Evaluating the impacts of National Health Insurance payment mechanisms on the ecology of the health care system—the case of physician workforce

National Health Insurance has implemented a lot of payment policies or reforms to enhance efficiency, equity, and/or quality. These policy interventions have profound impacts on providers’ behavior, which in turns will shape the ecology of the health care delivery system in many ways such as the supply and distributions of health care facilities and health care professionals. Using physician workforce as an example, this study aims to analyze the relationship and dynamics of payment mechanisms and the health care delivery system. The main data sources are the claim data of National Health Insurance. This research will analyze and present how the distributions of physician workforce and health care utilizations (productivities) have evolved over time in terms of specialties, geography, and organizational settings. Furthermore, considering the increasing demand of health care due to population ageing and the changing characteristics of physician workforce in terms of age, gender and individual labor supply, this research will try to use system dynamic approach to simulate how the future physician workforce and health care delivery system would possibly look like in various scenarios. The findings will serve as the bases for policy recommendations.