| Summary: | 碩士 === 中國醫藥大學 === 醫務管理研究所 === 92 === Given that there is no way for the Bureau of National Health Insurance to know the out-of-pocket payment for medical care, the motive of this research is originated from the concern for the money that out-of-pocket payment for medical care under National Health Insurance system. The major task of this research is to evaluate the absolute of out-of-pocket payment, and to assess the absolute of hidden cost-sharing; meanwhile, we also seek to establish the mechanism and method for routine collection and analysis of out-of-pocket payment in the future; and also to conduct further statistic examination, so as to analyze and discuss factors that might effect this out-of-pocket payment.
This research method is a combination of face-to-face interview survey and diary.
This method will study sample population from the jurisdiction of Central Regional Bureau of BNHI, which include Taichung City, Taichung County, Changhwa County, and Nantou County, from which a sample of 1,500 individuals will be interviewed and supplemented with diary record. From the data we collected, all out-of-pocket payments for medical care will be classified into two categories. The first category is for all out-of-pocket payments that were predominantly determined by providers; the second category is those out-of-pocket payments that were largely determined by the insured. Among these two categories, the first one is also defined as hidden cost-sharing, and is the focus of this research.
Research result indicates that, within two months, the total sum of this absolute of out-of-pocket payment is 192,287 dollars, and that of the “hidden cost-sharing” is 30,850 dollars. Besides, the more frequent a patient receive medical treatment, and the higher the premium for the accessory risk part in the commercial health insurance; the higher “out-of-pocket payment” one will have to pay; this agrees to the “significant co-relation” in Statistics.（p<0.01） The rate for receiving medical treatment is 32.2%; the average times for hospital-going is 2.68, and the average “out-of-pocket payment” is 951.16 dollars. The average “hidden cost-sharing” for each insured is 29.05 dollars, and the substantial cost-sharing is 83.24 dollars. The “out-of-pocket payment” discussed and analyzed in this research does not include inpatient fee, but only the ambulatory (outpatient) service.
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