https://scholars.lib.ntu.edu.tw/handle/123456789/586936
標題: | Half-Managed Care: A Preliminary Assessment of a Capitation Program in a Health Care System Without Gatekeepers | 作者: | SHOU-HSIA CHENG Chang C.-M. Chen C.-C. CHI-YUAN SHIH Tsai S.-L. |
公開日期: | 2017 | 出版社: | SAGE Publications Inc. | 卷: | 47 | 期: | 3 | 起(迄)頁: | 519-531 | 來源出版物: | International Journal of Health Services | 摘要: | In 2011, a novel capitation program was launched in Taiwan under its universal health insurance plan. This study aimed to assess the short-term impact of the program. Two hospitals in the greater Taipei area, one participating in the "loyal patient" model (13,319 enrollees) and one in the "regional resident" model (13,768 enrollees), were analyzed. Two comparison groups were selected by propensity score matching. Generalized estimating equation models with differences-in-differences analysis were used to examine the net effects of the capitation program on health care utilization, expenses, and outcomes. Enrollees in the loyal patient model had fewer physician visits in the host hospital, but more physician visits outside that hospital during the program year than they had the year before. Compared with non-enrollees, the loyal patient model enrollees incurred fewer physician visits (β = -'0.042, p <.001), fewer emergency department visits, (β = -'0.140, p <.001), and similar total expenses and outcome. For the regional resident model, no differences were found in the number of physician visits, expenses, or outcomes between enrollees and non-enrollees. The novel capitation models in Taiwan had minimal impact on health care utilization after 1 year of implementation and the health care outcome was not compromised. ? SAGE Publications. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85022007128&doi=10.1177%2f0020731415615310&partnerID=40&md5=ba744009ef8c0b724c44f5492e9dd1f4 https://scholars.lib.ntu.edu.tw/handle/123456789/586936 |
ISSN: | 0020-7314 | DOI: | 10.1177/0020731415615310 | SDG/關鍵字: | capitalism; comparative study; health care; health expenditure; health impact; health insurance; health survey; participatory approach; controlled study; emergency ward; female; health care utilization; human; human experiment; male; managed care; program impact; propensity score; resident; statistical model; Taiwan; adolescent; adult; aged; capitation fee; child; economics; health insurance; infant; insurance; middle aged; newborn; organization; preschool child; Taiwan; trends; Taipei; Taiwan; Adolescent; Adult; Aged; Capitation Fee; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Managed Care Programs; Middle Aged; Organizational Innovation; Propensity Score; Taiwan; Universal Coverage |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。