Title: The effect of Taiwan's National Health Insurance programme on hospital physicians' perceptions of their careers: a survey

Authors: Blossom Yen-Ju Lin, Shi-Ping Luh, Cheng-Hua Lee

Addresses: Institute of Health Service Management, China Medical University, 91 Hsueh Shih Rd., Taichung, 404, Taiwan, ROC. ' Department of Surgery, Taipei Tzu-Chi Medical University Hospital, Taipei, Taiwan. ' Bureau of National Health Insurance, Taipei, Taiwan

Abstract: This study, done on the 10th anniversary of the Taiwan National Health Insurance programme, examines five health policy and payment reforms, including case payment, separation of drug prescription and dispensing, reasonable outpatient volumes, hospital global budgeting, and self-governing hospital budgeting. Structured questionnaires included how hospital physicians perceived the five reforms to have affected their lives regarding conflicts in values, increased pressures, changes in behaviour, quality of personal life and satisfaction. The items of hospital physicians| career satisfaction and regrets were also included. The 182 licensed hospital western medicine physicians responded the surveys in April 2005. This study found the five reforms had a negative effect on hospital physicians| perceptions of their careers. With the evidence of hospital physicians| career satisfaction was positively related to their willingness to be doctors again, more concerns should be put for the young generations| willingness to join the medical profession in the future.

Keywords: hospital physician careers; doctors; behavioural freedom; career satisfaction; global budgeting systems; self-governing hospital budgets; policy evaluation; health policy reforms; payment reforms; Taiwan; National Health Insurance; healthcare; public policy.

DOI: 10.1504/IJPP.2007.012907

International Journal of Public Policy, 2007 Vol.2 No.3/4, pp.264 - 280

Published online: 23 Mar 2007 *

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