Ya-Ming Liu
National Cheng Kung University, Taiwan
Posters & Accepted Abstracts: Prim Health Care
This study divides health care expenditures into observable effects and structural shifts to explore the contribution of population ageing and high technology on the growth of outpatient service, inpatient service and prescription drug expenditures in Taiwanâ??s health care system experiencing the shift of payment schemes from cost-based to global in 2002. Based on the three-million cohort claim data from National Health Insurance Database (2000-2010), my results show that in the short run, implementing global budges results in negative structural shifts on outpatient service and prescription drug expenditures only at the lower percentiles. For inpatient services, the observable effect and structural shift still keep increasing over entire distribution. In the long run, the observable effect dominates the growth of health care expenditures. Specifically, population ageing attributes to the growth of prescription drug expenditures at the higher percentiles. The adoption of high technology drives the growth of top outpatient service and inpatient service expenditures. As noted by Chandra and Skinner (2012), to identify patients who really need specific high-cost technology would increase marginal health benefits of medical technology. As the expenditures on outpatient care that accounts for around 50% of national health expenditure (MHW, 2015), improving the management of outpatient health care for high-cost patients would be very crucial to the effectiveness of cost control policy in a single public payer system. One main implication of this study is that while the government health care agency aims to control health care expenditures, understanding the heterogeneity of each contributor on the growth of expenditures is an important step to evaluate a health care expenditure containment policy.
E-mail: ymliu@mail.ncku.edu.tw
