Recent Trends in Taiwanese Medical Spending

50 Pages Posted: 24 May 2021

See all articles by Stacey Chen

Stacey Chen

University of Tokyo, Graduate School of Public Policy

Hongwei Chuang

International University of Japan - Graduate School of International Management

Date Written: 2016

Abstract

Since the creation of National Health Insurance (NHI) in 1995, Taiwan’s medical spending has been increasing rapidly, as has been the case in most countries worldwide. This paper follows international standards in documenting recent trends in Taiwan’s medical spending by category, relying on official statistics, Surveys of Family Income and Expenditure (SFIE) data, and administrative reimbursement panel data from the NHI Universal Database (NHIUD). Two findings are noteworthy. First, we find a rapidly widening gap since 1996 between rich and poor in terms of out-of-pocket payments and those by private health insurance; meanwhile, the gap between them in terms of NHI expenditure has remained roughly constant. This trend can be attributed mainly to a positive income gradient in personal health care expenditure among elderly individuals (aged 65 or older). Second, end-of-life hospital spending is enormous in both magnitude and proportion. Average end-of-life hospital spending is more than 30 times average hospital spending by the total population. It accounts for 15.9 percent of total hospital care expenditure (or 5.0 percent of overall medical spending), even though the population near death accounts for only 0.51 percent of the overall population. Two-thirds of end-of-life hospital spending is on the elderly, who also constitute two-thirds of the population near death. For both the elderly and working-age adults, the share of end-of-life hospital spending strikingly aligns with the share of deaths.

Keywords: income gradient, medical spending, end-of-life hospital spending, Taiwan’s health data

JEL Classification: H51, I13, I14, I15

Suggested Citation

Chen, Stacey and Chuang, Hongwei, Recent Trends in Taiwanese Medical Spending (2016). Fiscal Studies, Vol. 37, No. 3-4, 2016, Available at SSRN: https://ssrn.com/abstract=3818608 or http://dx.doi.org/10.2139/ssrn.3818608

Stacey Chen (Contact Author)

University of Tokyo, Graduate School of Public Policy ( email )

International Academic Research Building,
7 Chome-3-1 Hongo, Bunkyo City, Tokyo 113-0033
Bunkyo, 113-0033
Japan
+819066885873 (Phone)

HOME PAGE: http://www.pp.u-tokyo.ac.jp/en/

Hongwei Chuang

International University of Japan - Graduate School of International Management ( email )

777 Kokusai-cho
Minami Uonuma-shi, Niigata 949-7277
Japan

HOME PAGE: http://rmap.iuj.ac.jp/profile/en.1e6f143481f9329c.html

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