我國醫療服務提升計畫對醫療資源不足地區的政策效果評估

Objectives: Taiwan has implemented numerous healthcare projects in rural areas, and the number of bidding budgets has increased yearly. The aim of this study is to evaluate the policy effect of medical quality improvement projects in medically underserved areas. Methods: This study used 2011-2013 data from Taiwan's National Health Insurance Database to analyze the effect of the national medical quality improvement policies have on the medically underserved areas. The experimental group comprised of hospitals participating in the projects, while the control group comprised of non-participating hospitals. We examined the effect of projects implemented to improve healthcare services by performing an empirical analysis using the DD method. Results: The outpatient-based evaluation indicators suggested the projects had considerable effect, such as increasing the outpatient cross-boundary medical care rate by 5.33%, increasing the interregional medical treatment rate of emergency departments by 1.14%, and decreasing preventable emergency department visits by 0.20%. Among these results, the outpatient cross-boundary medical care rate reached a statistical significance, while the other two indicators did not. The preventable hospitalization rate showed a contrarian growth of 0.26%, which was also not statistically significant. Conclusions: Policies to provide regional medical services across jurisdictional boundaries will help medical care needs of rural populations.