Background and Purpose: The purpose of this study was to examine the changes various services for children residing in Taipei City before and after February 1st, 2001 when the subsidy of outpatient care services has been dissolved. Specifically, this study sought to provide answers to the following two questions: First, Was there a substitution effect resulting from changes in relative price of outpatient services and emergency services? Second, Were children’s inpatient services been affected by the changes in policy? Methods: This study examined the use of outpatient services, emergency services and inpatient services covered by the National Health Insurance in 2000 and 2001 for children residing in Taipei City (the study group). The study group was compared with the control group, which included all the other children residing in cities and counties other than Taipei City. Results: Results from this study indicated that, comparing to children in other counties and cities in Taiwan, children aged 1-6 in Taipei City had lower frequency of outpatient care utilization in the post-policy-change period, comparing to the pre-policy-change period. At the same time, they also consumed more of the third and fourth level of emergency care. This result suggested that parents might substitute emergency care for outpatient services due to the changes in relative price. Finally, there was no significant difference in utilization of inpatient care. Conclusion: The findings from this study suggested that parents were sensitive to the decrease in relative price of emergency care due to the policy change and substituted away from outpatient care toward emergency care. This might not only present a waste of the emergency medical resources, but also has adverse effects on the quality of emergency care. Moreover, there were no significant reduction of hospitalization; there is, no actual benefit of children's health outcome being observed. Results from this study suggest that a further evaluation of government subsidy program is needed in order to facilitate more efficient use of medical care resources.
- children's medical care subsidy program
- medical care utilization
- substitution effect