Objectives: The purpose of this study was to analyze the health insurance status and medical utilization and its related factors for foreigners at Kaohsiung-Pingtung area in Taiwan. Methods: The study used secondary data to attain the research purposes. Data from Bureau of National Health Insurance Kao-Ping Branch between 2004 to 2007 were used. A total of 119,100 cases were analyzed. Descriptive analysis was used to examine foreigners¡¦ health insurance and medical utilization. T -test was used to investigate the differences between medical utilization and personal characteristics, such as demography, nationality and insured payrolls. Regression analysis was applied. Logistic regression was employed to examine whether the foreigners used the services both from inpatients or outpatients. Multiple regressions were applied to predict the medical expenditures and times. Results: Most of cases were aged from 21 to 40, females, category 1 insured, low income, dangerous work and seeking medical care for pregnancy and maternity care. The results from logistic regression revealed that males had lower odds to use medical care (OR=0.636 CI: 0.616 to 0.657), outpatient care (OR=0.634 CI: 0.614 to 0.655) and inpatient care (OR=0.804 CI: 0.757 to 0.853) compared with females. Insured came from mainland have higher odds to use inpatient care (OR=1.184 CI: 1.124 to 1.246) compared with other countries. People had 2 to 3 insured years used higher medical care (OR=5.873 CI: 5.636 to 6.119) and outpatient care (OR=5.886 CI: 5.649 to 6.314) compared with those whose insured under 1 year. If insured period over 3 years, they would have 5 more times probabilities to inpatient care than whose time under 1 year (OR=5.017 CI: 4.664 to 5.398). Category 5, low-income insured, had more than 8 times probabilities to use inpatient services than category 1 who had stable work. Results from multiple linear regressions indicated longer insured period, came from mainland and catastrophic illnesses patients would have more outpatient and inpatient visiting times significantly. So did the medical expenditures. Conclusions: Gender, age, nationality, insurers¡¦ category, qualified, the insured payroll, catastrophic illness and occupational accidents were the determination of medical utilization among foreigners at Kaohsiung-Pingtung Area in Taiwan. Future researchers could use questionnaire to get more complete relevant factors and follow the medical utilization and health status of foreigners. To provide the policymakers facilitate the planning of public health interventions.

Mental illness and psychological distress is associated with higher rates of medical service usage and treatment of these issues results in more appropriate medical utilization rates. Little research has been conducted in an integrated care clinic, wherein health psychologists or behavioral health specialists work together with physicians to provide patient care. The current study examines the effects of brief behavioral and mental health interventions on patient medical utilization in this setting with care delivered by medical residents and doctoral psychology trainees. Access to the health system’s electronic billing records allowed for objective measures of annual healthcare utilization in terms of inpatient, outpatient, and emergency department use. A quasi-control group was constructed using propensity score matching in order to compare patients who had received a primary care psychology intervention to those who had not. Rates of inpatient utilization decreased significantly among treated patients overall as well as among treated patients identified as frequent attenders; there was no change in inpatient utilization among patients in the control group overall nor among frequent attenders in the control group, indicating that there is likely an effect of behavioral and mental health treatment on rates of inpatient visits. Rates of emergency department use and specialty outpatient visits were comparable between treated and control group patients, suggesting the lack of a treatment effect in these areas. Strengths, limitations, possible mechanisms, and implications for future research are discussed.

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