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政府研究計畫詳細資料

計畫中文名稱 醫療費用成長與醫療技術選擇
計畫英文名稱 Growth of Health Expenditures and Choice of Medical Technology
科資中心編號 PG8912-0232 研究性質 應用研究
計畫編號 DOH89-HI-1014 研究方式 委託研究
主管機關 行政院衛生署 全程期間 8904 - 9003
執行機構 中國社會保險學會 本期期間 8904 - 9003
補助(委託)單位 行政院衛生署 本期經費 1680 千元
研究領域 經濟 年度 89
研究人員 林振輝
中文關鍵詞 醫療品質；醫療科技；論量計酬；部分負擔
英文關鍵詞 Quality of health care；High-tech of health care；Fee-for-service；Coinsurance

由於醫療品質和高科技的使用密切相關，而且Newhouse（1992）證明高科技的使用對於醫療費用的成長有舉足輕重的影響，在醫療資源有限的前題下，如何兼顧費用與品質，成為醫療政策決策者及相關研究者關心的議題。另外，全民健康保險制度的實施也必然會造成其他層面的影響，包括對社會福利、總醫療服務量、以及醫療服務市場結構等的影響。這些變數的影響方向值得我們深入探討，俾便全面評估現行制度的利弊。在本研究中，我們假設醫療服務提供者的經營目標是利潤、服務量及服務品質的函數，然後利用賽局理論以建構台灣的醫療市場模型。並利用實際資料進行實證研究。此外，本研究亦將利用實證結果來估算模型的基本參數，並且進行設算（Calibration）及政策模擬分析（Simulation），以了解在各種不同的健保政策（例如提高部分負擔）下，社會福利、總醫療費用、總醫療服務量、醫療服務品質、高科技的使用、及市場結構等有何影響，以供決策者參考。
It seems that there is an intimate relationship between the quality of health care and the use of high-tech of health services. Also, as found by Newhouse (1992), the use of high-tech of health services has great impact on the rise of health expenditures. Hence, with only limited resource available for us, the trade-off between the quality of health care and the growth of health expenditures through the use of high-tech of health services unavoidably becomes an important issue to be concerned by policy-makers and students of health care reform.The implementation of the National Health Insurance program must also create some problems in other dimensions. These problems include its impacts on the social welfare, the total volume of health services, and the market structure of health services. It is worthwhile for us to study these impacts so that we may have a better understanding about the benefits and costs of implementing the program.In our research, we shall assume that the objective of providers of health services is a function of profits, the service volume and the quality of health services. Next, we shall use game-theoretic approach to model various types of institution of the National Health Insurance. Then, we shall conduct an empirical study with Taiwan’s data to estimate the model. After this, we shall use calibration and simulation approach to study the impacts of various health policies (e.g. raising the coinsurance ratio) under the current system on the social welfare, the total health expenditure, the total volume of health services, the quality of health services, the excess demand for the health services, and the market structure of health services. Findings of this research may provide policy-makers better information for health care reform.