The National Health Insurance (NHI) program was officially launched in Taiwan on 1 March 1995. Three objectives are stressed in the program¡¦s implementation: (1) universal enrollment and equal-opportunity medical care; (2) balanced finances and long-term operational viability; (3) better quality medical care and better health for citizens. The initial balance of revenues and expenditures was stable, but there is a deficit during 1998. In order to prevent the financial status from keeping on worsening, the Bureau of NHI (BNHI) implement the global payment system, and expand the payroll-related premium base. What are the long-tem influences of these policies on the financial status and medical quality?
Up to now, those researches of handling the financial problem of the NHI, focused mostly on those influences of the individual policies, rare studied the long-term whole influences of multiple policies. Moreover, those methods of the researches were mostly questionnaires, data analysis, regression, rare simulated methods. Hence, this dissertation applies system dynamics to explore the long-term influences of multiple policies on handling the financial problem of the NHI. There are two purposes in the research. One is that using those interacted relationships of decisions taken by the BNHI, beneficiaries, and contracted medical care institutions to understand those causes of the financial problem of the NHI, the other is that evaluating the long-term influences of multiple policies on handling the financial problem of the NHI.
This research reaches two achievements. First, submitting casual loop diagrams focused on the financial problem of the NHI, can provide the BNHI, beneficiaries, and CMCI to have a further understanding on the financial problem of the NHI. Second, building the model of the financial problem and policies of the BNHI can simulate and evaluate he results of multiple policies on handling the financial problem of the NHI. In order to improve the financial imbalance of the NHI, the BNHI proposes three policies. Policy I, implement the global payment system. Policy II, implement the global payment system and expand the payroll-related premium base. Policy III, implement the global payment system, expand the payroll-related premium base and promote health communication. The simulation results are as follows: Policy III can solve the financial imbalance of the NHI and improve the health of citizens.
This research has two reservations. First, only explore the financial status and medical quality. Second, different criteria using for judging the priority of policies under multilple objectives may have different results. Hence, the future research can deeply consider extending the model boundary and selecting the criteria using for judging the priority of policies under multilple objectives.
| Identifer | oai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0725102-202435 |
| Date | 25 July 2002 |
| Creators | Hwang, Lih-Lian |
| Contributors | Showing H. Young, Yi-Ming Tu, Kai Sung, Chia-Ping Chen, Herng-Chia Chiu |
| Publisher | NSYSU |
| Source Sets | NSYSU Electronic Thesis and Dissertation Archive |
| Language | Cholon |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0725102-202435 |
| Rights | unrestricted, Copyright information available at source archive |
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