The purpose of this research aims to (1) construct the predict model by system dynamics on the outpatient visits; (2) investigate the influence on hospital performance after drug price policies made; and (3) offer feasible schemes by scenario simulation. National Health Insurance (NHI) system intends to safeguard the right to health care for all residents in Taiwan. NHI system has gained high public satisfaction so far. However, medical expenditures and pharmaceutical costs have propelled the rapid growth in recent years because of the stipulation of the insurance premium rate, the general push for improved health care quality, and inclusion of new drugs as well as new technologies. To prevent the deficit of the NHI system¡¦s finances from widening further, the Bureau of NHI is urged to reform the reimbursement policies, including Adjustments of Drug List and Payment Scheme, Global Budget Payment System, and Adjust Reasonably Reimbursement Criteria as well. Based on the statistics, a quarter of the total revenues were for the drug cost. Legally mandated drug price adjustments have a great influence on the financial burden of the medical institutions. On the basis of the simulation analysis, the major findings of this research are summarized as follows: (1) The adjustments of the prescription depend on the amount of the profit gained from the drugs; (2) The increase the refillable prescriptions for patients with chronic illnesses enhances the profit of the drugs; (3) With the implementation of the system dynamics, the counterintuitive phenomenon can be identified and used to guide the future policies of the medical institutions. This research also suggests that the total comprehension of finding the leader loop in the dynamic complexity system within the management of the medical institutions is beneficial in providing the relative adjustment policies for a hospital.

Purpose: The Bureau of National Health Insurance (BNHI) use the Global Budget (GB) System to control the medical expense growing up, and it was put into practice in each hospital in July 2002. This research explores the medical expense before and after the GB System was put into practice. Method: Using the data of BNHI, we explore the average daily cost of admission data of schizophrenia (ICD-9 CM code 295) in acute ward. The total cost were separated into several detail subjects (drug amount, psychiatric treatment amount, test amount, self payment amount, and other) to be analyzed. Data of 1999 and 2000 were selected as ¡§before GB period¡¨, and 2003 and 2004 were selected as ¡§post GB period¡¨. We also collect following variables to adjust the effect of GB. Patient¡¦s data: age, gender, comorbidity, insurance count, urbanization. Hospital data: hospital levels, hospital power, geographic location, owner, teaching hospital. Doctor data: age, gender. The 14-day and 30-day re-admission rate. Results: The growth of total medical expense is 40% after the implement of GB, which is lower than the estimated 60%. In the psychiatry, the total cost or subgroups of the total cost were increased. The average daily drug amount were 150.42 NTD before the GB¡Aand192.53 NTD post GB; the psychiatric treatment average daily amount was 551.24 NTD before the GB, and 737.94 NTD post GB; the average daily test amount was 75.54 NTD before the GB, and 90.60 NTD post GB; the average other amount was 970.03 NTD before the GB, and 1317.06 NTD post GB; the average daily total medicine amount was 1773.18 NTD before the GB, and 2371.92 NTD post GB. After adjusting the patient, doctor, hospital, and studying year, the before/after GB is still an independent factor to predict higher cost in every amount. Nevertheless, the growth of the average daily total medicine amount is minimized to 14.83% which is much lower than the growth of 40% of the total medical expense after the adjustment of the individual items. After adjusting patient¡¦s, hospital¡¦s and doctor¡¦s factors, the 14-day and 30-day re-admission rates are lower than ¡§before GB period¡¨. Conclusion: The short-term re-admission rate, one of the medical quality indicators, declined after the implement of GB and the growth of total cost at least was suppressed to the set goal. Various adjustments of medical behaviors are believed to be made to get the best cost-benefit.

Abstract After the National Health Insurance was implemented ,it provides our citizens not only the basic medical treatment but also reduce the financial burden. However, the financial difficulties is becoming worse for National Health Insurance of Taiwan. In order to reduce the medical expenses. The Health Insurance authorities implemented many different policies.Balance billing was one of these interventions. The purposes of this research included to understand the relationships between the balance billing and the characteristics of physicians and patients .Particularly, this research focused on the perceptions of balance billing form the Physicians and hospitalized patients¡¦points of view. The Andersen¡¦s health behavior model was the conceptual framework for this study. The questionnaire was sent out to 200 doctors and 1000 patients in Kaohsiung , Pingtung regional hospitals ,with 101 (response rate 50.6%) and 638 (63.8%)returned , respectively. The characteristic and the attitude towards balance billing system such as medical quality, medical care and medical expenses from both physicians and patients were collected. Descriptive analysis and logistic regression were used to analyze this study. The Results from physicians survey are summarized as follows: 1.There were no statistical significance between the physicians¡¦ characteristics (such as age, gender, and tenure) and the agreement of balance billing .Ninety-four out of 101 physicians agreed on the new policy. 2.There would be no influence of balance billingon the medical care from the perspective of physicians. 3.Physicians who agreed on the viewpoints of paying extra payments would lead to the better treatment were 12 times more likely to accept the balance billing. 4.There were no difference among medical expenditures, the level of understanding, and the policy of balance billing. The results from inpatient survey are summarized as follows: 1. Inpatients demographic characteristics, (such as education¡Boccupation and disease), were significant related to the agreement of the policy of balance billing system. However, there were no statistical difference in age, gender, language, and private insurance. 2.Most inpatients who agreed on the balance billing policy were 1.8 times more to believe that if they paid out-of-pocket, they would gain more medical attention form physicians. 3.Regarding the quality of care, inpatients whoever agreed upon the policy of balance billing would perceive that they would receive 3 to 3.8 times higher quality of care in medical materials and medicine, respectively. 4.The more the agreement of the balance billing policy, the higher the satisfactory. 5.Inpatients who understood the new policy were more likely to pay extra payment. Based on the results from this study, it is certain to conclude that both the doctors and inpatient of the region hospital are supporting the balance billing policy .The average score of the inpatient questionnaire is 3.305.And 93.1% of the surveyed. Doctors accepted the policy of balance billing. We encouraged the bureau of National Health Insurance to continuing communication with the public and the providers to assure the success of new policy.

¡@¡@This study applies the method of literature analysis. It aims at the investigation of the whole range of the reason and process of the making of Peasant Health Insurance and its performance and its following disadvantages and faults. This study mainly intends to get the findings and solutions so as to be the efficient reference for the authorities. First of all, in this thesis, the academic principles of Insurance, Social Insurance and Peasant Insurance have been widely and deeply investigated, and then the history of the start of the reason and its development and recent performance of Peasant Health Insurance Act has also been fully related so as to be the basis of the academic analysis. The disadvantages and faults of Peasant Health Insurance in detail pointed out. An analysis of the literature of the previous researchers mainly on financial issues has been presented in order to give the evidence that the findings and solutions offered by this study could better be used for the future related amendment and policy decision on behalf of the long-term development of Peasant Health Insurance and most importantly, for the interest of the farmers. This study¡¦s conclusion presents the solutions: first, professionalism and specialization¡Xavoiding political interference and building a sound financial system correspondent with the principles of insurance; second, re-examination of the qualification of the farmers, appropriate to the real social state and adjusting the identification; third, the re-organization of the administrative and supervising departments¡Xelevating their administrative ranks; fourth, the orientation from Peasant Health Insurance Act to Peasant Insurance Act, and the guarantee of the welfare state of the Civil Annual Insurance for farmers or a single unit of the old farmer annual insurance; fifth, the positive alternative strategies for agricultural products¡Xhelping farmers technically face the impact of mass foreign products after entering WTO.

The National Health Insurance (NHI) in Taiwan has implemented over ten years. It¡¦s always attention-getting when the govermnet changes some policy or insurance premium of NHI. This time, our government wants to make a bigger reform of NHI called ¡§second generation NHI¡¨ and it will make a bigger storm of our social. So this research compares the NHI with ¡§second generation NHI¡¨ not only to let us know what NHI in Taiwan is but also to give the government the references of NHI. This research will discuss insurance organization, insured object, insurance agent, insurance recompense, insurance Healing institute and insurance finance between NHI and ¡§second generation NHI¡¨ and it will point out what are good and bad of two NHIs to help the government to correct NHI. Finally, I find five problems of our NHI¡¦s development in the result of my research; they are problems of insurance finance, NHI Payment, waste of NHI expense, quality of cure and executive extent of NHI. Also, I suggest several parts of NHI: first, advance the health protection; second, manage the medicine strictly; third, improve the use of NHI IC card; fourth, public NHI¡¦s financial affairs; fifth, make a new NHI payment; sixth, assist the Healing institutes; seventh, establish the bureau of national social insurance and eighth, adhere to the original plan of NHI.

Thesis (Ph. D.)--University of Texas at Austin, 2002. / Vita. Includes bibliographical references. Available also from UMI Company.

Sustaining splendid health has always been a wish for every employee of any formal organisation. If health is not excellent, employees are likely not to function as expected hence it is imperative to have social health insurance. This article reports on the findings derived from a research conducted in Kinshasa, Democratic Republic of Congo. The researcher personally distributed structured questionnaires among employees in 15 organisations. Findings show that the majority of the respondents experience problems in organizing their health care where it emerged that, 1) the majority of the employees from public sector are not assisted in organizing their health care, 2) they use out-out-pocket financing means for their health care, 3) in general, employees from public sector are not aware of health insurance and interestingly employees from mix companies and private sector are knowledgeable on health insurance, 4) respondents with post matric qualifications prefer to use private hospital when they are sick, 5) employees choose health facility based on good quality service provided. In general, it emerged from the findings that there is willingness to pay contribution should the social health insurance be introduced.

No description available.

Research aim: to analyse the financing system of health insurance in Lithuania, to hightlight the financing problems of health insurance and to define the opportunity of perfection.

Thesis (Ed. D.)--Georgia Southern University, 2007. / "A dissertation submitted to the Graduate Faculty of Georgia Southern University in partial fulfillment of the requirements for the degree Doctor of Education." Under the direction of Rosemari Stallworth-Clark. ETD. Electronic version approved: May 2007. Includes bibliographical references (p. 110-125).