Title: Treatments, outcomes, and costs for AMI patients in Taiwan

Authors: Winnie Yip, Matthew Polisson, Ying-Chun Li, Yiing-Jenq Chou, William Hsiao

Addresses: Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK. ' Department of Economics and Nuffield College, University of Oxford, Oxford OX1 1NF, UK. ' Institute of Health Care Management, National Sun Yat-Sen University, 70 Lienhai Road, Kaohsiung 80424, Taiwan, ROC. ' Institute of Public Health and Department of Public Health, School of Medicine, National Yang-Ming University, 155 Li-Nong Street, Pei-Tou, Taipei, Taiwan, ROC. ' Department of Health Policy and Management, Harvard School of Public Health, 124 Mt. Auburn Street, Suite 410 South, Cambridge, MA 02138, USA

Abstract: This study examines the treatment-outcome and treatment-cost relationships for Acute Myocardial Infarction (AMI) in Taiwan, where National Health Insurance (NHI) was adopted in 1995. We assessed usage trends in technologically advanced procedural treatments for 31,226 AMI patients from 1997 to 2001, isolated the effects of changes in treatment usage on mortality and medical spending, and compared the values of estimated life-gains to their associated cost increases. Taiwan|s experience suggests that by providing comprehensive coverage and by controlling provider prices, NHI was able to improve population-level health by making available technologically advanced procedural treatments while at the same time managing the inflationary pressures associated with these innovations.

Keywords: universal healthcare; healthcare technology; AMI; acute myocardial infarction; angioplasty; bypass surgery; Taiwan; treatment outcomes; treatment costs; mortality; medical spending; heart attacks.

DOI: 10.1504/IJHTM.2009.025820

International Journal of Healthcare Technology and Management, 2009 Vol.10 No.3, pp.169 - 181

Published online: 24 May 2009 *

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