Evolution of Taiwan’s health care system

Lu, Jui-fen Rachel; Chiang, Tung Liang

doi:10.1017/s1744133109990351

Cited by 65 publications

(27 citation statements)

References 12 publications

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“…Currently, the National Health Insurance program covers more than 99% of the population of Taiwan [12], and the NHIRD provides medical claims, registration, and reimbursement data [7,8]. …”

Section: Methodsmentioning

confidence: 99%

Major adverse cardiovascular events in adult congenital heart disease: a population-based follow-up study from Taiwan

Lin

Liu

et al. 2014

BMC Cardiovasc Disord

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BackgroundThe aim of the present study was to identify the long-term major adverse cardiovascular events (MACE) in adult congenital heart disease (ConHD) patients in Taiwan.MethodsFrom the National Health Insurance Research Database (1997-2010), adult patients (≥18 years) with ConHD were identified and compared to non-ConHD control patients. The primary end point was the incidence of MACE. Cox proportional hazards models were used to compute hazard ratios as estimates for multivariate adjusted relative risks with or without adjusting for age and sex.ResultsA total of 3,267 adult patients with ConHD were identified between 2000 and 2003 with a median follow-up of 11 years till December 31, 2010. The five most common types of ConHD were atrial septal defects, ventricular septal defects, patent ductus arteriosus, tetralogy of Fallot, and pulmonary stenosis. Overall, the incidence of MACE was 4.0-fold higher in the ConHD group compared with the controls. After adjustment for age and gender, the patients with ConHD had an increased risk of heart failure, malignant dysrhythmia, acute coronary syndrome, and stroke. The adult ConHD patients had a decreased life-long risk of MACE if they received surgical correction, especially in the patients with atrial septal defects.ConclusionsAfter a median of 11 years of follow-up, the Taiwanese patients with ConHD were at an increased risk of life-long cardiovascular MACE, including heart failure, stroke, acute coronary syndrome, and malignant dysrhythmia. Surgical correction may help to decrease long-term MACE in ConHD patients, especially those with ASD.

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“…Currently, the National Health Insurance program covers more than 99% of the population of Taiwan [12], and the NHIRD provides medical claims, registration, and reimbursement data [7,8]. …”

Section: Methodsmentioning

confidence: 99%

Major adverse cardiovascular events in adult congenital heart disease: a population-based follow-up study from Taiwan

Lin

Liu

et al. 2014

BMC Cardiovasc Disord

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“…Taiwan initiated its National Health Insurance (NHI) program in March 1995. This system currently enrolls up to 99% of the Taiwanese population and contracts with 97% of all medical providers in Taiwan [14]. In this study, we used the Longitudinal Health Insurance Database 2000, which was released from the NHI organization, and included 1,000,000 randomly selected subjects, based on reimbursement data in 2000.…”

Section: Methodsmentioning

confidence: 99%

Hyperlipidemia and statins use for the risk of new-onset anxiety/depression in patients with head and neck cancer: A population-based study

et al. 2017

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ObjectiveAnxiety/depression is common among patients with head and neck cancer (HNC), and can negatively affect treatment compliance and outcome. The aim of this study was to assess the association between hyperlipidemia and the risk of new-onset anxiety/depression after the diagnosis of HNC and the influence of administering statins.MethodsA matched longitudinal cohort study of 1632 subjects (408 HNC patients with preexisting hyperlipidemia and 1224 age- and sex-matched HNC patients without hyperlipidemia) was included and analyzed by using data from Taiwan’s National Health Insurance Research Database from January 1996 to December 2012. The incidence and hazard ratios (HRs) for the development of new-onset anxiety/depression were examined between the two groups. Cox proportional hazard regression was applied to estimate the relative risks of anxiety/depressive disorders adjusted for potential confounding factors. To estimate the risks of anxiety/depression in different sub-groups, a stratified analysis was also used.ResultsHNC patients with preexisting hyperlipidemia had a higher risk for comorbidities such as hypertension, diabetes mellitus, and cardiovascular disease (P <0.001). The incidence rate of anxiety/depression in the HNC patients with preexisting hyperlipidemia was also significantly higher than that among patients without hyperlipidemia (10.78% vs 7.27%, respectively; P = 0.03). A Cox regression model revealed that preexisting hyperlipidemia was an independent risk factor for anxiety/depression (aHR, 1.96; 95% CI, 1.30–2.94). Statins use was protective against anxiety/depression among HNC patients with hyperlipidemia (aHR, 0.85; 95% CI, 0.46–1.57), especially for individuals older than 65 years and for females.ConclusionsPreexisting hyperlipidemia was associated with increased risk of new-onset anxiety/depression in the HNC patients. Statins use for HNC patients with hyperlipidemia could decrease the risk of anxiety/depression, especially for those older than 65 years and for female patients.

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“…In particular, Lee Teng‐Hui boldly took on agencies that once operated employer‐based social health insurances and the Ministry of Finance. By doing so, he was able to show his “political will” to enact the National Health Insurance Act in 1994 . The political struggle between bureaucratic agents and political actors did not fade away and, in many respects, undermined the Second Generation Reform of NHI in later years.…”

Section: Five Sociopolitical Elements For Reformsmentioning

confidence: 99%

“…First, Taiwan's strong regulation on providing and benefiting from services not covered by the NHI has suppressed the development and introduction of many innovative and advanced medical treatments and technologies. This, in turn, has unduly limited citizens' freedom of choices of services . Secondly, citizens' freedom of choices of care providers remains loosely regulated.…”

Section: Five Sociopolitical Elements For Reformsmentioning

confidence: 99%

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Examining sociopolitical elements of health system reform: The experience of Singapore and Taiwan

Yeh

Serrano

2019

Health Planning & Management

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Summary This essay suggests five sociopolitical dimensions that influence the success of health system reforms. It examines the experience of two high‐income Asian countries, Singapore and Taiwan, and illustrates how these five dimensions matter. These five sociopolitical dimensions are public trust, perceived government performance, political legitimacy, equity/solidarity, and demand for choice. Public trust in government, perceived government performance, and the legitimacy of political authorities were necessary for governments in both countries to enact key reforms. Public perceptions of government capacity combined with public conceptions of equity were deliberated and clarified as stakeholders sought to reach consensus based on values upheld by segments of each society. Nevertheless, these elements alone are not enough to sustain major institutional reforms in light of ongoing social, political, and demographic changes. This essay provides a different approach to traditional policy cycle models and seeks to emphasize stewardship and governance in health systems.

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Evolution of Taiwan’s health care system

Cited by 65 publications

References 12 publications

Major adverse cardiovascular events in adult congenital heart disease: a population-based follow-up study from Taiwan

Major adverse cardiovascular events in adult congenital heart disease: a population-based follow-up study from Taiwan

Hyperlipidemia and statins use for the risk of new-onset anxiety/depression in patients with head and neck cancer: A population-based study

Examining sociopolitical elements of health system reform: The experience of Singapore and Taiwan

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