THE IMPACT OF NATIONAL-HEALTH INSURANCE ON THE VOLUME AND SEVERITY OFEMERGENCY DEPARTMENT USE

National Health Insurance (NHI) was introduced in Taiwan on March 1, 1 995, To evaluate the influence of NHI on the volume and severity of em ergency 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 admissio ns to the intensive care units of patients transferred from smaller ho spitals, but its percentage significantly decreased (P < .05), which m ay be a result of the significant increase in the total number of inte rhospital transfers, It was hypothesized that the universal coverage a nd a copayment contributed to these changes. Copyright (C) 1998 by W.B . Saunders Company.