健康相關的私人保險對個人醫療利用的影響;The effect of private health insurance on the medical care utilization

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题名:	健康相關的私人保險對個人醫療利用的影響;The effect of private health insurance on the medical care utilization
作者:	許家銘;Hsu, Chia-Ming
贡献者:	產業經濟研究所在職專班
关键词:	醫療險;私人保險;醫療利用;普通最小平方法;工具變數;private health insurance;private insurance;medical care utilization;ordinary least squares;instrumental variable
日期:	2017-06-29
上传时间:	2017-10-27 13:58:30 (UTC+8)
出版者:	國立中央大學
摘要:	本研究主要是探討健康相關的私人保險對個人醫療利用的影響，資料來源為台灣2005年「國民健康訪問暨藥物濫用調查」(National Health Interview Survey, 簡稱NHIS)中「12∼64 歲個人問卷」所提供的資料。本文研究模型使用普通最小平方法觀察私人保險對於個人醫療利用的影響，但因為購買健康相關的私人保險和醫療利用可能有內生性的問題存在，所以使用工具變數(健康檢查及安全意識)，來克服與內生性相關的估計偏差，另外使用Probit Model去探討使用醫療服務的機率。實證結果得出，私人保險和醫療險對於總醫療支出皆呈現顯著正向關係，但醫療險對於住院相關自費支出呈現反向關係且沒有顯著影響；有私人保險和醫療險在西醫門診和急診次數的使用上呈現顯著的減少；在個人特徵上，年齡越高，醫療支出和看診機率越高；女性則是看診機率比男性高。 ;This research investigates the effect of private health insurance on the medical care utilization. This data source is 12 ~ 64 years old personal questionnaire of 2005 National Health Interview Survey (NHIS) in Taiwan. We use the ordinary least squares to analyze the effect of private insurance on the medical care utilization. Due to the endogeneity problem arising from the potential correlation between the unobserved factors affecting individual’s purchase of private insurance and the medical care utilization, the instrumental variable (i.e., “physical examination” and “safety consciousness”) was employed to overcome the estimation bias associated with the endogeneity. This research also explored the likelihood of medical service utilization by the Probit model. The research results indicated that private insurance and private health insurance both have a significantly positive influence on the medical care utilization; but the latter is reversely related to the self-pay hospitalization expenditure, though the estimate is statistically insignificant. The individuals with private insurance and private health insurance tend to use less outpatient and emergency visits. In addition, the elderly and the female use more outpatient care.
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