Transcript National Health Account in Taiwan: An update Chung

National Health Account in Taiwan:
An update
Chung-Fu Lan
National Yang-Ming University
Pi - Joen Lee
Department of Health, ROC (Taiwan)
Seoul, 5th SHA Meeting
June 16, 2009
Financial Flows in Taiwan’s Health Care System
Health Financing Overview, Taiwan 2005
Population (million)
Gross domestic products (GDP) per capita
Total Expenditure on Health (TEH) per capita
Public
general gov’t (excl. social security)
social security fund
Private
23
US$ 15,714
US$ 957
US$ 562
US$ 52
US$ 511
US$ 395
General government spending on health as a share of total government
spending
11.50%
Pharmaceuticals as a share of TEH
26.50%
TEH as a share of GDP
6.09%
TEH Per Capita & GDP Per Capita
in OECD Member Countries and Taiwan, 2005
7000
6500
Norway
6000
5500
Iceland
5000
Netherlands Denmark
Canada
Austria
Belgium
France
4500
4000
3500
Germany
3000
Italy
Japan2005
New Zealand
2500
Greece
Portugal
2000
1500
Hungary
1000
Turkey2005
Ireland
Sweden
United Kingdom
Finland
Australia2005
Spain
Korea
Taiwan
Czech Republic
500
Mexico Poland
GDP (Per Capita:US$)
Slovak Republic2005
0
0
10000
20000
30000
40000
50000
60000
70000
80000
Total Expenditure on Health by
Financing Source, 2005
Out-of-pocket Health Expenditure
Out-of-pocket Expenditure by Provider,
2005
HP.4 Retail sales
and other
providers of
m edical goods,
33.9%
HP.3.1 Office of
physicians,
8.3%
HP.3 Providers of
am bulatory health
care,
29.5%
HP.1 Hospitals,
28.9%
HP.2 Nursing and
residential care
facilities, 19,559,
7.6%
HP.3.2 Office of
dentists ,
13.7%
HP.3.3 Office of
other health
practitioners,
3.8%
HP.3.5 Medical and
diagnostic
laboratories, 1,917,
0.7%
HP.3.6 Providers of
hom e health care
services,
3.1%
Out-of-pocket Expenditure by Function,
2005
In-patient
services,
19.1%
HC.4, HC.5,
HC.6 & HC.7,
34.6%
HC.1-HC.3,
65.4%
Day care
services,
0.1%
Out-patient
services,
43.1%
Hom e care
services,
3.1%
Out-of-pocket Payments for
Medical Care in Two Months
Variable
NHI cost-sharing: inpatient and outpatient
Mean
SD % of total
113
642
6.9
NHI cost-sharing: prescription drugs
14
63
0.9
Over-the-counter drugs
48
321
2.9
Extra-billing for inpatient hospital bed
356
6378
21.6
Extra-billing for laboratory and diagnostic
177
2449
10.8
Extra-billing for surgery
224
2173
13.6
Extra-billing for medical equipments or
supplies
118
2305
7.2
68
820
4.1
527
-
32.0
1645
19 264
100
Extra-billing for anesthesiology
All others
Total out-of-pocket payments
Note: All monetary values are in NT Yuan
Reference: Chi C., Lee J-L., Tsai S-L., and Chen W-Y. Out-of-pocket payment for medical care under Taiwan’s National
Health Insurance system. Health Econ, 2008; 17: 961-75.
Preliminary Analyses on
Disease & Pharmaceutical Accounts
Personal Health Care Expenditure,
Disease Specific, 2005
ATC Drug Expenditure, 2008
_____________ATC____________________________________NT$(M)____Growth rate
C Cardiovascular system
A Alimentary tract & metabolism
N Nervous system
J Antiinfectives for systemic use
L Antineoplastic & immunomodulating agents
B Blood & blood forming organs
M Musculo-skeletal system
R Respiratory system
G Genitourinary system & sex hormones
H Systemic hormonal preparations (excl. sex hormon & insulin)
S Sensory organs
D Dermatologicals
V Various
P Antiparasitic products, insecticides & repellents
26,317
14,125
14,097
13,961
13,306
9,549
4,713
4,622
2,589
1,797
1,201
1,167
585
160
7.8%
6.7%
6.0%
6.6%
17.9%
9.0%
0.7%
-2.4%
7.2%
12.8%
3.3%
-1.0%
52.5%
3.0%
___________Total
* Growth rates are compared with drug expenditure year 2007
108,187
7.8%
On-going Works
• To refine data & information on OOP
expenditures
– A National Household Health Care Expenditure
Survey
• To complete Taiwan’s SHA-based Health
Accounts, Year 1999 to 2004 & 2006 to 2008
• To adjust with Consumer Price Index (CPI) &
Medical Consumer Price Index (MCPI); or at
constant year 2000 prices
• To interpretate the NHA’s policy implications
Thank You