The impact of National Health Insurance on the volume and severity of emergency department use

Am J Emerg Med. 1998 Jan;16(1):92-4. doi: 10.1016/s0735-6757(98)90075-4.


National Health Insurance (NHI) was introduced in Taiwan on March 1, 1995. To evaluate the Influence of NHI on the volume and severity of emergency department (ED) visits, a retrospective analysis was conducted. The results showed that NHI did not result in a substantial increase in ED volume (P > .05), but the severity as measured by triage nurses did increase (P < .01). There was no change in the number of admissions to the intensive care units of patients transferred from smaller hospitals, but its percentage significantly decreased (P < .05), which may be a result of the significant increase in the total number of interhospital transfers. It was hypothesized that the universal coverage and a copayment contributed to these changes.

MeSH terms

  • Emergency Service, Hospital / statistics & numerical data*
  • Hospitals, Public / statistics & numerical data
  • Hospitals, University / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data
  • National Health Programs*
  • Patient Transfer / statistics & numerical data*
  • Retrospective Studies
  • Severity of Illness Index
  • Taiwan
  • Universal Health Insurance