全民健保醫療服務使用公平性之探討

One of the major objectives of Taiwan's National Health Insurance (NHI) program, which has been put into effect in March 1995, is to link utilization of medical care to medical needs but divorce ability to pay from the receipt of medical services. The purpose of this research is to examine whether this goal has been met or whether the extent of inequIty has been reducing since the implementation of NHI.
The concentration coefficient method is employed to investigate whether inequity exists in the delivery of NHI. The equitable principle employed in this research is horizontal equity, which means that medical services should be distributed according to medical needs. The data used for the analysis are from the 1996 Survey of Satisfaction on NHI and the 1998 NHI claims.
Results show that the NHI program is less equitable in terms of the delivery of health care services according to level of need. In particular, indices of equity on Chinese medicine and dental services suggest inequity favoring the better-off. Overall, the horizontal inequity index is 0.022 for Taiwan's NHI program compared to that of a low of -0.10 in Denmark and a high of about 0.06 in Australia.