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Open AccessArticle

The Impacts of the Hierarchical Medical System on National Health Insurance on the Resident’s Health Seeking Behavior in Taiwan: A Case Study on the Policy to Reduce Hospital Visits

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Department of Medical Research, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), No. 670, Chung Te Road, Tainan City 701, Taiwan
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Department of Hospital and Health Care Administration, Chang Jung Christian University, No.60, Sec. 1, Erren Rd., Rende District, Tainan City 71710, Taiwan
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Department of Health Care Administration, Chia Nan University of Pharmacy and Science, No.1, Changda Rd., Gueiren District, Tainan City 71101, Taiwan
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Department of Information Technology and Communication, Shih Chien University Kaohsiung Campus, No. 200 University Road Neimen, Kaohsiung 84550, Taiwan
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Department of Internal Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), No. 670, Chung Te Road, Tainan City 701, Taiwan
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(17), 3167; https://doi.org/10.3390/ijerph16173167
Received: 12 July 2019 / Revised: 19 August 2019 / Accepted: 28 August 2019 / Published: 30 August 2019
(This article belongs to the Section Health Care Sciences & Services)

Objective: This study investigated the impacts of the hierarchical medical system under the national health insurance program on residents’ healthcare-seeking behavior in Taiwan. Background: Healthcare authorities in Taiwan initiated an allowance reduction for outpatient visits at regional hospitals and higher hierarchical hospitals in 2018. The ultimate goal is to implement a hierarchical medical system to provide residents accessible as well as consistent medical services. Methods: This research was conducted through a questionnaire survey, and data were collected between August and December 2018 from the records of subjects who had recently sought medical attention. A total of 1340 valid questionnaires were returned. Results: A principal finding was that there were significant differences in the knowledge of new policies by age, marital status, annual income, education level, and occupation (p < 0.001). Regarding the effects on healthcare-seeking behavior, there were significant differences from persons aged 40–49 years (p < 0.1), in junior high school (p < 0.05), not aware of the policy (p < 0.001), and awareness of both the hierarchical medical system and the policy to reduce outpatient visits to large hospitals (p < 0.001). Conclusion: The health administration authorities should devote more effort into promoting knowledge of the policy in order to better inform the public about the hierarchical medical system. View Full-Text
Keywords: hierarchical medical system; national health insurance; healthcare-seeking behavior; reduction in hospital visits hierarchical medical system; national health insurance; healthcare-seeking behavior; reduction in hospital visits
MDPI and ACS Style

Yan, Y.-H.; Kung, C.-M.; Yeh, H.-M. The Impacts of the Hierarchical Medical System on National Health Insurance on the Resident’s Health Seeking Behavior in Taiwan: A Case Study on the Policy to Reduce Hospital Visits. Int. J. Environ. Res. Public Health 2019, 16, 3167.

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