The Impacts of Drug Copayment Policy on Medical Utilization and Expenses for Epilepsy Patient in Taiwan

• Main Authors: Hou-Jen Chen, 陳厚任
• Other Authors: Ya-Seng Hsueh
• Format: Others
• Language: zh-TW
• Published: 2004
• Online Access: http://ndltd.ncl.edu.tw/handle/88984062732534590230

碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 92 === Bureau of National Health Insurance (NHI) implemented drug copayment policy on August 1, 1999. This new policy was designed to reduce the growth of ambulatory care expenditure and prescription utilization. This study aimed to evaluate the impact of drug copayment policy, and it used NHI claim data from 1998 to 2001 and tax report information with difference-in-difference methodology to analyze. This study observed epilepsy patients’ medical utilization and health status for both short-term (i.e., one year after the policy) and long-term (i.e., two year after the policy) periods. Besides, it evaluated correction of “cure item” column in the NHI claim data by analyzing epilepsy patients. The main findings were concluded as below: 1.The impacts of epilepsy patients’ medical utilization and expenditure: (1) Prescription expenditure: There were no significant effects on total prescription expenditure and antiepileptics expenditure for both short- term and long-term periods. (2) Prescription days: There was a significant decrease on total prescription days and antiepileptics days for both short-term and long- term periods. (3) Ambulatory care visits: There was a significant decrease on total ambulatory care visits and epilepsy-related ambulatory care visits for both short-term and long-term periods. 2.Using length of stay and emergency care visits as health status indicator, the impact of epilepsy patients'' health status: (1) Length of stay: There was no significant effect on total length of stay for both short-term and long-term periods, and there was a significant decrease on epilepsy- related length of stay. (2) Emergency care visits: There was no significant effect on total emergency care visits and epilepsy-related emergency care visits for both short-term and long-term periods. 3.By analyzing epilepsy patients’ medical utilization and expenditure, this study found there were lots of data missing in “cure item” column in NHI claim data. Besides, there were lots of significant differences from medical utilization and expenditure between patients who had records in the column and those who did not have records. Based on above findings, this study suggests: 1.It is appropriate to maintain the current drug copayment policy. 2.In order to release the financial burden for those chronic patients who really need medical cares,govern- ment should motivate doctors to prescribe more longer duration of medicine for chronic diseases as incentive. Meanwhile, government should encourage chronic patients to discuss with doctors to know whether they should take longer duration of medicine for chronic diseases or not. 3.In order to avoid more researchers will have been confused by NHI claim data in the future, Bureau of NHI should evaluate the existence of “cure item” column.