title: The determinants of health care expenditure toward the end of life: evidence from Taiwan.
abstract: This paper empirically investigates the relationship between the health care expenditure of end-of-life patients and hospital characteristics in Taiwan where (i) hospitals of different ownership differ in their financial incentives; (ii) patients are free to choose their providers; and (iii) health care services are paid for by a single public payer on a fee-for-services basis with a global budget cap. Utilizing insurance claims for 11 863 individuals who died during 2005-2007, we trace their hospital expenditures over the last 24 months of their lives. We find that end-of-life patients who are treated by private hospitals in general are associated with higher inpatient expenditures than those treated by public hospitals, while there is no significant difference in days of hospital stay. This finding is consistent with the difference in financial incentives between public and private hospitals in Taiwan. Nevertheless, we also find that the public-private differences vary across accreditation levels.
authors.affiliation: Central University of Finance and Economics, China Center for Human Capital and Labor Market Research, Beijing, China.
authors.forename: Simon
authors.initials: S
authors.lastname: Chang
authors.forename: Yang
authors.initials: Y
authors.lastname: He
authors.forename: Chee-Ruey
authors.initials: CR
authors.lastname: Hsieh
mesh_terms: D002755:Choice Behavior; D005260:Female; D005102:Health Expenditures / Q000639:trends*; D016304:Hospitals, Private / Q000191:economics* / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D012044:Regression Analysis; D012051:Reimbursement Mechanisms / Q000191:economics / Q000592:standards*; D013222:State Medicine / Q000191:economics; D013624:Taiwan; D013727:Terminal Care / Q000191:economics*; D019472:Universal Health Insurance
keywords: Taiwan; end-of-life patients; health care expenditure; national health insurance; private hospitals; public hospitals