Factors contributing to patient dumping in Taiwan
Resource
Health Policy, Volume 77, Issue 1, June 2006, Pages 103-112
Journal
Health Policy
Journal Volume
77
Journal Issue
1
Pages
103-112
Date Issued
2006
Author(s)
Abstract
Objective: Little research has been carried out to explore the issues surrounding patient dumping outside of the US. This study, therefore, uses a national research survey to examine the factors contributing to patient dumping within Taiwan. Methods: A self-administered postal survey was undertaken to assess the prevalence of patient dumping in Taiwan, with the study subjects being superintendents of general hospitals. Data from the Bureau of Medical Affairs at the Department of Health in Taiwan were used in conjunction with the Taiwan National Health Insurance Research Database (NHIRD) to obtain estimates of factors potentially contributing to patient dumping. A multiple logistic regression analysis was performed to determine the relationships between the perceived extent of patient dumping occurring within the respondents' healthcare networks, as well as other factors, including the total number of hospitals, total number of hospital beds, the percentages of beds in public, for-profit and teaching hospitals (vis-?-vis all hospital beds), discharges, discharges covered under the case payment system, transferred inpatients, and the perceived degree of competition within each healthcare market. Results: A total of 485 survey questionnaires were distributed, of which 251 were returned, giving a response rate of 51.75%. The responses from 29.9% of the sample group indicated that the perceived extent of patient dumping occurring in their service area was 'serious' or 'very serious'. The regression analysis showed that after controlling for other factors, the superintendents' perceived extent of the patient dumping occurring within their healthcare networks was positively related to the total number of patients covered under the case payment system, the total number of discharged patients, the extent of healthcare market competition and the number of respondent's hospital beds. Conclusions: We conclude from our findings that, under the National Health Insurance system, patient dumping is a widespread problem within Taiwan's healthcare industry. ? 2005 Elsevier Ireland Ltd. All rights reserved.
Subjects
Market competition; National Health Insurance; Patient dumping
Other Subjects
article; competition; general hospital; health care industry; health care organization; health survey; hospital bed capacity; hospital discharge; hospital patient; human; medical research; multivariate logistic regression analysis; patient referral; patient transport; postal mail; prevalence; prospective payment; questionnaire; regression analysis; self evaluation; statistical significance; Taiwan; teaching hospital; United States; Health Services Research; Hospitals, General; Humans; Patient Transfer; Questionnaires; Taiwan
Type
journal article