The equality of resource allocation in health care under the National Health Insurance System in Taiwan

Kreng, Victor B.; Yang, Chi-Tien

doi:10.1016/j.healthpol.2010.08.003

Cited by 75 publications

(63 citation statements)

References 47 publications

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“…The gap in health indicators can be seen not only between the countries themselves, but also between the different regions within the counties or the provinces. The results of the present study are in line with the results of other studies conducted in Iran (Mousavi et al, 2013;Nastaran, 2001;Sepehrdoust, 2011;Tahari Mehrjardi, Babaei Mybodi & Morovati Sharifabadi, 2012) or abroad (Asanin & Wilson, 2008;Boutayeb & Helmert, 2011;Fang et al, 2010;Horev, Pesis-Katz & Mukamel, 2004;Kreng & Yang, 2011;Peters et al, 2008;Pong et al, 2009;Theodorakis, Mantzavinis, et al, 2006) on the gap in health indicators. Planners and policymakers should concentrate on finding the reason for the existence of the developmental distances and gaps and on seeking solutions.…”

Section: Discussionsupporting

confidence: 92%

Inequalities in the Distribution of Health Care Facilities

Mousavi

Nemati

Asar

et al. 2016

Journal of Health Management

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Inequality in the distribution of health care facilities is one of the main barriers to health care access. The purpose of this study was to assess the regional differences in health care facilities across the Kohgiluyeh and Boyer-Ahmad (KBA) province in order to reduce the gap between different regions. The study was carried out in the KBA province in the southwest of Iran. Fifteen health indices were selected based on their availability in the 2011 Statistical Centre of Iran (SCI) annual report. Data analysis was conducted through using numerical taxonomy. The findings obtained showed a huge gap between the different counties of the province. Yasouj had the highest (0.73) health indicator level, while Charam (0.982) had the lowest. Our findings can provide a big picture of the inequalities that exist in this province for policy-makers. Consequently, it enables policy-makers to make greater efforts for understanding the present conditions and moving towards a more equal distribution of health care services and facilities.

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Section: Discussionsupporting

confidence: 92%

Inequalities in the Distribution of Health Care Facilities

Mousavi

Nemati

Asar

et al. 2016

Journal of Health Management

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“…It is plausible that complex free flap cases are being routinely performed in larger hospitals, which are mostly located in Northern Taiwan. 16 Although higher volume hospitals were associated with slightly less likelihood of 30-day rehospitalization, the results were not statistically significant.…”

Section: Resultsmentioning

confidence: 82%

The Associations of Hospital Volume, Surgeon Volume, and Surgeon Experience with Complications and 30-Day Rehospitalization after Free Tissue Transfer: A National Population Study

Mahmoudi

Chang

et al. 2017

Plastic &Amp; Reconstructive Surgery

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Background Greater provider volume is associated with better outcomes. There is, however, a paucity of evidence on volume-outcome associations for surgical complications and 30-day all-cause rehospitalization after free tissue transfer (FTT) or free flap. Surgical complications and frequent rehospitalization are important quality indicators that substantially hinder appropriate healthcare spending. We hypothesized that increased provider volume and surgeon experience are associated with lower complication and hospital readmission rates. Methods We conduct a retrospective cohort study of adults 18–64 years of age who underwent FTT. We examined 100% of all FTT operations between 2001 and 2012 using Taiwan’s national data. We used regression modeling to examine associations between volume and outcome. All of our models were adjusted for patient, surgeon, and hospital characteristics. Results Seventeen percent of FTT operations (4,201 out of 25,327) had complications. Infection was the most prevalent complication after FTT (70%) and 30-day rehospitalization rate was about 20%. Hospital volume was associated with small decrease in complications in FTT (OR=0.99; CI:0.99–0.99; p < 0.01). For surgeons, years of experience and not annual case volume decreased surgical complications (OR=0.98; CI=0.97–0.99; p=0.01). We did not find any association between hospital or surgeon volume, or surgeon’s years of experience and 30-day rehospitalization. Conclusions Higher-volume hospitals and more experienced surgeons were shown to have lower likelihood of complications after surgery. Hospital process and structure affect outcomes and reduce surgical complications. Reducing a 30-day rehospitalization may require a payment reform as it demands a coordinated care pre and post hospital discharge.

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“…Ratio? )MCDA a Ranking of 47 programs funded by the region[32]UK2 Primary Care TrustsAllocation of points methodPBMA66 proposals approved that met criteria out of 134 submitted[33]GhanaNational levelDiscrete Choice ExperimentMCDARanking of 11 health programs[34]CanadaProvincial levelDiscrete Choice ExperimentMCDADevelopment of decision tool[35]UKPrimary Care TrustMix of ratio (for main criteria) and points allocation (for sub-criteria)PBMA£3.37 m disinvested, £2 m used for defecit reduction[36]TaiwanNational Health InsuranceGrey incidence mathematical expressionMCDAAccess to care optimization[37]KoreaHospitalGoal programming multicriteria decision modellingMCDAStaffing and other logistic optimization for hospital resource allocation to meet goals[38]TanzaniaNational Ministry of HealthNo weights describedMCDAPrioritization of 9 programs[39]UKDepartment of (Public) HealthDiscrete Choice ExperimentMCDARanking of 14 different preventative health measures[40]South AfricaDepartment of HealthRating ScaleMCDAEvaluation of LBC as cervical cancer screening tool[41]CanadaHealth Authority40 points could be allocated to any of 40 itemsPBMA$40 m in resources released, used for defecit and reinvestment[42]CanadaHealth AuthorityAllocation of points methodMCDA9 alternative programs ranked[43]CanadaHealth AuthorityAllocation of points methodPBMA44 disinvestments, $4.9 million in cost reduction[44]CanadaUniversity faculty of medicineAllocation of points methodPBMA55 disinvestments, $2.7 million in cost reduction[45]…”

Section: Resultsmentioning

confidence: 99%

‘Real-world’ health care priority setting using explicit decision criteria: a systematic review of the literature

Cromwell

Peacock

Mitton

2015

BMC Health Serv Res

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BackgroundHealth care decision making requires making resource allocation decisions among programs, services, and technologies that all compete for a finite resource pool. Methods of priority setting that use explicitly defined criteria can aid health care decision makers in arriving at funding decisions in a transparent and systematic way. The purpose of this paper is to review the published literature and examine the use of criteria-based methods in ‘real-world’ health care allocation decisions.MethodsA systematic review of the published literature was conducted to find examples of ‘real-world’ priority setting exercises that used explicit criteria to guide decision-making.ResultsWe found thirty-three examples in the peer-reviewed and grey literature, using a variety of methods and criteria. Program effectiveness, equity, affordability, cost-effectiveness, and the number of beneficiaries emerged as the most frequently-used decision criteria. The relative importance of criteria in the ‘real-world’ trials differed from the frequency in preference elicitation exercises. Neither the decision-making method used, nor the relative economic strength of the country in which the exercise took place, appeared to have a strong effect on the type of criteria chosen.ConclusionsHealth care decisions are made based on criteria related both to the health need of the population and the organizational context of the decision. Following issues related to effectiveness and affordability, ethical issues such as equity and accessibility are commonly identified as important criteria in health care resource allocation decisions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0814-3) contains supplementary material, which is available to authorized users.

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The equality of resource allocation in health care under the National Health Insurance System in Taiwan

Cited by 75 publications

References 47 publications

Inequalities in the Distribution of Health Care Facilities

Inequalities in the Distribution of Health Care Facilities

The Associations of Hospital Volume, Surgeon Volume, and Surgeon Experience with Complications and 30-Day Rehospitalization after Free Tissue Transfer: A National Population Study

‘Real-world’ health care priority setting using explicit decision criteria: a systematic review of the literature

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