| dc.description.abstract | Since the implementation of National Health Insurance (NHI) on Taiwan for more than 20 years, it is important for the government to control the expansion of medical costs and reduce waste of medical resource. Therefore, copayment is a significant part of the design of the NHI system. The purpose of this study is to exam the changes in medical use of different patient groups (income, age) with different diseases (upper respiratory tract infection, diabetes) after a substantial increase in the outpatient copayment in 2005. This study used the observation data of the one-year (2004/07/15-2006/07/14) implementation of the NHI outpatient copayment increase policy to observe the medical utilization of different groups in upper respiratory tract infection and diabetes patients, and the analysis is based on different incomes and different age groups. We use the ordered logit regression model as an empirical research model, computing the marginal effects of the policy and the marginal effects of income to measure this copayment policy.
The results of this study show that in terms of policy effects, the choice of hospital level for patients with upper respiratory tract infection has a significant impact on the copayment increase policy; while the diabetes patients, only the low-income group, the regional population and farmers are affected by the policy. On the other hand, in the terms of income effects, the high-income groups are less affected by the policy. For those people, as long as the income increases, the more likely they are to go to a high-level hospital for medical treatment, but this effect is small.
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