【优质】Rethinkinghealthcaresystem.ppt

* * * * * * * * * * * * * * * Other considerations Implication from NHI expenditure control Physicians visiting Consultation time Affecting specialty choices of medical trainees long-run sustainability Another viewpoint The increase of life expectancy can be explained by a number of factors, such as, rapid reduction in age-specific mortality (eg. infant mortality and maternal deaths), socio-economic factors (eg. income and education), health-related behaviors (eg. smoking and physical activity), etc. Marie DesMeules, Douglas Manuel and Robert Cho, BMC Womens Health 2004, 4(Suppl 1):S9 Another viewpoint Nolte and McKee’s study suggested that amenable mortality (referring to deaths from certain causes that should not occur in the presence of timely and effective health care) account for an average of 23% and 32% of total mortality in males and females under age seventy-five respectively based on OECD countries profiles. Ellen Nolte and C. Martin McKee, 2008, Health Affairs, 27(1):58-71 Another viewpoint Mortality from causes also fell in most of OECD countries over the period 1997-98 through 2000-01. However, the decline was generally much less steep than the decline in amenable mortality. Ellen Nolte and C. Martin McKee, 2008, Health Affairs, 27(1):58-71 Taiwan’s evidence Preliminary study results from NHRI, Yang-Ming Institute of Health and Welfare Policy also evidenced the similar trend that the amenable mortality had a significant decline during 1981 to 2005, in particular before and more after the launch of National Health Insurance in Taiwan. By YC Lee, YT Huang, YW Tsai, SM Huang and KN Kuo Rethinking Resource Allocation Resource: Health Statistic in Taiwan 2006, Department of Health, Aug, 2008 A New Paradigm emerging evidence is recasting health systems not as a drain on those resources but as an opportunity to invest in the health of the population and in economic growth. Recent studies showed that, no matter developing, middle- or high-income countrie