Taiwan implemented its National Health Insurance program (NHI) in 1995. It covers 20 million people; the enrollment rate is 96%. NHI uses a single-pipe, fee-for-service payment system. All physicians practice at four levels of institutions: medical centers, regional hospitals, district hospitals, and physician offices. NHI has a low co-payment, easy access to all facilities, and no referral system.; Health expenditures grew by more than 10% in each of the past four years while NHI's premium revenues increased 2.36% yearly between 1995 and 1998. The average outpatient visit is 15 per beneficiary per year. In 1998, NHI ran a deficit due to slow reform action and low premium collections.; This dissertation is based on Taiwan's NHI outpatient claim data for calendar year 1997. The analyses are limited to services related to eye care. Differences among physicians in medical care practice patterns have been well documented. Various practice settings, geographic variations, and physician characteristics should explain the treatment and charge variations in addition to the patients' clinical severity and characteristics.; The study's conceptual framework is based on the supplier-induced-demand model, cognitive model, behavioral model, and sociological model. Statistical techniques utilized are paired t test, chi square, and general linear regression. Four components (all eye care study, cataract surgery episode study, physician characteristic study, and physician profiling) comprise the study. The study's purposes are to provide detailed baseline information on utilization and expenses. Additionally, comparative data with other countries have epidemiological, economic values. Application of the findings acknowledges how well NHI meets beneficiaries' needs. In addition, the findings can be applied to policy to control rising health costs through utilization review and physician profiling.; The major findings are (1) The volume of cataract surgery rate matches the WHO' standard. (2) The charge per visit is much higher in medical centers than physician offices after controlling the patients' ages and genders. (3) Region five has highest density of ophthalmologists explaining the high volume of cataract surgery compared to other regions. (4) Male physicians charge 2.8% higher than female physicians.
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机译：台湾于1995年实施了国民健康保险计划（NHI）。该计划覆盖了2000万人；入学率为96％。 NHI使用单管道收费服务付款系统。所有医生都在四个级别的机构执业：医疗中心，区域医院，地区医院和医生办公室。 NHI的共付额低，可以轻松使用所有设施，并且没有推荐系统。在过去四年中，医疗保健支出在过去四年中每年增长10％以上，而NHI的保费收入在1995年至1998年之间每年增长2.36％。平均每位受益人每年门诊15次。 1998年，由于改革行动缓慢和低保费收入，国民健康保险出现了赤字。本文基于台湾1997日历年的NHI门诊索赔数据。分析仅限于与眼保健有关的服务。医务实践模式中医师之间的差异已得到充分证明。除了患者的临床严重程度和特征外，各种实践环境，地域差异和医师特征还应解释治疗和收费差异。该研究的概念框架基于供应商诱导的需求模型，认知模型，行为模型和社会学模型。使用的统计技术是配对的 t 检验，卡方检验和一般线性回归。该研究包括四个部分（所有眼保健研究，白内障手术发作研究，医师特征研究和医师概况分析）。该研究的目的是提供有关利用率和费用的详细基准信息。此外，与其他国家的比较数据具有流行病学，经济价值。研究结果的应用证实了国民健康保险如何充分满足受益人的需求。此外，这些发现还可用于通过使用情况审查和医生分析来控制不断上升的健康成本的政策。主要发现是（1）白内障手术率符合WHO标准。 （2）在控制了患者的年龄和性别之后，医疗中心的每次访问费用比医生办公室高得多。 （3）第五区域的眼科医生密度最高，这说明与其他地区相比，白内障手术量大。 （4）男医生的收费比女医生高2.8％。
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