| Summary: | 碩士 === 臺北醫學大學 === 醫務管理學系 === 92 === Children are the future of a country; therefore, taking good care of children is to create good health of the future population, which in a sense is to build up the strength of a nation. The authority of Taiwanese government has been paying attention to this issue. The Department of Health of Taipei City started to carry out the Medical Care Subsidy Program for Children on December 25th, 1995. The changes of policy provided a natural experiment for this study to investigate the effect of the program on children’s health care utilization.
The purpose of this study is to examine the changes of outpatient care utilization, emergency care utilization and inpatient care utilization for the children aged 1 to 6 before and after February 1st, 2001 when the subsidy of outpatient care services has been removed.
Specifically, this study sought to provide answers to the following two questions: First, was there substitution effect resulting from changes in relative price of outpatient services and emergency services? Second, were children’s inpatient services been affected by changes in policy?
Results from this study indicate that, comparing to other counties and cities in Taiwan, children aged 1-6 in Taipei had lower frequency of outpatient care utilization in the post-policy-change period, comparing to the pre-policy -change period. At the same time, they also consumed more of the third and forth level of emergency care. This result suggests that parents might substitute emergency care for outpatient services due to the changes in relative price. Finally, there was no significantly difference in the utilization of inpatient care found in this study.
The findings from this study suggest that parents were sensitive to the decreases in relative price of emergency care due to the policy change and substituted away from outpatient care toward emergency care. This might not only a waste of the emergency medical resources, but also has adverse effects on the quality of emergency care. Moreover, there were no significant reduction of hospitalization and actual benefit of children’s health outcome. Results from this study suggest a further evaluation of government subsidy program is warranted in order to facilitate more efficient use of resources.
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