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The impact of universal National Health Insurance on population health: the experience of Taiwan
BACKGROUND: Taiwan established a system of universal National Health Insurance (NHI) in March, 1995. Today, the NHI covers more than 98% of Taiwan's population and enrollees enjoy almost free access to healthcare with small co-payment by most clinics and hospitals. Yet while this expansion of c...
Autores principales: | , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924329/ https://www.ncbi.nlm.nih.gov/pubmed/20682077 http://dx.doi.org/10.1186/1472-6963-10-225 |
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author | Lee, Yue-Chune Huang, Yu-Tung Tsai, Yi-Wen Huang, Shiuh-Ming Kuo, Ken N McKee, Martin Nolte, Ellen |
author_facet | Lee, Yue-Chune Huang, Yu-Tung Tsai, Yi-Wen Huang, Shiuh-Ming Kuo, Ken N McKee, Martin Nolte, Ellen |
author_sort | Lee, Yue-Chune |
collection | PubMed |
description | BACKGROUND: Taiwan established a system of universal National Health Insurance (NHI) in March, 1995. Today, the NHI covers more than 98% of Taiwan's population and enrollees enjoy almost free access to healthcare with small co-payment by most clinics and hospitals. Yet while this expansion of coverage will almost inevitably have improved access to health care, however, it cannot be assumed that it will necessarily have improved the health of the population. The aim of this study was to determine whether the introduction of National Health Insurance (NHI) in Taiwan in 1995 was associated with a change in deaths from causes amenable to health care. METHODS: Identification of discontinuities in trends in mortality considered amenable to health care and all other conditions (non-amenable mortality) using joinpoint regression analysis from 1981 to 2005. RESULTS: Deaths from amenable causes declined between 1981 and 1993 but slowed between 1993 and 1996. Once NHI was implemented, the decline accelerated significantly, falling at 5.83% per year between 1996 and 1999. In contrast, there was little change in non-amenable causes (0.64% per year between 1981 and 1999). The effect of NHI was highest among the young and old, and lowest among those of working age, consistent with changes in the pattern of coverage. NHI was associated with substantial reductions in deaths from circulatory disorders and, for men, infections, whilst an earlier upward trend in female cancer deaths was reversed. CONCLUSIONS: NHI was associated in a reduction in deaths considered amenable to health care; particularly among those age groups least likely to have been insured previously. |
format | Text |
id | pubmed-2924329 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-29243292010-08-21 The impact of universal National Health Insurance on population health: the experience of Taiwan Lee, Yue-Chune Huang, Yu-Tung Tsai, Yi-Wen Huang, Shiuh-Ming Kuo, Ken N McKee, Martin Nolte, Ellen BMC Health Serv Res Research Article BACKGROUND: Taiwan established a system of universal National Health Insurance (NHI) in March, 1995. Today, the NHI covers more than 98% of Taiwan's population and enrollees enjoy almost free access to healthcare with small co-payment by most clinics and hospitals. Yet while this expansion of coverage will almost inevitably have improved access to health care, however, it cannot be assumed that it will necessarily have improved the health of the population. The aim of this study was to determine whether the introduction of National Health Insurance (NHI) in Taiwan in 1995 was associated with a change in deaths from causes amenable to health care. METHODS: Identification of discontinuities in trends in mortality considered amenable to health care and all other conditions (non-amenable mortality) using joinpoint regression analysis from 1981 to 2005. RESULTS: Deaths from amenable causes declined between 1981 and 1993 but slowed between 1993 and 1996. Once NHI was implemented, the decline accelerated significantly, falling at 5.83% per year between 1996 and 1999. In contrast, there was little change in non-amenable causes (0.64% per year between 1981 and 1999). The effect of NHI was highest among the young and old, and lowest among those of working age, consistent with changes in the pattern of coverage. NHI was associated with substantial reductions in deaths from circulatory disorders and, for men, infections, whilst an earlier upward trend in female cancer deaths was reversed. CONCLUSIONS: NHI was associated in a reduction in deaths considered amenable to health care; particularly among those age groups least likely to have been insured previously. BioMed Central 2010-08-04 /pmc/articles/PMC2924329/ /pubmed/20682077 http://dx.doi.org/10.1186/1472-6963-10-225 Text en Copyright ©2010 Lee et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Lee, Yue-Chune Huang, Yu-Tung Tsai, Yi-Wen Huang, Shiuh-Ming Kuo, Ken N McKee, Martin Nolte, Ellen The impact of universal National Health Insurance on population health: the experience of Taiwan |
title | The impact of universal National Health Insurance on population health: the experience of Taiwan |
title_full | The impact of universal National Health Insurance on population health: the experience of Taiwan |
title_fullStr | The impact of universal National Health Insurance on population health: the experience of Taiwan |
title_full_unstemmed | The impact of universal National Health Insurance on population health: the experience of Taiwan |
title_short | The impact of universal National Health Insurance on population health: the experience of Taiwan |
title_sort | impact of universal national health insurance on population health: the experience of taiwan |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924329/ https://www.ncbi.nlm.nih.gov/pubmed/20682077 http://dx.doi.org/10.1186/1472-6963-10-225 |
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