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| Title: | 台灣幼兒醫療補助和幼兒住院費用替代
Taiwan Children Copayment Subisdy and Hospitalization Offsets in Young Children |
| Authors: | 連賢明 |
| Contributors: | 財政系 |
| Date: | 2020-11 |
| Issue Date: | 2025-06-23 13:21:50 (UTC+8) |
| Abstract: | 台北市於1995 年首先針對3 歲以下兒童減免醫療部分負擔，並於1998 年將對象擴及4-6 歲兒童，期望透過減免部分負擔來降低就醫門檻，增加幼兒醫療利用。這補助政策實施後頗獲好評。內政部於是計畫於2001 年實施「三歲以下兒童醫療補助計畫」。由於立法延宕，這法案一直到2002 年才通過，造成台北市6 歲以下兒童在2001 年間僅提供住院補助，取消門診補助。這一年的兒童醫療補助中斷，提供了一個良好機會來分析部分負擔對6 歲以下醫療利用變化，了解兒童門診和住診服務替代或互補性，以及後續兒童健康影響。本計畫透過三方面分析 2001 年醫療補助中斷所引發效果。第一年使用1998-2006 年6 歲以下門診資料，以台北市6 歲以下兒童為實驗組，新北市同年齡兒童為控制組，採「差異中的差異」模型進行分析，了解6 歲（特別是3 歲）以下醫療價格彈性，並比較不同疾病和家戶所得兒童的價格彈性是否不同。另外，基於這事件具明確時間點，我們也輔以「不連續迴歸模型」來估計幼兒門診價格彈性。第二年計畫因中斷補助造成僅補助住診，藉以分析門住診醫療利用的替代性，特別著重慢性或重症病患。第三年計畫串連兒童10-12 歲死亡檔和住院檔，相較於新北市兒童，了解10-12 歲的累積死亡率或住診就診次數和費用是否相同，以分析這事件是否損害兒童長期健康效果。
In 1998, Taipei City implemented “Medical Care Subsidy Program for Children under 3”, subsequently expanded to children under 6 from 1998, that aimedto reduce the parents’ economic burden, and enhanced the children’s health through the co-payment exemption. A similar program was adopted by the Ministry of Interior in 2001to cover all Taiwan children, but did not pass the Legislation Yuan until 2002. This legislation delay results in the subsidy in 2001 covering only the copayment of inpatient, but not outpatient services, in Taipei City. The one year subsidy-free window creates an excellent opportunity to study the price elasticity of outpatient services for children (particularly under 3), the offset between the children’s outpatient and inpatient services, as well as the long term consequence of health impact. This proposal plans tostudy this one year subsidy-free event from three perspectives. With the help of outpatient and inpatient NHI claims between 1998 and 2006, the first aim is to investigate the price elasticity of outpatient use of children under 6.To reduce the selection bias, we adopt the “Difference-in-Differences” method----treating children under 6 in Taipei city as the treatment group and the same cohorts in New Taipei city as the control---and calculate the price elasticity of children in different age cohorts, illnesses and household income groups. Moreover, given there is a specific time of subsidy termination, we supplement the analysis by employing the regression discontinuity model that compares the health use of children under 6 before and after Feb 2001. Next, given that the event results in the termination of the copayment subsidy of outpatient services (not inpatient services), the second aim plans to investigate the offset between the outpatient and inpatient services for children under 6, especially focusing on the more severe children who frequently use the services of teaching hospitals. Finally, by merging NHI claim with the death registry records, thethird aim plans to use the cumulated rates of death or inpatient admissions between 10 and 12 to examinewhether the event produces a long-term consequences of children’s health. |
| Relation: | 科技部, MOST106-2410-H004-011-MY2, 106.08-108.07 |
| Data Type: | report |
| Appears in Collections: | [財政學系] 國科會研究計畫
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