform.
Highlights
To test the hypothesis that the distribution of healthcare services is according to health need can be achieved under a rather open access system
Sources of data Data used for this analysis were from the 2001 National Health Interview Survey (NHIS) of Taiwan that was conducted by the National Health Research Institute and the Bureau of Health Promotion, Taiwan
Healthcare utilization determined by health need is well revealed We used a rather open access system to examine the relationship between health need and healthcare utilization
Summary
To test the hypothesis that the distribution of healthcare services is according to health need can be achieved under a rather open access system. Numerous countries have endorsed a policy objective that access and use of healthcare should be based on need, not the ability to pay [2]. The Institute of Medicine (IOM) estimates that at least 18,000 Americans die prematurely each year because they lack health insurance to get appropriate healthcare [3]. Poverty is associated with increased chronic diseases, not seeking medical care and premature death [4,5,6]. The reasons women do not seek care in the case of obstetric emergencies including lack of knowledge, financial costs, attitudes of family members and religion [7]. Many studies reveal that patient use of services tends to
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