Out-of-pocket payment for medical care under Taiwan's national health insurance system

The objective of this study is to estimate the amount of and factors associated with out-of-pocket (OOP) payment for medical care under Taiwan's National Health Insurance (NHI) program. This research used two methods to collect original data. The first method consisted of using a sample household Survey and household diary records to collect data on OOP payment prospectively over a two-month period from a random sample of 600 households in central Taiwan. Using the individual as the unit of analysis, we obtained a total of 1062 sample subjects. To ascertain the quality and accuracy of survey data, the claim records of the bureau of NHI were merged with the survey data. These data were analyzed by a two-part model, with a probit model for use of health care and an ordinary least-squares model for OOP payments. Results of this research indicate that on average an individual's annual OOP payment for medical care was E 247, which is substantial, compared with the average E 144 for per capita NHI earmarked tax. Finally, results of model estimation indicate that supplemental health insurance and household income were positively associated with any use of health care, while household income was also positively associated with OOP payment for health care. Copyright (C) 2007 John Wiley & Sons, Ltd.