| Summary: | 碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 107 === Background:
The implementation of the Medical Care Network Program has been more than 35 years. The implementation of National Health Insurance has been more than 25 years.
However, the number of medical services has increased year by year. The number of hospitals nationwide has been decreasing year by year.
Is the distribution of medical resources in various medical areas currently available and balanced? Has the problem of cross boundary medical utilization improved compared with 20 years ago? Does it affect the inpatient''s cross boundary behavior factors? All of the above are the scope of this study.
Objective:
The main purpose of this study was to compare the distribution of medical resources and the cross boundary inpatients hospitalization across the 20 years, and to explore whether there are differences in factors affecting the cross boundary hospitalization of patients. The study is going to understand the current status of resources in Taiwan''s current medical boundary and compare the differences in the proportion of hospitalizations across the 20 years. Further explore the factors affecting the cross boundary medical utilization of inpatients and compare whether there is a difference after 20 years.
Methods:
This study used the National Health Insurance Patient Hospitalization Experience Survey conducted by the National Health Insurance Administration of the Ministry of Health and Welfare. The survey period was from November 2018 to March 2019 in Taiwan, and the current status of the latest medical resources distribution was used to understand the medical resources distribution and its impact on inpatients across the medical boundary.
Results:
The main result of this study is that the proportion of Taiwan''s overall cross-boundary inpatient has declined; regional medical resources （number of physicians per 10,000 population, number of acute general beds per 10,000 population, presence or absence of medical centers/severe first aid hospitals, number of Regional Hospitals ） are significantly associated with cross-boundary medical utilization.
Conclusions:
In the two decades, there is still a phenomenon of uneven distribution of medical resources in Taiwan. It is recommended that the health authorities reassess the medical resources in each medical boundary so that medical resources are evenly distributed.
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