Dissertations / Theses on the topic 'National Health Insurance Scheme (NHIS)'
To see the other types of publications on this topic, follow the link: National Health Insurance Scheme (NHIS).
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 38 dissertations / theses for your research on the topic 'National Health Insurance Scheme (NHIS).'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Owusu-Asamoah, Kwasi. "Modelling an information management system for the National Health Insurance Scheme in Ghana." Thesis, Loughborough University, 2014. https://dspace.lboro.ac.uk/2134/16415.
Abstract:
The National Health Insurance Scheme (NHIS) in Ghana was introduced to alleviate the problem of citizens having to pay for healthcare at the point of delivery, given that many did not have the financial resources needed to do so, and as such were unable to adequately access healthcare services. The scheme is managed from the national headquarters in the capital Accra, through satellite offices located in districts right across the length and breadth of the country. It is the job of these offices to oversee the operations of the scheme within that particular district. Current literature however shows us that there is a digital divide that exists between the rural and urban areas of the country which has led to differences in the management of information within urban-based and rural-based districts. This thesis reviews the variables affecting the management of information within the scheme, and proposes an information management model to eliminate identified bottlenecks in the current information management model. The thesis begins by reviewing the theory of health insurance, information management and then finally the rural-urban digital divide. In addition to semi-structured interviews with key personnel within the scheme and observation, a survey questionnaire was also handed out to staff in nine different district schemes to obtain the raw data for this study. In identifying any issues with the current information management system, a comparative analysis was made between the current information management model and the real-world system in place to determine the changes needed to improve the current information management system in the NHIS. The changes discovered formed an input into developing the proposed information management system with the assistance of Natural Conceptual Modelling Language (NCML). The use of a mixed methodology in conducting the study, in addition to the employment of NCML was an innovation, and is the first of its kind in studying the NHIS in Ghana. This study is also the first to look at the differences in information management within the NHIS given the rural-urban digital divide.
2
Ofori-Birikorang, Andrews. "Promoting a New Health Policy in the Ghanaian Media: Newspaper Framing of the National Health Insurance Scheme from 2005-2007." Ohio : Ohio University, 2009. http://www.ohiolink.edu/etd/view.cgi?ohiou1249077245.
3
Teddy, Gina. "From policy to process : an insider perspective of implementing the national health insurance scheme (NHIS) at the Districts in Ghana." Thesis, University of York, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.542808.
4
James, Candice. "The impact and constitutionality of the proposed National Health Insurance scheme with regard to the provision of health services by subnational governments." University of Western Cape, 2020. http://hdl.handle.net/11394/7345.
Abstract:
Magister Legum - LLMIn South Africa, there are two health systems through which health services are delivered,1 namely private and public. These two systems were inherited from the apartheid regime.2 With South Africa’s political change from a system of parliamentary sovereignty to a constitutionally supreme system in 1996, huge changes were bound to come including changes to the health sector.3 This meant the overhauling of health legislation, as the right of access to health care services became guaranteed in the Constitution of the Republic of South Africa, 1996.4 In 1997, the White Paper on the Transformation of the Health System (White Paper on Health)5 was introduced with the aim of developing a national health system.6 There has been a lot of progress made in reforming the health sector, however there are still many cracks that the national government aims to remedy through the realisation of universal health coverage (UHC).
5
Mathekgane, Justice Mpho. "The laws regulating National Health Insurance scheme :prospects and challenges." Thesis, University of Limpopo, 2013. http://hdl.handle.net/10386/2542.
6
Mack, Zonique Lewore. "A critical analysis of the suitability of a national health insurance scheme in South Africa." Thesis, Cape Peninsula University of Technology, 2011. http://hdl.handle.net/20.500.11838/1657.
Abstract:
Thesis (MTech (Public Management)--Cape Peninsula University of Technology, 2011In South Africa’s two-tiered health system, some enjoy health care based on ability to pay and others utilize services in an under-funded sector. The rift in the two, public and private sectors, primarily exists because income categories either curb or allow the necessary contributions. This thesis reports on the various contributing mechanisms, through which health care can be ensured universally, without causing impoverishment. The framework or criteria selected for this study includes feasibility, equity, efficiency and sustainability of a contributing mechanism. Furthermore, the contributing mechanisms – tax-funded, NHI, voluntary health insurance and out-ofpocket – are resident within four health care models namely, Beveridge, Bismarck, NHI and Out-of-pocket. These models are discussed as well as relevant country examples are provided. In the pursuit of answering whether the NHI scheme is suitable for South Africa, the study shows that government or tax-funding and NHI provides the contributing mechanisms that are applicable to the South African situation within the context of different challenges. It is recommended that, in the government’s discussions about health care reform, prepayment, universalism and health care expenditure, amongst others, be considered.
7
Khetrapal, S. "Public-private partnerships in the health sector : the case of a national health insurance scheme in India." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2016. http://researchonline.lshtm.ac.uk/3141184/.
Abstract:
Public-Private Partnerships (PPPs) in the health sector are essential in light of the challenges the public sector is facing in healthcare finance, provision and management. Recognizing the need to provide insurance coverage to those below the poverty line (BPL), Rashtriya Swasthya Bima Yojana (RSBY) was introduced in 2008 by the Ministry of Labour and Employment in India. RSBY is a social health insurance scheme for the informal sector, where health care delivery and management involves a multitude of stakeholders from both public and private sectors who are governed by contractual agreements. A family of up to five pays INR 30/- (£0.30) annually for enrolment for a coverage of INR 30,000/- (£302). The balance of the premium is subsidized and shared by the Central (75%) and the State (25%) governments. This research aims to evaluate the availability, provision and management of health services under RSBY Public-Private Partnership contracts and factors that might influence them in order to inform policy makers on how to improve scheme implementation for the BPL beneficiary. The study was conducted in the districts of Patiala and Yamunanagar, in the States of Punjab and Haryana respectively. The study has both qualitative and quantitative components using primary and secondary data. The results of the study can be broadly categorized under the main pillars of scheme design and implementation. These include political, regulatory and institutional capacity; stakeholder contracting; enrolment of beneficiaries; empanelment of health facilities; and finally provision and utilization of services. RSBY has clearly attempted to address the existing gaps in the provision of health services by offering a balanced Public-Private Partnership model that provides some degree of financial protection to the end user. Despite the weaknesses identified, it is a robust and evolving model that needs to be continuously developed, on the basis of lessons learnt from implementation of the scheme.
8
Alhassan, Yussif Nagumse. "The role of the National Health Insurance Scheme in shaping equity of access to healthcare in Ghana." Thesis, London Metropolitan University, 2014. http://repository.londonmet.ac.uk/1080/.
Abstract:
In light of recent emphasis on achieving Universal Health Coverage through social health insurance in low income countries, this thesis examined how the National Health Insurance Scheme in Ghana impacts on equity of access to healthcare in Tamale District of northern Ghana. Using mainly a qualitative approach, the thesis specifically examined whether the NHIS promotes equity in health insurance coverage and whether insured members are able to access healthcare equitably. Against this background, four broad findings were identified. Firstly, even though the NHIS improved insurance coverage in the Tamale District, enrolment was largely inequitable because most socially disadvantaged groups/individuals were less able to insure. This was mainly because such groups were predisposed to developing low willingness and low ability to enrol in the NHIS as a result of their individual and community characteristics as well as NHIS and healthcare system factors. Secondly, the NHIS improved the affordability of healthcare services and reduced the risk of catastrophic healthcare expenditure among insured members, particularly insured low income households. Thirdly, while the NHIS improved the financial resources of healthcare providers and the availability of medicines and medical supplies, it adversely impacted on the general quality of healthcare services mainly because the supply of healthcare resources failed to keep up with a high demand for healthcare services by insured members. Fourthly, the NHIS also improved the use of formal care, particularly among insured low income households due to their greater healthcare needs and previous inability to afford the cost of healthcare services. However, due to long waiting times associated with accessing NHIS healthcare, the improvement in financial access to healthcare by the NHIS failed to eradicate the use of ‘informal’ forms of care (e.g. drugstore, herbal/traditional medicine) among insured members. Based on these findings, this thesis concludes that the NHIS could enhance equity in access to care if there are opportunities created to enable socially disadvantaged groups to enrol in the scheme as well as improve the availability and quality of healthcare services for insured members.
9
Lloyd, Bridget. "Stakeholder perceptions of human resource requirements for health services based on primary health care and implemented through a national health insurance scheme." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7813_1363786823.
Abstract:
In 2007, at its 52nd Conference in Polokwane, the African National Congress (ANC) called for the implementation of a National Health Insurance (NHI) scheme. The announcement resulted in much debate, with critics voicing concerns about the state of the public health system, lack of consultation and the expense of a NHI scheme. However, little attention has been paid to the
human resource (HR) needs, despite the fact that 57% of recurrent expenditure on health1 is on HR. This research aimed to identify the HR requirements to support the implementation of an effective and equitable health system funded by a NHI in South Africa. An overview of the current burden of disease and distribution of HR is provided. Through interviewing key stakeholders the study attempted to elicit information about factors which will hamper or assist in developing such a health system, specifically looking at the HR situation and needs. The research explores HR
odels and proposes key HR requirements for implementation of a health system funded by a NHI in South Africa, including skills mix and projected numbers of health workers and
proposes ways to improve the deficient HR situation. Exploratory qualitative research methods were used comprising in-depth individual interviews, with a purposive sample of key informants, including: public health professionals and health managers (working in rural and urban areas)
researchers
academics and NGO managers. The contents of the interviews were analysed to identify common responses about and suggestions for HR requirements within the framework of a NHI. 1 Personal communication Dr Mark Blecher, Director Social Services (Health), National Treasury, 17 July 2009 The literature review includes policy documents, position papers and articles from journals and bulletins. Key informants were asked to identify literature and research material to support recommendations. The research findings indicate that despite the South African Government&rsquo
s expressed commitment to Primary Health Care (PHC), the National Department of Health has continued to support and sustain a clinical model of health service delivery (Motsoaledi, 2010), primarily utilising doctors and nurses. The clinic based services are limited in their ability to reach community level, and, being focused on curative aspects, are often inadequate with regard to prevention, health promotion and rehabilitation services. While the curricula of health professionals have been through some changes, the training has continued to be curative in focus and the clinical training sites have not been significantly expanded to include peripheral sites. While there are many Community Health Workers in the country, they remain disorganised and peripheral to the public health system. The mid level worker category
has not been fully explored. Finally there are no clear strategies for recruitment and retention of health workers in rural and under-resourced areas. In addition to the continued use of a clinical model, transformation of the health system hasbeen hampered by inadequate numbers of health workers, particularly in the rural and periurban townships and informal settlements. There is no clear strategy for addressing the critical
health worker shortage in under-resourced areas, particularly rural areas. The last section makes recommendations, which will be submitted to the relevant task teams working on the NHI. It is intended that recommendations arising out of the research will influence the process and decisions about HRH within a NHI funded health system.
10
Kim, Hunjin. "An analysis of the policy-making process of the National Health Insurance scheme in the Republic of Korea." Thesis, University of Edinburgh, 2003. http://hdl.handle.net/1842/24776.
Abstract:
This thesis focuses on the policy-making process of the National Health Insurance scheme (NHI) in the Republic of Korea (Korea). The analysis of the policy process of the Korean NHI scheme also makes it possible to observe the development of social policy in Korea. Health care in Korea was basically provided through the market until the implementation of the NHI scheme in 1977. The health care programme was initially introduced for a restricted section of the workforce, but gradually the programme was expanded to cover the entire population. The study addresses the questions of why and how has the NHI scheme developed. The policy-making process of the NHI scheme in Korea can be explained better by socio-political elements than by economic factors. Policy-making in the 1960s and 1970s was carried out by a limited number of policy-makers within a confined policy-making institution. At the beginning of the 1980s, however, the government pursued a more explicit strategy of reform. Since then, the range of the participants embedded in the policy-making arena has gradually become diverse and complex. As democratic processes became stronger, the policy-making structure became dynamically transformed, and power in the process was distributed among various social actors in the society. The economic crisis at the end of the 1990s had a significant impact on the style and structure of policy-making. There was a greater involvement of civic and interest groups in the policy-making process, and the government was less able to take any unilateral policy decisions. The policy-making process of the NHI scheme over the past four decades led to the development of the reformist and anti-reformist groups, and these groups contributed to building ideological foundations not only for the NHI development but also for social policy development in Korea. Two distinctive features were identified as one of the many by-products created by the NHI policy process. First, the policy-making style in the health care policy developed from 'authoritarian leadership' to 'pluralist and corporatist styles'; second, citizenship has been developed in the society and has influenced the policy-making process.
11
Dalinjong, Ayizem Philip. "The impact of the National Health Insurance Scheme on the interactions between providers and clients in the Bolgatanga and Builsa districts of Ghana." Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/12217.
Abstract:
Includes abstract.Includes bibliographical references.
Prepayments and risk pooling through social health insurance has been advocated by international development organizations. Social health insurance is seen as a mechanism that helps mobilize resources for health, pool risk, and provide more access to health care services for the poor. Hence Ghana implemented the National Health Insurance Scheme (NHIS) to help promote access to health care services for Ghanaians. The study examined the influence of the NHIS on the behaviour of health care providers in their treatment of insured and uninsured clients.
12
Basadi, Richard Angwaasuwe. "Assessment of service provider preparedness and concerns in the process of implementing the National Health Insurance Scheme in Ghana : a study of the Upper West Region." Master's thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/9433.
Abstract:
Includes bibliographical references ( leaves 85-88).This study focuses on assessing health provider preparedness in the move towards the implementation of national health insurance with specific reference to the Upper West Region. The paper uses both quantitative and qualitative methods to review the level of knowledge of health staff on the concept of health insurance, the availability of health professionals, essential drugs, infrastructure and equipment, which are essential for providing quality health care.
13
Ahmed, Farouq Raj. "National health insurance scheme with emphasis on Ghana." Master's thesis, 2018. http://www.nusl.cz/ntk/nusl-429331.
Abstract:
The goal of this thesis is to examine the role of the NHIS in providing basic healthcare and its accessibility especially in rural Ghana. The NHIS was first introduced in 2003 to eliminate the cash for services system of health provided services. The implementation of the scheme increased access and use of basic healthcare services. Most healthcare institutions are poised with challenges in management, delivery and utilization of healthcare services. This study aims to access the effect of the NHIS on healthcare delivery in Ghana.
14
Botha, Cecilia Liza. "Private doctors' responses on the implementation of a National Health Insurance Scheme (NHIS)." Thesis, 2018. https://hdl.handle.net/10539/25279.
Abstract:
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree of Master of Science in Nursing. Johannesburg 2018.There are numerous challenges and concerns, about a future mandatory National Health Insurance Scheme. The proposed South African NHI scheme, is that of capitation and a single-payer model in order to achieve Universal Heath Coverage. The objectives of this study, focused on exploring opinions and responses of medical doctors working in two private health care institutions. [Abbreviated Abstract. Open document to view full version]
LG2018
15
Augustine, Leon. "Implementation of a social health insurance scheme in South Africa." Thesis, 2006. http://hdl.handle.net/10413/1440.
Abstract:
The Department of Health (DOH) has embarked on a noble initiative to address the disproportionate distribution of resources and spending within the public and private healthcare sectors. Social Health Insurance (SHI) has thus been mooted as the vehicle to obtain a more equitable healthcare dispensation. This thesis explores the state of preparedness of the DOH, for the implementation of SHI. Ten aspects of health have been identified which will assist in determining if sufficient reforms have been implemented to facilitate the successful implementation of SHI. The prospective mechanism of financing of SHI is compared to the highly acclaimed model employed by the Australian Department of Health. Two research methodologies have been utilized viz. the case study approach and semi structured interviews, to provide comprehensive data. This enabled the researcher to adequately answer the research question. The responses from the respondents on the 10 aspects of healthcare have been arranged into themes to facilitate a greater understanding of the issues being highlighted. Established strategic management instruments have been utilized to analyze the data obtained and evaluate the preparedness of the DOH for the implementation of SHI. Following the data analysis, recommendations are proposed that would facilitate the successful implementation of SHI, thereby promoting its viability and sustainability in providing quality healthcare to all who call South Africa home.Thesis (MBA)--University of KwaZulu-Natal, 2006.
16
Tsai, Shian-Teng, and 蔡憲騰. "A Scheme for Managing Reasonable Rehabilitation Payment of National Health Insurance." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/79144260771123786941.
Abstract:
碩士大葉大學
資訊管理學系碩士在職專班
98
The National Health Insurance (NHI) had raised the national health insurance rate seven years ago. There is always the pressure from the public on increasing the National Health Insurance expenditure, especially the treatment fee of rehabilitation. Therefore, it is an important issue for the management and control of National Health Insurance expenditure. The study is for reducing the medical fee of rehabilitation. It first assesses the feasibility of implementation, and then builds the management information system for rehabilitation treatment in order to provide the timeliness and slow the growth of the payment claim of rehabilitation treatment for the rationalization of the payment of rehabilitation treatment. The development of the management information system is based on the regulation of ISO27001. Besides providing the information of controlling patients to the hospitals in advance, the proposed management system can also reach to the agreement for the timeliness of medical treatment for rehabilitation so that BNHI can pay the medical fees of rehabilitation based on the reasonable intensity. Furthermore, any doubts on payment, we reserve the respect of the rationalization and flexibility of opinions from the investigation committee to achieve the purpose of the rationalization of payment of rehabilitation treatment.
17
Liu, Cheng-Chuan, and 劉成娟. "Utilization Analysis of Computed Tomography under the National Health Insurance Scheme." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/81835412106910181063.
Abstract:
碩士國立陽明大學
公共衛生研究所
87
The utilization of medical technology is one of the main reasons for the medical expenditure increasing. In Taiwan, the ratio of Computed Tomography(CT) has been increased 15% from 1990 to 1996. It is deserved to research whether high technology utilization is related to individual''s or hospital''s specific characters or not. The database includes national wide inpatient information from 1997 Jan. to Dec. which is supported by Bureau of National Health Insurance. This paper focus on the relationship of CT scan utilization between factors of individuals and different hospitals (i.e. Total patient, neurology group, cereovascular group). A model has been developed which tries to help people to analyze the hospital easier. The key finding of this paper as following: 1. The utilization rate of CT scan per used patient during the same period: once: 91.3%, more than twice 8.7%. The highest utilization for CT scan is 12 times. 2. The analysis of individual utilization rate for totally, neurology group and cereovascular group are 8.56%, 33.9%, 43.46%. In totally patient group, the elder patients trend to have higher utilization rate of CT scan and sex also effects the rate. 3. Analysis of hospital utilization rate: The effective factors of whole patients are hospital level, public or private, average length of stay, quantity of CT scanner. The effective factors of neurology group are hospital level, public or private, average length of stay. The effective factors of cereovascular group are hospital level, public or private, quantity of CT scanner. As can be seen, the CT utilization rate will increase 2.1% when one new CT scanner is added. This conclusion can be deeply concerned by authority when a hospital applying a new CT scanner. The quantity of CT utilization is not a proper standard to determine the hospitals. This paper offer an objective adjust CT rate through analyze variety casemix. This can be used by authority to verify CT utilization rate or be the reference materials in hospital management.
18
Ngqolowa, Dundu Davey. "Legal framework regulating the National Health Insurance Scheme :prospects and challenges." Thesis, 2017. http://hdl.handle.net/10386/1933.
Abstract:
Thesis (M.Dev.) -- University of Limpopo, 2017.This mini-dissertation examines the policies regulating the National Health Insurance Scheme. It explores the reforms on the health care system in South Africa. In addressing this issue, the mini-dissertation investigates the constitutional obligation of the South African government regarding the provision of health care services. It also focuses on the two primary issues relating to health care services. Firstly, South Africa has allocated significant budget to fix the ailing health care system. Secondly, South Africa commands huge health care resources compared with many other middle-income countries, however the bulk of these resources are in the private sector and serve a minority of the population. It further looks at the lessons that South Africa could learn from the successes of the National Health Insurance Scheme implementation in Organisation for Economic Co-operation and Development (OECD) countries as it proceeds with the implementation of the National Health Insurance.
19
Chuang, Yu-Hsiu, and 莊玉秀. "Hospital Compliance with Financial Reporting Guidelines under National Health Insurance Scheme." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/44992965599570956534.
Abstract:
碩士國立陽明大學
醫務管理研究所
104
Background Taiwan’s National Health Insurance Administration (NHIA) began with public disclosure of financial reports of medical organizations with a medical revenue NT$ 600 million or more from 2013. The purpose of this research is to examine these financial reports to identify hospital compliance with financial reporting guidelines concerned. Methods Document analysis and content analysis were conducted to analyze financial reports of 109 hospitals in 2013 and 111 hospitals in 2014. Results Although NHIA's Methods for Filing Financial Reports by Contracted Medical Care Institutions under the National Health Insurance Act ("MFFR") has provided suggested formats for financial reports to be filed, these formats are for reference purposes and not required. Hospitals under different ownership/fiscal control are allowed to submit their reports in their own unique formats that they have been using previously, with vast differences in their respective classification of account items and method of representation and disclosure, resulting in the reduction in understandability and comparability that are characteristics of, and indeed prerequisites for, quality financial reporting. At the same time, hospitals are allowed to submit financial reports within ten months of the end of the calendar year, leading to the serious loss of their timeliness and relevance. Moreover, the requirement for hospitals to disclose merely six financial statements renders it nearly impossible to determine whether the hospitals have actually complied with the cost-benefit principle, or with the requirements for prudence, conservatism, or completeness. For private legal-person hospitals, 17% of the financial reports filed have used selective representation method in reporting their medical revenues, gravely undercutting the neutrality principle for financial reporting. Additionally, it is also found that a few CPA firms are suffering from low audit quality. Presently, neither the MFFR nor the relevant rules and regulations clearly defines the exact entity, or the level of entities related in economic substance, that are the subject of the financial reporting requirements, nor guidance as to the standards for consolidated reporting of revenues by these related entities, or as to the depth and extent of disclosure of their intra-entity transactions, leaving some of the entities directionless in their effort to comply with the reporting and disclosure requirements. Lastly, the NHIA's public information webpage provides the general public only a scanned PDF copy of the financial reports filed by the hospitals, defying the users the ability to directly access and re-use the contents of the financial records and files. Conclusions This study found room for improvement in hospital compliance with financial reporting guidelines. It suggests NHIA to initiate an XBRL platform for hospitals to report financial reports uniformly, to develop accounting framework and terms that fit hospital practices, and to improve monitoring functions. Meanwhile, accounting firms must fulfill their obligation of loyalty in practices, while public participation in supervising the compliance concerned is important.
20
Feng, Sun Chia, and 孫佳鳳. "The impact of National Health Insurance scheme on the health indicators in Taiwan." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/56236315655077511183.
Abstract:
碩士中國醫藥大學
環境醫學研究所
92
This research had three objectives. The first is to analyze the general health status of Taiwan people between 1994 and 2004, to evaluate if the National Health Insurance scheme improves the short-form 36 scores of people between these two years. The second objective is to evaluate the impact of the NHI scheme on the health indicators in Taiwan, including life expectancy, infant mortality rate, neonatal mortality rate, and maternal mortality rate from 1974 to 2002. The third is to explore the impact of the NHI scheme on the avoidable mortality rate in Taiwan, using the statistical data from 1974 to 2002. The results show that comparing with the general population or people not enrolled in health insurance scheme in 1994, the 2002 population have no significant different physician component scores of SF-36 questionnaire, but have significantly lower mental component scores of SF-36 questionnaire by 0.3 standard deviations. From the SF-36 scores, this study fails to find the evidence of positive impact of the NHI scheme on the health status of the general population in Taiwan. Similar results are found if the population is confined in the geographical middle area of Taiwan. Using the life expectancy, infant mortality rate, neonatal mortality rate, maternal mortality rate, and preventable mortality rate as indicators, the time series analysis of AR models show that there is no significant difference between the predicted and observed data from 1995 to 2002. This study fails to find the evidence of positive impact of the NHI scheme on the general or some specific health indicators in Taiwan. Using the avoidable mortality rate as indicators, the time series analysis of AR models show that there is no significant difference between the predicted and observed data from 1995 to 2002. This study fails to find the evidence of positive impact of the NHI scheme on the general or some specific health indicators in Taiwan. Some reasons are also discussed in the study.
21
Tsai, Kun-Ju, and 蔡坤儒. "Utilization Analysis of Magnetic Resonance Imaging under the National Health Insurance Scheme." Thesis, 2001. http://ndltd.ncl.edu.tw/handle/15307464251255639361.
Abstract:
碩士國立陽明大學
公共衛生研究所
89
The utilization of medical technology is one of the main reasons of the rising medical expenditure. In Taiwan, the number of Magnetic Resonance Imagine (MRI) has increased rapidly, 10 to 72 from 1990 to 1999. It deserves to research whether high technology utilization and medical expenditure are related to individual’s or hospital’s specific characters or not. The analysis is based on the national wide inpatient information from Jan. to Dec. of 1997, supplied by Bureau of National Health Insurance. This paper focuses on the relationship of MRI utilization between factors of individuals and different hospitals (i.e. Total inpatients group, neurological medicine group, nerve center system disease group). A regression model has been applied to find out potentially abnormal MRI utilization by hospitals and to provide a reference for professional examinations by Bureau of National Health Insurance. The key findings of this paper are as follows: 1.The utilization rate of MRI used by patients during the same period are: once is 94%, more than twice is 5.2%. The highest utilization frequency of MRI is 6 times. 2.The utilization rate by total inpatients group is 1.26%: 17.47% for neurological medicine patients group and 2.49% for nerve center system disease patients group. 3.The common effective factors for the above three patient groups are age, the category of insurance coverage, public and private hospitals, pieces of MRI equipment, CT utilization and average length of stay. 4.The analysis of utilization rate by total hospitals is 2.2%; 21.58% for hospitals of neurological medicine and 3.34% for hospitals of nerve center system disease. 5.Analysis of effective factors of utilization rate by hospitals are sex, the category of insurance coverage, the category of city countryside and pieces of MRI equipment; hospital level and the category of city countryside for hospitals of neurological medicine; the category of city countryside and pieces of MRI equipment for hospitals of nerve center system disease. This paper analyzed the hospital MRI utilization by adopting risk adjustment to analyze patients’ various case-mix. In that way, we can get an objective MRI rate. This result can be a reference in authority’s verification or hospital management.
22
Wayburne, Paul Allen. "Developing a constitutional law paradigm for a national health insurance scheme in South Africa." Thesis, 2014. http://hdl.handle.net/10539/15214.
Abstract:
Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Commerce, Law and Management, School of Law, 2014.The proposed National Health Insurance (‘NHI’) is the most extensive health policy initiative proposed by the South African government since 1994, to bridge the divide between the private and public health sectors. It is intended that the NHI will fund health care services for the entire population. Yet, despite its laudable goals, the implementation of NHI might be stalled by litigation concerning its constitutionality. In this thesis, I construct a constitutional paradigm within which such challenges can be understood. Departing from the premise that the Constitution places a positive obligation on the state to implement redistributive policies in the health sector in order to progressively realise the right to have access to health care services, the thesis identifies the tensions underlying the proposed implementation of NHI and aligns these to liberty-based and equality-based understandings of the right to health, respectively. This analysis takes place after having considered the history of health care reform in South Africa and debates on the desirability of NHI. The thesis then investigates and sets out the constitutional principles, values and standards embodied by the rights to equality, freedom and security of the person, and access to health care services, and considers the extent to which current the formulation of the proposed NHI adheres to these principles. Potential constitutional challenges to NHI by private sector interest groups are identified. These challenges are primarily concerned with adverse effects that the implementation of NHI may cause to current beneficiaries of private sector health services. It is argued that these adverse consequences will, for the most part, not justify a finding that relevant features of NHI are unconstitutional. This is either because they will not amount to an infringement of the relevant constitutional rights or because such an infringement will be capable of reasonable justification in terms of the general limitations clause. Only where the impairment of existing rights is disportionate or is related to some extraneous purpose inconsistent with constitutional rights and values will NHI not pass constitutional muster. Ultimately, the constitutionality of different features of NHI will depend on how the rights of those who already have access to health care services under the current health financing system are balanced with those who currently lack such access.
23
Omoruan, Augustine Idowu. "The design and implementation policy of the National Health Insurance Scheme in Oyo State, Nigeria." Thesis, 2018. http://hdl.handle.net/10500/25895.
Abstract:
Given the general poor state of health care and the devastating effect of user fee, the National Health Insurance Scheme (NHIS) was instituted as a health financing policy with the main purpose to ensure universal access for all Nigerians. However, since NHIS became operational in 2005, only members of scheme are able to access health care both in the public and in private sectors, representing about 3% of Nigerian population. The thesis therefore examines the design and implementation policy of NHIS in Oyo state, Nigeria. Key design issues conceptual framework guides the analysis of data. The framework identifies three health interrelated financing functions namely revenue collection, risk pooling and purchasing. Data was collected from the NHIS officials, employees of the Health Maintenance Organisations (HMOs) and the Health Care Providers (HCPs) using key informant interview. In addition, in-depth interview and semi structure questionnaire were used to gather data from the enrolees and the nonenrolees. Empirical findings show that NHIS is fragmented given the existence of several programmes. In addition, there is no risk pooling neither redistribution of funds in the scheme. Revenue generated through contributions from the enrolees was not sufficient to fund health care services received by the beneficiaries because of the small percentage of the Nigerian population that the scheme covers. Further findings indicate that enrolled federal civil servants have not commenced monthly contribution to the NHIS. They pay 10% as co-pay in every consultation while federal government as an employer subsidised by 90%. Majority (76.8%) of the respondents agreed that they were financially protected from catastrophic spending. However, the overall benefit package was rated moderate because of exclusion of some priority and essential health care needs. Although above half (57%) of the respondents concurred that HMOs are accessible, in the overall, (47.6%) of the respondents were not satisfied with their services. In the case of the HCPs, majority (61.9%) of the respondents claimed that there is no excessive waiting time for consultation. Furthermore, (64.3%) rated their interpersonal relationship with the HCPs to be good. However, more than half of the respondents (54%) disagreed on availability of prescribed drugs in NHIS accredited health facilities. For the nonenrolees, findings show that most of the respondents (72.9%) were willing to enrol, but significant proportion (47.5%) indicated financial constraint as impediment to enrolment.Sociology
D. Phil. (Sociology)
24
Okoro, Chijioke. "Assessing the quality of care received by diabetes patients under the Nigeria National Health Insurance Scheme: does enrollment in health insurance matter?" Thesis, 2017. https://hdl.handle.net/2144/23376.
Abstract:
BACKGROUND AND PURPOSE OF RESEARCH:
Nigeria’s National Health Insurance Scheme (NHIS) was setup to secure
universal access to affordable quality care. However, after 11yrs, and despite launching
different programs, NHIS coverage is still less than 3% nationally, and out-of-pocket
payments (OOP) remain the major health financing mechanism. The reasons for the low
level of enrollment in NHIS are not well understood. Quality of care may be a factor in
enrolment. This study compares technical and perceived quality of care between NHIS
enrollees and the uninsured, using diabetes as a tracer condition. It also compares OOP
and generic prescription patterns by health insurance enrollment status.
METHODS:
We conducted a cross sectional clinic-based intercept study. Subjects were adult
diabetes patients recruited from 10 NHIS accredited hospitals in Abuja, Nigeria. Data
collection included survey and chart review, covering technical aspects of quality –
performance of eye and feet exam and HbA1c request; perception of quality, generic
medication prescribing pattern and OOP. We performed logistic regression analysis to
evaluate the effect of NHIS enrollment status on the technical quality of care, perceived
quality of care, generic prescribing and OOP.
RESULTS:
Out of 455 participants, 149 (33%) were NHIS enrollees, 10 (2%) were enrolled
in private health insurance and 296 (65%) had no insurance. After adjusting for correlated
data and controlling for facility, BMI, chronic disease score, age, sex, and education,
patients under NHIS coverage were 0.85 times less likely to have eye exam (Cl=0.4–1.8),
0.98 times less likely to have feet exam (Cl= 0.4–2.2), and 0.98 times less likely to have
A1c test requested (Cl= 0.7–1.3), compared to those without insurance. These findings
were not statistically significant at alpha=0.05. On the other hand, compared to the
uninsured, NHIS covered patients perceived care to be worse even though they spent
significantly less, 56% (Cl=45%–69%) in OOP in public hospitals.
DISCUSSION/CONCLUSION:
Perception of care quality under the NHIS could be a contributory factor to the
reluctance of prospective enrollees. To advance towards the goal of universal health
coverage, NHIS must strengthen policy to overcome identified barriers such as
medication stock outs and wait times at the facility level.
25
Chiu, Yuan-JOu, and 邱遠柔. "A MEDIA ANALYSIS OF THE FINANCING SCHEME OF THE PHASE П NATIONAL HEALTH INSURANCE PROGRAM." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/44700622390594678000.
Abstract:
碩士國立臺北大學
社會工作學系
96
In a democratic society, the media has played an important role in shaping public opinions regarding government policies. Nevertheless, the relationship between welfare policy and the media has rarely been studied in Taiwan. This thesis intends to explore the roles of the media in the promotion of the Phase II National Health Insurance Program with special reference to it financing scheme. This thesis has referred to the research conducted by Collins et al. (2006) about the 2002 Canadian health care reform debate, which exploring four media effects by examining Canadian newspapers. The method employed in this research is content analysis. The research has identified 198 clippings about the report of the financing schemes of the Phase II NHI, gathered from four newspapers: the China Times, the United Daily News, the Min Sheng Daily News, and the Liberty Times. These materials have been coded into quantitative data and analyzed with the statistical software. The categories of the quantitative data include the type of the news, the source of information, the subject of the report, the tone and position of the news, and so on. Besides, qualitative analysis of these reports has been conducted in order to supplement the interpretations of the quantitative analysis. The research findings are as follows. Six periods of intensive reports from January 2005 to June 2006 can be identified, following such key events as the NHI Consensus Conference, the 10th anniversary of the NHI implementation, the falling of the famous model (Lin, Chi-Ling) from horseback, the NHI revised draft proposed by the DoH, the resignation press conference of the Premier Hsieh, and the NHI revised draft reviewed by the Legislative Yuan. In the first three periods, the government was the main source of the information and could dominate the report to some extend. Also, the media reports about the Phase II NHI tended to be in a positive tone. The injury of the famous model Lin and the following treatments uncovered the issue of the unfair sharing of the NHI contribution fees and therefore the Phase II NHI had attracted the public attentions. More information was needed by the public, but the officials seemed to be more uncertain about the details of the Phase II NHI. At the same time, non-official sources of information coming from scholars, experts, medical professionals, and NGOs were shown on the media. The tone of reporting the financing scheme had gradually changed from positive to negative and may influence the passage of the NHI revised draft based on the Phase II NHI Planning in the Legislative Yuan.
26
Mabidi, Mpho Brendah. "A critical discussion of the right of access to health care services and the National Health Insurance Scheme." Thesis, 2013. http://hdl.handle.net/10386/1036.
Abstract:
Thesis (LLM. (Labour Law)) -- University of Limpopo, 2013The South African government gazzetted the Green Paper introducing the NHI on 12 August 2012. This policy seeks to progressively realize the right of access to quality health care services for everyone. Those who cannot provide for themselves will be assisted by government at the expense of the elite. The NHI was first recommended by the Taylor Commission and it has been under the discussion since then. Since this announcement, there has been growing pressure for mandatory health insurance to be included in the development of a comprehensive social security system, as was envisaged by the Taylor Committee of Inquiry. This discussion was further debated at the 52nd conference of the African National Congress (ANC) in Polokwane in December 2007 where numerous resolutions were taken with regard to the NHI. The Freedom Charter of 1955 and also section 27 and 28 also provided some guidance.
27
Lee, YuYi, and 李玉怡. "The Effect of National Health Insurance and New Labor Pension Scheme on Wage Rates in Taiwan." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/02485974772356095289.
Abstract:
碩士國立臺北大學
經濟學系
100
This thesis investigates the impacts of National Health Insurance and New Labor Pension Scheme on the wage rates in Taiwan. National health insurance and New Labor Pension Scheme are implemented in March 1995 and July 2005, respectively. Both of them are financed by premiums, which are proportional to an employee’s salary. The premium rate may introduce distortions to the labor market. We find that, on average, private sector employees’ wage rates declined relative to the public sector counterparts under both of National Health Insurance and New Labor Pension Scheme. We also compare the results with the previous studies to explore the divergence under different ways of sample restrictions.
28
Lee, Pei-Hsuan, and 李培瑄. "Medical Care Utilization and Expenditures Under Taiwan National Health Insurance Scheme Among Patients with Multiple Sclerosis." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/54173157359362006457.
Abstract:
碩士國防醫學院
公共衛生學研究所
101
The multiple sclerosis is a kind of rare disease, and it is one of the top five rare diseases in Taiwan. In current healthcare system, although patients with multiple sclerosis are only provided treatments as relieves of symptoms on the mitigation, supportive care and functional rehabilitation. It still causes a serious financial burden for both patients and the authority of National Health Insurance. Objectives: The objectives of this study were to investigate multiple sclerosis outpatients and inpatient medical expenditure and their associated factors based on 2001-2005 National Health Insurance Research database in Taiwan. Methods: We used a cross-sectional retrospective study design, based on the 2001-2005 National Health Insurance databases of outpatient prescriptions and treatment detail files (CD) and inpatient use and medical expenditures detail files (DD). Multiple sclerosis patients (ICD-9-CM: 340) were selected in our study, and data was analyzed by IBM SPSS Statistics 21.0. Results: The results found that the number of multiple sclerosis in outpatient and inpatient care, women was three times more than men gender. The disease prevalence was 0.12-0.19/per 10,000 of general population, average age was 42-45 years old, and most of the patients treated in the neurological department. For outpatient utilization, gender, clinical department and hospital level had significant effects on outpatient care expenditure. With regards to inpatient care, case’s age, admission days had significant effects on inpatient care expenditure. In the hospital level of medical care utilization, most of patients were more likely to use private corporate hospitals than other kinds of hospital. Conclusions: In this study, it showed that those cases preferred to choose large medical institutions, and the medical accessibility were also affect the medical care utilization for this group of people. Finally, this study suggests healthcare system should monitor medical utilization regularly for patients with multiple sclerosis, and to initiate appropriate health policies for them in the future. Keywords: Rare disease, Multiple sclerosis, Prevention of Rare Disease and Drugs Act, Medical utilization, Medical expenditure, Inpatient, Outpatient
29
Njie, Hassan, and Hassan Njie. "Feasibility of a National Health Insurance Scheme in the Gambia: Health Care Providers and Consumers Perspectives on the Design." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/53023115254747567154.
Abstract:
碩士臺北醫學大學
醫務管理學研究所
103
Title: Feasibility of a National Health Insurance Scheme in the Gambia: Health Care Providers and Consumers Perspectives on the Design Author: Hassan Njie Thesis advisor: Professor Herng Ching Lin Background: Developing countries have been and still are grappling with high catastrophic financial payments, which have created financial barriers to health service utilization. Studies have also shown that developing countries including low and middle- income countries (LMICs) are considering reforms in their health care systems to provide universal health coverage (Mills et al. 2012). The aim of this study is to explore the feasibility of a national health insurance scheme in the Gambia by sounding the perspectives of health care providers and consumers Methods and Materials: The study adopted a descriptive cross sectional survey using a questionnaire that has four dimensions. Study participants comprised health care providers (125) and consumers (125) totaling 250 participants. Data was collected in all the six public hospitals in the Gambia from 1st August to 20th August. IBM SPSS (Version 22) was used to analyze data. Data analysis were exclusively descriptive statistics Results: Overwhelming majorities of study population are strongly in favor of a national health insurance scheme in the Gambia (97.2%) and 88% think it is feasible. Half of the study population thinks tax should be the main source of funding for the health insurance scheme in the Gambia (48.4%) with out-of- pocket payment less preferred (6.0%). Majority of the study population preferred Capitation (40%) as payment method for health care providers. Fee For Performance was ranked second (30.8%) while Per Diem was least preferred (9.2%). About two- third of participants prefer a gatekeeper in the national health insurance scheme (75.2%) while 14.4% disagreed with the remaining 10.4% undecided. 83.2% of study participants thinks health care providers should be accredited before they are reimbursed by the national health insurance scheme Conclusion: the government of the Gambia must ensure that all stakeholders are consulted during the planning, design and implementation of national health insurance scheme. This will enhance inclusiveness, acceptance and provide support to the scheme. The government should also look into external sources of funding for the health insurance scheme such as donor agencies and bilateral partners who fund the largest share of total health spending in the country. Discussions should center on providing subsidy for the poor, women and children who are the most vulnerable in society. More research specifically large-scale longitudinal studies surveying key stakeholders is recommended.
30
Ankomah, Kwadwo. "The Distribution and Utilization of Health Services in Ghana before and after the Introduction of the National Health Insurance Scheme." Master's thesis, 2011. http://www.nusl.cz/ntk/nusl-313757.
Abstract:
The introduction of Hospital Fees Regulations (LI 1313) in popularly called "cash and carry" in 1985 made it mandatory for fees to be charged at the point of service delivery. This almost made health care in Ghana beyond the reach of the poor. Realizing the effect of the "cash and carry" on the poor, the then government in 2003 came out with the National Health Insurance Policy to make health care services accessible and equitable to all Ghanaians especially the poor and the vulnerable in the society. The government has invested a lot of money in the NHIS in an effect to make more accessible to the poor. The general perception of the Ghanaian populist is that NHIS is more accessible to those are well to do because they live in cities and towns closer to the NHIS offices and health facilities to the detriment of the poor who are mostly found in the rural areas. This study is focused on the level of involvement of the poor in the National Health Insurance scheme to ascertain if the desired aim of making health care equitable and accessible to the poor is being achieved.
31
Hei-Jen, Jou, and 周輝政. "The impact on health care expenditure and utilization under Taiwan national health insurance after implementing a new co-payment scheme." Thesis, 2001. http://ndltd.ncl.edu.tw/handle/32771811270263882438.
Abstract:
碩士國立臺灣大學
財務金融學研究所
89
THE IMPACT ON HEALTH CARE EXPENDITURE AND UTILIZATION UNDER TAIWAN NATIONAL HEALTH INSURANCE AFTER IMPLEMENTING A NEW CO-PAYMENT SCHEME Name: Jou, Hei-Jen Advisor: Professor Lee, Tsun-Siou and Professor Lai, Mei-Shu June, 2001 Key words: co-payment, national health insurance, health care expenditure Health care utilization by the people in Taiwan increased significantly after the introduction of the national health insurance, which leaded to rapid expansion of the expenditure. However, the premium of the national health insurance did not increase simultaneously during the first five years so that financial imbalance occurred since 1998. Therefore, a new co-payment scheme was carried out on August 1st, 2000, which focused on the medication fees, frequent outpatient visits and rehabilitation services, trying to decrease the moral hazard of consumers. The purpose of the present study is to examine the impact of the new co-payment scheme by analyzing the change of health care utilization and expenditure under the national health insurance. We used piecewise linear regression and discontinuous piecewise linear regression to analyze monthly and seasonal data of national health insurance. Durbin-Watson test was used to test for autocorrelation in time order. In the analysis of monthly data, we found that the rapid growth of expenditure of outpatient medical service slowed down and even became decreasing after the introduction of the new co-payment scheme. The difference is statistically significant. The number of outpatient visit became decreasing after the introduction of the new co-payment scheme. The difference is statistically significant by piecewise linear regression but not by discontinuous linear regression. However, the claimed cost of per outpatient visit was still increasing, not affected by the new co-payment scheme. In the analysis of seasonal data, the expenditure of outpatient medical service became nearly zero-growth or even decrease after the introduction of the new co-payment scheme. The difference is statistically significant. The number of outpatient visit became decreasing. The difference is statistically significant. However, the new co-payment scheme did not affect the cost of per visit. In conclusion, the increase of co-payment changed people’s demand for medical service through market power, including significantly inhibit the rapid growth of expenditure of outpatient service; led to negative growth of the number of outpatient visit; but could not inhibit the increase in the cost of per outpatient visit. Because the expenditure of outpatient service accounted for 68% of the total expenditure of national health insurance, co-payment is a simple and effective policy that markedly inhibited the rapid growth of health care utilization and expenditure.
32
Hsieh, Fang-Chun, and 謝芳純. "Medical Care Utilization and Associated Factors among Drug Inmates Who Joined Taiwan 2nd Generation National Health Insurance Scheme." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/91132582092734623881.
Abstract:
碩士國防醫學院
公共衛生學研究所
102
Background: In recent years the number of imprisoned Taiwan grew by nearly 20% and one of the main reasons was the increased number of drug offenders. Inmates suffer from illegal drug abuse may have a higher proportion of mental illness, substance abuse and chronic problems than the general population and needed pay much attention to their health needs. Since the year 2013 inmates join Taiwan National Health Insurance scheme, it is necessary to securitize the prison healthcare system to evaluate the change of prisoners’ healthcare needs. Objectives: The purposes of this study are to understand the medical care utilization and the determinants of drug offenders in a prison, and to examine their perception to the prison’s medical care service. Methods: A cross-sectional survey by using a structured questionnaire, which recruited 580 drug offenders (Response rate was 99%) in this study. Results: The results found that the most prevalent diseases were colds, skin diseases, and chronic diseases among the drug offenders. There were 70% of the respondents have ever used prison outpatient visits, and the mean of medical visit per person was 16.5 times annually. Family medicine (70%) was the most popular clinical division which utilized in the prison, and most of the respondents (70%) reported that they paid less than NT$250 in each visit on the medical copayment. General speaking, the inmates expressed they satisfied with medical care, particularly in medical affordability. However, they did not satisfy with timing of medical visit, accessibility and convenience. In multiple regression analysis, those participants who aged more than 45 years, have multiple illnesses, chronic diseases, inmate types, smoking, psychological needs unmet were statistically correlated to the usage of outpatient medical visits (R2=46.7%). Those factors of inmate types, low income, fair self-rated health, and unmet physical therapy needs were significantly correlated to prison medical care satisfaction (R2=22.4%). Conclusion: To improve the quality of medical care for drug offenders in prison, this study suggests that the prison medical care system should strengthen preventive care service and to increase medical care accessibility for this group of people.
33
Huang, Tzu-Wei, and 黃子溦. "Equity between the Insurees'' premium Burden and Their Medical Care Expenditures in Taiwan''s National Health Insurance Scheme." Thesis, 2000. http://ndltd.ncl.edu.tw/handle/04342521269906728468.
Abstract:
碩士國立政治大學
風險管理與保險學系
88
Equity is widely acknowledged to be an important policy objective in the health care field. The principle comes in two versions：a horizontal version(persons in equal need should be treated the same) and a vertical version(persons with greater needs should be treated more favourably the those with lesser needs)。 The purpose of this study is to investigate the equity between the insurees’ premium burden and their medical care expenditures in Taiwan’s National Health Insurance Scheme .The sample combines two sets of data，which are data for the insured and their dependents’ premiums and medical expenditures of utilization obtained from the Bureau of NHI ; individual income tax return data obtained from the Data Processing Center of the Ministry of Finance. According the data ，we will be able to use the regression model of stepwise and probit methods to analysis the purpose of this study. The major findings are twofold：First， at present the regulations in the premium exists the horizontal and vertical the inequity ， so the system can’t bring the income replaecment， About medical dilvery， NHI is favorable person lower-income .To achieve ability to pay， the gap between the upper and bottom of insured payroll-related amount class should be lengthened.And to lighten the burden of insuree with dependents .Second， in the medical delivery deductible amounts paid by beneficiaries will be changed from fixed amounts to fixed rate to control the wasting medical resource.
34
Wang, Mei Chih, and 王美治. "A Research on the Due Premium Contribution of Governing National Health Insurance Scheme in the Republic of China." Thesis, 1993. http://ndltd.ncl.edu.tw/handle/74754717570637753127.
Abstract:
碩士國立臺灣大學
財務金融學系
81
The research was processing to interview the insured persons and empolyers, and was looking for the summary of responses sho- -uld be helped to find some approaach for the universal health insurance program less costly and more efficient. By using questionnaire investigation and nonparametric stat- istics like chi-square test, Kruskal-Wallis one-way ANOVA, cochr- an Q test to process data analysis,the results show: 1.Over half of the interviewed persons disagreed that gover- nment will be no responsibility for National Health Insur- ance Scheme financial deficit. 2.The interviewed persons who are low level education can''t understand the difference nature of social insurance betw- een social relief. 3.The interviewed who are GEI(Government Employees'' Insuran- ce)or LI(Labor Insurance) insured and the other is uninsu- red, these three groups people had different opinion about the reason of insured person should pay premium. 4.The more high level positoin executives,the more disagree- able "Employer no-fault compensation theory". 5.About National Health Insurance will be implemented in the near future, may increase the employer''s share of the con- tribution, the survey says:Corporations will temporary ab- sorb this amount by themself, but 12.3% will shift cost to product price, 14.5% will produce automatically, and 3% consider to close the factory or transfer overseas. 6.The interviewed corporations felt that appropriate contri- bution rate of universal health insurance is shared by the employer and the insured person in equal proportion,that is fifty percent. 7.Survey says: 6% of service firms and 20.2% of manufacture firms thought that the changes contribution of employer in National Health Insurance will impact the whole industry.
35
Chen, Yueh-Yi, and 陳悅儀. "The policy analysis of the process to establish drug list and payment scheme of national health insurance in Taiwan." Thesis, 1996. http://ndltd.ncl.edu.tw/handle/43050257127697599727.
36
Wu, Ching-I., and 吳靜宜. "Impact of differential copayments on the numbers of visits--a case study based on Taiwan''s National Health Insurance Scheme." Thesis, 1996. http://ndltd.ncl.edu.tw/handle/13655795410830474689.
37
Chang, Ying-Mei, and 張瑛玫. "A Longitudinal Study of Cost-Benefit Analysis (CBA) of National Health Insurance Scheme for Children Teeth Fluoridation and Anti-decay Program." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/08371548473826669634.
Abstract:
碩士中國醫藥大學
醫務管理學研究所碩士班
97
Objective: Children teeth fluoridation and anti-decay treatment program was implemented by Bureau of Nation Health Insurance from July 1 2004 for over four years. The author analyzes an insurance database to evaluate the utilization of dental care preventive service and cost-benefit effectiveness (CBA) of teeth fluoridation and anti-decay treatment program in central part of Taiwan. Methods: A retrospective study was conducted using an insurance database from Bureau of Nation Health Insurance - Central regional branch with registered children born in 2001 who received teeth fluoridation and anti-decay program. The difference of utilization of dental care preventive service analysis was based on each individual child’s character and required dental treatment. For cost-benefit analysis, children were selected who were eligible receiving or non- receiving this benefit from July 1, 2004 till 2007. Two groups were compared by frequency matching analysis, based on sex, medical provide territories, insured fee. Additional Incremental benefit/cost method (ICB) of cost-benefit analysis (CBA) is also conducted to evaluate the service providing cost increasing (△C) and dental treatment cost decreasing effectiveness (△B). Results: No statistic significant differences between children sex and receiving or non-receiving this benefit factor, however, significant difference were showed at medical providing territories and insured fee factor (p<.0001). Children who receiving teeth fluoridation every half year (including 2,3,4 times), the average visiting frequency and treatment cost had statistic significant differences with children who receive single teeth fluoridation course(p<.05), i.e., the final teeth fluoridation in the last six months is less than the initial teeth fluoridation in the first half year. This result is also showed in dental caries and the pulpitis treatment (p<.05). Conclusions: In the selected children, parent’s decision making and territory variance (ex: cities vs. townships) gave influence of children to receive teeth fluoridation and incidence rate of caries. In the meantime, the analysis result of health insurance utilization is same as foreign countries’ study result, that is, teeth fluoridation may reduce dental treatment cost and utilization of dental care service. In addition, the assumption in this research model, cost-benefit effectiveness (CBA) analysis shows that present fluoridation benefit cannot cover its own cost. Recommendation: Based on this research, the teeth fluoridation may reduce the dental care service cost. However, the total saving cost cannot cover the government investment. Although cost saving is not the priority consideration factor of every beneficial program, but facing financial limitation and increasing public health expenditure, government needs to further study the balance of service providing scope and financial impact, which becomes an issue that can be discussed . Hope this study can provide a reference for future public health resource allocation and policy amendment.
38
Tsay, Yeuan-Pern, and 蔡遠鵬. "An analysis on the deduction factors of reimbursement for inpatient medical expenses under the national health insurance scheme--A Case Study of District Teaching Hospital." Thesis, 1998. http://ndltd.ncl.edu.tw/handle/03971613059491927779.