https://scholars.lib.ntu.edu.tw/handle/123456789/552197
標題: | The soaring mechanic ventilator utilization under a universal health insurance in Taiwan | 作者: | SHOU-HSIA CHENG I-SHIOW JAN Liu P.-C. |
公開日期: | 2008 | 卷: | 86 | 期: | 2-3 | 起(迄)頁: | 288-294 | 來源出版物: | Health Policy | 摘要: | Objectives: The use of mechanic ventilators (MVs) is increasing in many countries. Taiwan's Bureau of National Health Insurance (NHI) launched a new payment program in 2000 to encourage integrated care for mechanically ventilated patients and to reduce the heavy utilization of high-cost intensive care unit. This study examines the trend in MV usage in Taiwan. Methods: This study used nationally representative NHI claim data from 1997 to 2004 to examine the MV usage. Total inpatient days and MV usage days were analyzed by piece-wise regression model. We also analyzed the major diagnoses related to MV dependence. Results: While the total hospital inpatient days increased only 49.41%, MV usage rose 181.75% over the 8-year study period. The increase in number of MV patient-days in ICUs has not been curbed, besides there was an increase in respiratory care center/wards. Acute respiratory failure (ARF), pneumonia and diabetes mellitus were the leading diagnoses for mechanically ventilated patients. Conclusions: The new NHI insurance payment program may have helped spark the increased trend in MV usage in Taiwan. The significant impact of insurance incentive on healthcare utilization is a critical issue for policymakers in developing healthcare programs. ? 2007 Elsevier Ireland Ltd. All rights reserved. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/552197 | ISSN: | 0168-8510 | DOI: | 10.1016/j.healthpol.2007.11.002 | SDG/關鍵字: | acute respiratory failure; article; artificial ventilation; brain hemorrhage; chronic obstructive lung disease; controlled study; diabetes mellitus; diagnostic procedure; health care cost; health care utilization; health insurance; health program; heart muscle ischemia; hospital patient; human; intensive care unit; major clinical study; pneumonia; respiratory care; septicemia; symptomatology; Taiwan; Databases as Topic; Humans; Intensive Care Units; Length of Stay; National Health Programs; Respiration, Artificial; Taiwan; Universal Coverage |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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