Ensuring the sustainability of the Taiwan National Health Insurance

Huang, San‐Kuei; Tsai, Shu‐Ling; Hsu, Ming-Tzu

doi:10.1016/j.jfma.2013.08.010

Cited by 18 publications

(12 citation statements)

References 2 publications

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“…The data were obtained from the National Health Insurance Research Database (NHIRD), which was released by the National Health Research Institute, and covers all benefit claims for approximately 23 million enrollees, representing approximately 99% of Taiwan's entire population. 12 Taiwan launched a single-payer National Health Insurance program in 1995 to finance the nationwide health care for all residents. 12 The claim data included detailed medical records, including outpatient visits and hospitalizations with diagnostic codes in the format of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM).…”

Section: Data Sourcementioning

confidence: 99%

“…12 Taiwan launched a single-payer National Health Insurance program in 1995 to finance the nationwide health care for all residents. 12 The claim data included detailed medical records, including outpatient visits and hospitalizations with diagnostic codes in the format of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). For the protection of privacy, identities of patients, physicians and institutions were scrambled, in accordance with data regulations of the National Health Insurance Administration, Ministry of Health and Welfare, Taiwan.…”

Section: Data Sourcementioning

confidence: 99%

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Psoriasis is associated with increased risk of bullous pemphigoid: A nationwide population‐based cohort study in Taiwan

Chang

et al. 2019

The Journal of Dermatology

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Psoriasis may coexist with bullous pemphigoid (BP); however, no cohort studies have investigated the relationship between psoriasis and the risk of BP. This study aims to investigate the relationship between psoriasis and the risk of BP in Taiwan. This cohort study consists of 109 777 psoriatic patients and 109 777 matched non‐exposed controls. Psoriatic patients diagnosed between 2002 and 2012 were identified from the Taiwan National Health Insurance Research Database. The age‐, sex‐ and index date‐matched non‐exposed group was selected from the same database. The relationship between psoriasis and the risk of BP was investigated using Cox proportional hazards analyses. Psoriasis was significantly associated with an increased risk of BP (hazard ratio, 3.05; 95% confidence interval, 2.10–4.43; P < 0.001). The mean interval between the diagnoses of psoriasis and BP was 2.86 years, with the highest occurrence in the first year after psoriasis diagnosis, and gradually decreasing with each year of observation. Psoriatic patients with BP were significantly younger than BP patients in the non‐exposed group (71.6 ± 13.9 vs 76.6 ± 7.7 years, respectively; P = 0.030). A higher proportion of patients with coexisting psoriasis and BP received phototherapy (20%). In conclusion, psoriasis was independently associated with a 3.05‐fold increased risk of BP, and psoriatic patients with BP were younger, with over one‐third of BP cases diagnosed in the first year after incident psoriasis. Therefore, clinicians treating patients with psoriasis may be aware of the possibility of the development of BP.

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Section: Data Sourcementioning

confidence: 99%

Section: Data Sourcementioning

confidence: 99%

Psoriasis is associated with increased risk of bullous pemphigoid: A nationwide population‐based cohort study in Taiwan

Chang

et al. 2019

The Journal of Dermatology

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“…The National Health Insurance program in Taiwan is famous for low expenditure, high medical service usage, high coverage rate, and acceptable medical quality [17]. Low expenditure with high usage rate, combined with ageing problem and increased cost due to technology advancement, undoubtedly put great pressure on hospital’s financial balance [18]. As a result, health professionals’ income is always the target of controlling cost, including physicians.…”

Section: Introductionmentioning

confidence: 99%

Work hours and turnover intention among hospital physicians in Taiwan: does income matter?

Tsai

Huang

Chien³

et al. 2016

BMC Health Serv Res

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BackgroundPhysician shortage has become an urgent and critical challenge to many countries. According to the workforce dynamic model, long work hours may be one major pressure point to the attrition of physicians. Financial incentive is a common tool to human power retention. Therefore, this large-scale physician study investigated how pay satisfaction may influence the relationship between work hours and hospital physician’s turnover intention.MethodsData were obtained from a nationwide survey of full-time hospital staff members working at 100 hospitals in Taiwan. The analysis sample comprised 2423 full-time physicians. Dependent variable was degree of the physicians’ turnover intention to leave the current hospital. The pay satisfaction was assessed by physicians themselves. We employed ordinal logistic regression models to analyze the association between the number of work hours and turnover intention. To consider the cluster effect of hospitals, we used the “gllamm” command in the statistical software package Stata Version 12.1.ResultsThe results show that 351 (14.5%) of surveyed physicians reported strong intention to leave current hospital. The average work hours per week among hospital physicians was 59.8 h. As expected, work hours exhibited an independent relationship with turnover intention. More importantly, pay satisfaction could not effectively moderate the positive relationship between work hours and intentions to leave current hospital.ConclusionsThe findings show that overtime work is prevalent among hospital physicians in Taiwan. Both the Taiwanese government and hospitals must take action to address the emerging problem of physician high turnover rate. Furthermore, hospitals should not consider relying solely on financial incentives to solve the problem. This study encouraged tackling work hour problem, which would lead to the possibility of solving high turnover intention among hospital physicians in Taiwan.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1916-2) contains supplementary material, which is available to authorized users.

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“…4 The electronic medical record exchange system will allow residents of remote townships and offshore islands to use their national health insurance IC (Integrated Circuit) cards after returning from hospitals of metropolitan areas so that physicians at their local public health centers can access hospital and outpatient records, discharge summaries, image reports, and laboratory reports through the Internet. 5,6 This will reduce the need for residents of remote townships to make frequent trips to hospitals of metropolitan areas. It will also provide a substantial saving in transportation costs and reduce the loss of working hours, while improving the quality of medical care.…”

mentioning

confidence: 99%

Using health information technology to reduce regional health inequality in Taiwan

Chiu

Hsu²,

Teng³

2015

Journal of the Formosan Medical Association

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Ensuring the sustainability of the Taiwan National Health Insurance

Cited by 18 publications

References 2 publications

Psoriasis is associated with increased risk of bullous pemphigoid: A nationwide population‐based cohort study in Taiwan

Psoriasis is associated with increased risk of bullous pemphigoid: A nationwide population‐based cohort study in Taiwan

Work hours and turnover intention among hospital physicians in Taiwan: does income matter?

Using health information technology to reduce regional health inequality in Taiwan

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