Dental global budget system in Taiwan has been operated for six years since 1998 and many things are still under evaluating. My research is aim at finding out whether the distribution of dental health resources is reasonable. Also, I put more attention to the distribution of medical resources and the inequality
between cities and counties under Nation Health Insurance?s six divisions. The data of this research comes from dental health insurance and the duration analyzed is form January 1997 to December 2002. By analyzing the reasonableness of providers? distribution of dental medical resource, I try to discover the change in the distribution indexes after dental global budget system has been taken into effort.
The analysis is focused on the equality of providers? distribution in dental medical resource and therefore, the goal indexes will be the number of registered dentists, the amount of expenditures, the number of outpatients, and the number of patients seeing the dentist. Lorenz curve and Gini coefficient are used to analyze the degree of inequality in health resources distribution and t-test and f-test are used in the process of statistic. Here, I offer two hypotheses:
Hypothesis 1: The distribution of dental medical resources is
more equableafter dental global budget system has been operated.
Hypothesis 2: The utilization of dental medical resources is more reasonable after dental global budget system has been operated.
The results of this research show that 4 indexes for the equability in the distribution of dental medical resources are not significant besides the total amount of expenditures applied by each dentist in each year after dental global budget system has been operated. Thus hypothesis 1 is not established. On the other hand, 5 indexes for the reasonable utilization of dental medical resources are significant besides the number of insured patients seeing the dentist in each year and the amount of each outpatient spending on seeing the dentist each time after dental global budge system has been operated. Thus, hypothesis 2 is not established either.
Accounting to this result, I also offer some suggestions for policy makers in the government while determining the decision of distribution as resource providers. Toward current operating system, the suggesting approaches of improvement will be aim at below dimensions:
a.Regulate service places of dentists in order to balance the dentists spread.
b.Enhance the supportable dental manpower or strengthen Integrated Delivery System for areas with lower dental resource distribution.
c.Enhance the supportable dental manpower or strengthen
Integrated Delivery System for areas with lower dental resource distribution.
d.Allocate the budget for divisions of Nation Health Insurance in order to fit the meaning of ?money to people? and eliminate the inefficiency of ?having insurance but no service?.
e.Improve the accessibility of the public, promote the dental service for more target patients, and regulate the division with value?1.
f.Transparent the information of dentists human capital so that dentists can choose where to practice.
With no doubt, there are still more expectations in the long-term progress. My suggestion is focused on two aspects?test the dental capitation and develop the professional manager and administrator for the global budget system.
