The soaring mechanic ventilator utilization under a universal health insurance in Taiwan
Journal
Health Policy
Journal Volume
86
Journal Issue
2-3
Pages
288-294
Date Issued
2008
Author(s)
Abstract
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.
SDGs
Other Subjects
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
Type
journal article