The Effects of Global Budget System of primary care on the Distribution of Health Resources in Kao-Ping Areas

• Main Authors: Hsiu-Ying Fang, 方秀媖
• Other Authors: Lin-Wen Mau
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/65145218398339235595

碩士 === 高雄醫學大學 === 公共衛生學研究所碩士班 === 93 === Objectives: The distribution of health resources influences the equity and accessibility of healthcare for patients. Especially after the implementation of the National Health Insurance program, theoretically, all the population should have the same access to health resources. Previous studies did not conclude consistent findings in whether global budget (GB) system could enhance the distributions of health resources. The present study attempts to evaluate the effects of global budget system of primary care on the equality of health resource distribution in Kao-Ping areas. Methods: The study design was retrospective secondary data analysis. Gini coefficient 、Kuznets’ indicators and coefficient of variation were used to measure distribution equality of primary physicians, clinic visits and expenditures among villages and townships in Kao-Ping areas before and after the GB system. Results: As a whole, the declining values of Gini coefficients indicated that the distributions of health resources in Kao-Ping areas become more equal after the GB system. The average value of Gini for primary physician was 0.184 before the GB system, and changed to 0.179 after GB system, which reached the significant level of declining to 0.005. The values of Gini coefficients for clinic visits and health expenditures also dropped. In terms of Kuznets’ indicator, however, significant disparities of health resource distributions were found between the over-served and under-served areas. Conclusions: The GB system improved the equality of health resources in Kao-Ping areas. However, it was not extended to the areas where health resources are relatively least sufficient. Possible reasons could be the number of population or population density cannot provide strong incentives for primary physicians to practice in remote areas.