Geographical allocation of the healthcare budget in the national health insurance program: What can we learn from other countries?
Journal
Taiwan Journal of Public Health
Journal Volume
38
Journal Issue
4
Pages
355
Date Issued
2019-08-01
Author(s)
Abstract
© 2019 Chinese Public Health Association of Taiwan. All rights reserved. In 1998, the National Health Insurance program of Taiwan implemented a global budget payment system for dental outpatient services, followed by traditional Chinese medicine, primary care, and hospitals. Under this scheme, the annual healthcare budget is distributed among six regional service areas for enhancing self-management within each area. However, the formulas used in the allocation of the annual budgets differ across sectors. This situation has drawn criticism from healthcare providers, and stakeholders have yet to reach a consensus regarding the types of revisions that should be implemented. For the formulation of healthcare budgets, many medical professionals and researchers are demanding the inclusion of factors such as the variations in healthcare needs, personal risk factors, costs involved in the healthcare service provision, and distribution of healthcare providers in the region. In this study, we review the methods employed in other countries for the distribution of budgets as well as the factors included in their formulas, trends in the development of the budget allocation systems, and their experiences following implementation. Our literature review revealed that the United Kingdom, Australia, and New Zealand allocate healthcare funds according to population-based (also referred to as "needs-based") distribution formulas. These formulas include factors pertaining to age and gender, morbidity, and socioeconomic status. Some of these formulas also account for differences in the supply-side costs and "unmet needs" in the healthcare provision. The methods in question are ostensibly highly effective in accounting for regional healthcare variations and also aim to reduce inequity in healthcare resource distribution. We suggest that morbidity and socioeconomic status should be included in the resource allocation formula in the future. According to the literature review findings, the government should develop localized measures of socioeconomic status that can be applied across Taiwan. The government should also investigate the status quo in relation to "unmet needs" in Taiwan.
Subjects
Global budget | Health inequity | Resource allocation | Resource allocation | Risk adjustment
Global budget; Health inequity; Resource allocation; Resource allocation; Risk adjustment
SDGs
Other Subjects
age; Australia and New Zealand; budget; consensus; female; gender; government; health care need; health care personnel; human; human experiment; male; morbidity; national health insurance; resource allocation; review; risk assessment; risk factor; social status; Taiwan; United Kingdom
Type
journal article