DC 欄位 | 值 | 語言 |
dc.contributor.author | 張睿詒 | zh_TW |
dc.creator | 張睿詒 | zh_TW |
dc.date | 2003-07-31 | zh_TW |
dc.date.accessioned | 2006-07-25T07:56:08Z | en |
dc.date.accessioned | 2018-06-29T16:55:52Z | - |
dc.date.available | 2006-07-25T07:56:08Z | en |
dc.date.available | 2018-06-29T16:55:52Z | - |
dc.date.issued | 2003-07-31 | - |
dc.identifier | 912416H002038 | en |
dc.identifier.uri | http://ntur.lib.ntu.edu.tw//handle/246246/5028 | - |
dc.description.abstract | 本研究評估多元保險機制下不同風
險分攤機制之實施,在平準基金與保險人
分別採不同風險計價模式下,對保險人選
擇誘因抑制與效率誘因維持情形,藉以分
析適當之風險分攤模式。
研究資料為中央健康保險局保險對
象2%隨機抽樣共371,620 人之1996 年及
1997 年相關檔案。平準基金採用之風險計
價模式為人口統計模式與診斷基礎模
式,保險人則採先前利用模式、診斷基礎
模式與全部資訊模式;風險分攤模式分別
為1996 年醫療費用前1%至5%的高風險
者風險分攤、1997 年醫療費用前1%至5%
的高費用者風險分攤、1997 年醫療費用
60,000 元至100,000 元為分攤臨界值之極
端值風險分攤,以及1997 年醫療費用30%
至70%的比例式風險分攤;此外,選擇誘
因衡量指標為平均預測絕對值與不利風
險期望損失,而效率誘因衡量指標為保險
對象以風險分攤支付比率與保險人所能
保有之獲利比率。
研究結果顯示四種風險分攤模式
中,若以維持效率誘因為重點,高風險者
風險分攤為較合適模式;若抑制保險人選
擇誘因為重點則以高費用者風險分攤效
果較佳;但若在兩者兼顧下可能採高比率
之高風險者風險分攤或低比率之高費用
者風險分攤較為適當。 | zh_TW |
dc.description.abstract | This study intends to evaluate the
impacts of various risk sharing forms on
the selection and efficiency incentives of
health plans in a competitive health
insurance market. Different risk-adjusted
models employed by the equalization
fund and health plans are to be analyzed
to understand the robustness of these risk
share forms.
A total of 371,620 beneficiaries,
eligible for the National Health Insurance
(NHI) from January 1, 1996 to January 1,
1997 were randomly selected from the
enrollment file of NHI. The risk-adjusted
models employed by the equalization
fund were the demographic and
diagnostic-based models. On the other
hand, health plans employed the prior
utilization, diagnostic-based, and all
information models. Risk sharing forms
analyzed were 1% to 5% high-risk
sharing, 1% to 5% high-cost sharing,
60,000 NT$ to 100,000NT$ excess loss,
2
and 30% to 70% partial capitation. The
measures of the selection incentive were
mean absolute predicted result and
unfavorable expected loss. The measures
of the efficiency incentive were the
proportion shared expenditures by a risk
sharing mechanism and insurer portion of
the efficiency gain.
The results showed that among four
risk sharing forms high-risk sharing could
provide better efficiency incentive than
the others. On the other hand, high-cost
sharing could contain selection incentive
better than the others. In order to
maintain both the incentives, large
percentage of high-risk sharing and small
percentage of high-cost sharing would be
appropriate choices. | en |
dc.format | application/pdf | en |
dc.format.extent | 155963 bytes | en |
dc.format.mimetype | application/pdf | en |
dc.language | zh-TW | - |
dc.language.iso | zh_TW | zh_TW |
dc.publisher | 臺北市:國立臺灣大學公共衛生學院醫療機構管理研究所 | zh_TW |
dc.rights | 國立臺灣大學公共衛生學院醫療機構管理研究所 | zh_TW |
dc.subject | 健康保險 | zh_TW |
dc.subject | 風險校正 | zh_TW |
dc.subject | 風險分攤 | zh_TW |
dc.subject | 風險選擇 | zh_TW |
dc.subject | health insurance | en |
dc.subject | risk adjustment | en |
dc.subject | risk sharing | en |
dc.subject | risk selection | en |
dc.title | 探討台灣風險計價模式之選擇與效率誘因及其最適化之分析 | zh_TW |
dc.type | report | en |
dc.identifier.uri.fulltext | http://ntur.lib.ntu.edu.tw/bitstream/246246/5028/1/912416H002038.pdf | - |
dc.coverage | 計畫年度:91;起迄日期:2002-08-01/2003-07-31 | zh_TW |
item.openairecristype | http://purl.org/coar/resource_type/c_93fc | - |
item.openairetype | report | - |
item.languageiso639-1 | zh_TW | - |
item.grantfulltext | open | - |
item.cerifentitytype | Publications | - |
item.fulltext | with fulltext | - |
crisitem.author.dept | Health Policy and Management | - |
crisitem.author.dept | Public Health | - |
crisitem.author.orcid | 0000-0003-3891-5313 | - |
crisitem.author.parentorg | College of Public Health | - |
crisitem.author.parentorg | College of Public Health | - |
顯示於: | 健康政策與管理研究所
|