The Determinants of Health Care Expenditure towards the End of Life: Evidence from Taiwan

Health Economics, 23(8), page 951-961

31 Pages Posted: 15 Apr 2012 Last revised: 24 Feb 2015

See all articles by Simon Chang

Simon Chang

University of Western Australia - Department of Economics; IZA Institute of Labor Economics

Yang He

Central University of Finance and Economics (CUFE)

Chee-Ruey Hsieh

Academia Sinica - Institute of Economics

Date Written: June 11, 2014

Abstract

This paper empirically investigates the relationship between the health care expenditure of end-of-life patients and hospital characteristics in Taiwan where (1) hospitals of different ownership differ in their financial incentives; (2) patients are free to choose their providers; and (3) health care services are paid for by a single public payer on a fee-for-services basis with a global budget cap. Utilizing insurance claims for 11,863 individuals who died during 2005-2007, we trace their hospital expenditures over the last 24 months of their lives. We find that end-of-life patients who are treated by private hospitals in general are associated with higher inpatient expenditures than those treated by public hospitals, while there is no significant difference in days of hospital stay. This finding is consistent with the difference in financial incentives between public and private hospitals in Taiwan. Nevertheless, we also find that the public-private differences vary across accreditation levels.

Keywords: Health care expenditure, end-of-life patients, private hospitals, public hospitals, national health insurance, Taiwan

JEL Classification: I11, I13

Suggested Citation

Chang, Kang-Hung and He, Yang and Hsieh, Chee-Ruey, The Determinants of Health Care Expenditure towards the End of Life: Evidence from Taiwan (June 11, 2014). Health Economics, 23(8), page 951-961, Available at SSRN: https://ssrn.com/abstract=2039868 or http://dx.doi.org/10.2139/ssrn.2039868

Kang-Hung Chang (Contact Author)

University of Western Australia - Department of Economics ( email )

35 Stirling Highway
Crawley, Western Australia 6009
Australia
+61-8-64882893 (Phone)

IZA Institute of Labor Economics ( email )

P.O. Box 7240
Bonn, D-53072
Germany

Yang He

Central University of Finance and Economics (CUFE) ( email )

39 South College Road
Haidian District
Beijing, Beijing 100081
China

Chee-Ruey Hsieh

Academia Sinica - Institute of Economics

128 Academia Road, Section 2
Nankang
Taipei, 11529
Taiwan

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