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    Please use this identifier to cite or link to this item: https://nccur.lib.nccu.edu.tw/handle/140.119/157500


    Title: 三歲以下兒童醫療補助計畫政策效果：不連續迴歸模型分析
    Program Evaluation of Copayment Subsidy Program for Children under Three: Evidence from Regression Discontinuity Design
    Authors: 連賢明
    Contributors: 財政系
    Date: 2017-04
    Issue Date: 2025-06-23 13:21:47 (UTC+8)
    Abstract: 內政部於 2002年實施「三歲以下兒童醫療補助計畫」，透過補助幼兒部分負擔，期望「減輕家庭負擔，使三歲以下兒童獲得適切健康照顧」。雖說這補助政策實施超過十年，每年花費約 17億 ，但相關政策效果研究仍相當有限。本研究計畫透過三個方面來分析兒童醫療補助的政策效果。基於這政策具明確年齡限制（三歲以下），造成政策在不同年齡間呈現不連續效果；在本研究第一年，計畫使用 2000-2010年 6歲以下幼兒健保門、住診資料，透過比較三歲前和三歲後幼兒的醫療利用，採不連續迴歸模型設計來估計幼兒門、住診保險價格彈性。其次，由於兒童醫療補助政策在 2002 年 3 月實施，之前出生幼兒所接受政策涵蓋年數並不一致；在本研究的第二年，計畫串連健保利用與幼兒出生檔和死亡檔，以台北市兒童為控制組，採差異中的差異法來比較補助年數是否影響這些小孩長期健康效果（如五歲、七歲累積死亡率或住診就診次數和費用）。最後，現有部分負擔金額隨醫院層級升高而增加，免除部分負擔因而大幅增加醫學中心幼兒照護需求。當醫院面對兒童醫療需求增加，究竟採增聘新人力，還是改由現有人力負擔？在本研究第三年，計畫將健保資料串連醫院評鑑資料，檢視醫療需求增加對醫事人力影響。
    In 2002, the Ministry of Interior implemented “Medical Care Subsidy Program for Children under 3” that aims to reduce the parents’ economic burden, and enhance the children’s health through the co-payment exemption. Ten years after the inauguration of this program, with the average expenditure over NT1.7 billion each year, the consequences of this program have not been fully studied. This proposal aims to investigate the impact of this subsidy program from three perspectives. Because the program is only eligible for children under three, the program results in a discontinuous effect with respect to the children’s age. With the help of outpatient and inpatient NHI claims, the first aim employs the regression discontinuity design (RDD) by comparing the health use of children just under 3 with that of just above 3, to obtain the price elasticity of inpatient and outpatient services for very young children. Next, by merging NHI claim with the data of birth registry and death registry, the second aim examines whether the long-term consequences of children’s health (e.g. the cumulated death rates at 5 or 7 years old) is positively related to years of exposure of this program. Given that the co-payment becomes larger as the accreditation of medical facility get better, the exemption of cost-sharing policy inevitably increases the health demand for children in medical centers. It is thus interesting to learn, in light of a large increase of health demand for children, whether hospitals hire new manpower or exploit the current manpower. With the help of basic files and accreditation files of hospitals, in the third aim we examine how the exogenous demand increase affects the supply of manpower among hospitals.
    Relation: 科技部, MOST103-2410-H004-010-MY2, 103.08-105.07
    Data Type: report
    Appears in Collections:[財政學系] 國科會研究計畫

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