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Healthcare in Taiwan. Presented By : Gail Francis Michael Nguyen Kim Sasaki Carmen Harrison Wendy Nguyen. Healthcare for older adults in Taiwan . National Health Insurance system Launched March 1, 1995 Mandatory single payer social health insurance system
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Healthcare in Taiwan Presented By: Gail Francis Michael Nguyen Kim Sasaki Carmen Harrison Wendy Nguyen
Healthcare for older adults in Taiwan • National Health Insurance system • Launched March 1, 1995 • Mandatory single payer social health insurance system • Provides equal health care coverage for ALL of Taiwan’s citizens • 99% of Taiwan’s population covered by 2004
Funding – Who Pays • Government is the sole purchaser & administrator of healthcare • Premiums in the form of payroll tax on wages and salaries • Responsibility for paying these premiums averages to about: • 38% for Households • 37% for Employers • 25% for Government
Government subsidizes • Low income households • Children under 18 in the near-poor households • Citizens over 70 in the near-poor households • Indigenous citizens under 20 or 55 or over who are unemployed • Military personnel and Veterans
Definition of terms • Compressions of morbidity - goal of living disease – and illness-free for as long as possible. • Relative expansion of morbidity – a decrease in disability free life expectancy. • Asolute expansion of morbidity – a decrease in life expectancy with disability. (Robine & Mathers, 1993)
Government Study of Compression of Morbidity • A study was developed in 2007 by the Taiwanese government to study the percentages of older adults in Taiwan that were free of disease and did not suffer from disability. (Ling,Dr. Hua, Dr. C., 2007)
Purpose of Study What percentage of older adults that were expected to have a: • Disability-free life expectancy • Disease-free life expectancy • Serious disease-free life expectancy • Cancer-free life expectancy
Disability-free Life Expectancy Diagnostic Criteria Vision Hearing Mechanism Limbs Mentally Lost Functions of Primary Organs, Suffering Facial Damage Unconscious Chronically Senile Dementia Multi-Disability Caused by Infrequent Disease. Others • Disability defined as physically/mentally disabled and certified by medical experts, based on a standardized set of diagnostic criteria.
Disease-free Life Expectancy & Serious Disease-free Life Expectancy • Disease is defined as any “chronic disease” or “major illness/injury (serious disease) and certified by physician diagnosis • Serious disease DOES NOT encompass “chronic disease”.
Cancer-free Life Expectancy • Cancer is defined as a specified kind of disease designated as “cancer”, wholly defined as a serious disease with indications of chronic disease. • Based on a medical examination by a physician
Results • Disability-free life expectancy, 4.5% (1.02 million) • Disease-free life expectancy, 11% (2.5 million) • Serious disease-free life expectancy, 3.1% (0.7 million) • Cancer-free life expectancy 1.9% (0.4 million)
Healthcare Implications for Study • Reform health care from the older adults who suffered from longer compressions of morbidity to shorter compressions of morbidity. • Address relative expansion of morbidity or absolute expansion of morbidity.
Healthcare Implications of Study continued…Compression of Morbidity • (Relative and Absolute) Expansion of morbidity exists in Taiwanese older adults. • Compression of morbidity is expected to increase. • This research initiated reforms in health care in Taiwan. • Increased access to health care services and screening. • National Healthcare services were increased.
References • Ling-Yu, Dr. L & Lea-Hua, Dr. C. (2007). Disability-Free Life Expectancy Trends in Taiwan : Compression , Expansion or Dynamic Equilibrium. Reves Online Journal, 10, May 27-29. • Robine, J., Mathers, C., & Bucquet, D. (1993). Distinguishing Health Expectancies and Health-Adjusted Life Expectancies from Quality-Adjusted Life Years. American Journal of Public Health, 83(6), 797-798.