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    Title: 健保財務狀況與國內社經因素之相關性研究
    The causality analysis between financial status of health insurance and socio-economic indexes
    Authors: 孫德基
    Contributors: 鄭宇庭
    孫德基
    Keywords: 廻歸分析
    相關分析
    保險密度
    保險滲透率
    Date: 2011
    Issue Date: 2012-04-12 14:00:36 (UTC+8)
    Abstract: 全民健康保險(簡稱健保或全民健保)的財務狀況,自民國84年開辦以來均呈現收支不平衡的現象。有鑑於此,本研究擬針對健保財務狀況的影響因子進行探討,故考慮國內整體的社會及經濟環境指標變數的變動趨勢,對健保保費收入與健保保費支出間的關係。此外,我們更納入保險主要指標(包含保險密度及保險滲透率)的概念,進一步探討社經指標對其影響程度。
    本研究導入相關分析及多元廻歸等方法,研究解釋變數(包含GDP、經濟成長率、國民所得或每人國民所得、GNP或每人GNP、失業率、勞參率、人口數、就業人口數、平均薪資等)對因變數(包含健保保費收入、健保保費支出、健保保險密度、健保保險滲透率等)間的關係。其研究結果顯示,在相關分析部分,除經濟成長率對健保財務狀況的影響不顯著外,其餘變數對健保財務狀況關係呈現相關性。在廻歸分析部分,就業人口數的增加將造成健保保費收入增加及健保保險滲透率的提高,反之則呈現遞減,而失業率、GDP、人口數的成長將造成健保保費支出的增加及健保保險密度的上升。
    Since the institution of the current healthcare system in Taiwan, known as National Health Insurance (NHI), in 1995, its financial condition faces the imbalance of the funding and the expenditure. Based on this issue, this project aims to research on the factors impacting the NHI financial condition. The factors take into consideration of the socioeconomic issues and the changing trends of the various economic indicators affecting the funding and the expenditure of the NHI. In addition by encompassing the concepts of insurance penetration and insurance density rate, the project further analyzes the impact of the socioeconomic indicators on the NHI.
    The project adopts the application of correlation analysis and multiple linear regression analysis to study the influences of the variables: gross domestic products (GDP), economic growth, gross national products (GNP), unemployment rate, workforce participation rate, population, employment rate and average salary, have on the variables: NHI receiving premiums, NHI expenditures, NHI insurance density rate and insurance penetration rate. The results show that under the correlation analysis model all of the variables except for the economic growth rate have the association impact on the NHI financial conditions. As for the analysis under the multiple linear regression analysis, the increase of the employment does increase premium receiving and penetration rate of the NHI and vice versa. With the same respect the increase of the unemployment, GDP and population increase the expenditures of the NHI and the insurance density rate.
    目 錄 I
    表目錄 II
    圖目錄 III
    第壹章 緒論 1
    第一節 研究背景與動機 1
    第二節 研究目的 3
    第三節 研究流程 3
    第貳章 文獻探討 5
    第一節 健保相關之定義 5
    第二節 文獻回顧 7
    第參章 研究方法 13
    第一節 資料來源概述 13
    第二節 操作性變數定義 13
    第三節 分析方法 18
    第肆章 實證分析 25
    第一節 探索性分析 25
    第二節 相關分析 36
    第三節 多元線性廻歸分析 38
    第伍章 結論與建議 49
    第一節 結論 49
    第二節 建議 51
    第三節 後續研究發展 52
    參考文獻 53
    Reference: 一、 中文文獻
    1. 王嘉偉,2002,「全民健康保險損失成本之分析」,逢甲大學統計與精算研究所碩士論文。
    2. 林小鳯,2002,「全民健康保險醫療費用影響之因素」,中國醫藥學院醫務管理學研究所碩士論文。
    3. 邱雅玲,2000,「台灣醫療健保支出成長因素之探討」,世新大學經濟學系碩士論文。
    4. 黃登源,1998,「應用迴歸分析」,台北:華泰書局。
    5. 陶宏麟、郭嘉祥,1998,「失業率變動、薪資成長與健保保費收入」,勞資論叢第八期,頁67-94。
    6. 郭駿耀,2004,「人口老化與健保費率」,長庚大學醫務管理研究所。
    7. 張凱鈞,2009,「以所得總額為費基徵收健保費對所得分配的衝擊」,國立台北大學財政學系碩士班碩士論文。
    8. 鄭文輝、蘇建榮,1997,「全民健保財務負擔及公平性之探討」,全民健康保險財務問題學術研討會,頁1-27。
    9. 鄭文輝,1998,「全民健康保險對象家庭財務負擔與醫療使用之探討」,行政院衛生署中央健康保險局八十七年度委託研究計畫。
    10. 鄭文輝、周麗芳、陳俊全與梁正德,2002,「全民健保財務調整方案對保險對家庭財務負擔影響之評估」, 行政院衛生署中央健康保險局九十年度委託研究計畫。
    11. 蔡貞慧與周穎政,2002,「台灣全民健康保險的醫療支出重分配效果」,1995~2000」,台灣衛誌,頁373-379 。
    12. 蔡貞慧、張鴻仁與王本仁,2004,「2002年調整保費及部份負擔對全民健康保險財務公平性之影響」,人文及社會科學集刊,頁1-27。
    13. 賴美淑、朱澤民、鄭文輝,2004,「全民健保財源籌措改革規劃」,行政院衛生署二代健保規劃叢書。
    二、 英文文獻
    1. Aronson, J.R., Johnson, P., Lambert, P.J., 1994. Redistributive effect and unequal tax treatment. Economic Journal 104, 262–270.
    2. Getzen, T. E. , 1991, Maco forcasting of national health expenditures. Advances in Health Economics and Health Services Research, 11, 27-48.
    3. Lu, J. F. R., Leung, G.M., Kwon, S., Tin, K.Y.K., et al., 2007. Horizontal equity in health care utilization: Evidence from three high-income Asian economies. Social Science and Medicine 64 (1), 199–212.
    4. Murthy, V. NR, and Ukpolo, V., 1994, Aggregate health care expenditure in the United States : evidence from co integration tests. Applied Economics, 26, 797-802.
    5. O’Donnell, O., van Doorslaer, E., Rannan-Eliya, R.P., Somanathan, A., 2007b. The incidence of public spending on health care: comparative evidence from Asia. World Bank Economic Review 21 (1), 93–123.
    6. Wagstaff, A., van Doorslaer, E., van der Burg, H., Calonge, S., et al., 1999. Equity in the finance of health care: some further international comparisons. Journal of Health Economics 18 (3), 263–290.
    Description: 碩士
    國立政治大學
    經營管理碩士學程(EMBA)
    99932070
    100
    Source URI: http://thesis.lib.nccu.edu.tw/record/#G0099932070
    Data Type: thesis
    Appears in Collections:[Executive Master of Business Administration] Theses

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