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研究生: 林隆全
Lung-Chuan Lin
論文名稱: 全民健保實施前後健康效益評估之比較
指導教授: 劉錦龍
Jin-Long Liu
口試委員:
學位類別: 碩士
Master
系所名稱: 管理學院 - 產業經濟研究所
Graduate Institute of Industrial Economics
畢業學年度: 92
語文別: 中文
論文頁數: 85
中文關鍵詞: 條件評價法願付金額存活分析位置尺度模型特徵價格模型健康效益全民健保
外文關鍵詞: location scale model, survival analysis, WTP, CVM, hedonic model, National Health Insurance, health benefit
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  • 本研究主要是探討制度的差異是否會影響民眾對於健康改善的願付金額。我們以全民健保實施前後為例,探討民眾對於健康改善的願付金額是否有所改變。
    由於國內對於健康改善的願付金額之相關研究,在研究主題、問卷設計、調查時間與調查地區都有所不同,所以經過篩選之後,研究主題設定為感冒;在個案選擇方面,分別為劉錦添、王榮德與劉錦龍(1996)之「空氣品質改善對學童健康效益評估」以及蕭代基與蕭新煌(2003)之「電力設施社會經濟影響研究」。
    實證模型採用Alberini et al.(1996)的方法。我們將函數設定成半對數型的函數形式,以配合存活分析(survival analysis)中的位置尺度模型(location scale model)。
    研究結果顯示,全民健保實施前後,民眾對於健康改善的願付金額分別為938和462元。我們將這兩份問卷合併估計,加入了一個劃分年份的虛擬變數,估計結果顯示,全民健保實施後的受訪者,其願付金額為實施前受訪者的58%。
    理論上,一個人對於避免疾病的願付金額應該包含三個部份:生病時的負效用之價值、生病時的時間損失之價值以及減輕身體不適的醫療費用(Harrington and Portney, 1987)。醫療費用又包含買成藥以及看醫生的費用。
    過去大部分為自費的年代,透過CVM所得到的願付金額可以充分反映這三項成本。然而,全民健保實施後,民眾就醫的現金支出大幅減少,經過這七年的適應期,民眾認為一場感冒所應支付的醫療費用已經與先前大不相同。
    因此,全民健保實施後,透過CVM衡量受訪者避免感冒的願付金額,會低估健康改善的經濟效益,需要透過中央健康保險局的資料加以調整,才能評估真正的健康效益。


    第一章 緒論 1 第一節 研究背景 1 第二節 研究動機與研究目的 5 第三節 研究方法與論文架構 6 第二章 文獻回顧 7 第一節 條件評價法的相關文獻 8 第二節 條件評價法應用在健康效益評估的相關文獻 13 第三章 人類健康風險降低效益模型 20 第四章 資料來源與資料說明 26 第一節 資料來源 26 第二節 資料說明 27 第五章 實證模型與變數說明 36 第一節 實證模型 36 第二節 變數說明 38 第六章 實證結果 45 第一節 全民健保實施前 45 第二節 全民健保實施後 49 第三節 綜合比較 53 第七章 結論 60 第一節 研究結論 60 第二節 研究限制 62 參考文獻 63 附錄一 1995年問卷節錄 68 附錄二 2002年問卷節錄 76

    張帆 (2000),環境與自然資源經濟學,台北:五南。
    劉錦添、王榮德、劉錦龍 (1996),「空氣品質改善對學童健康效益評估」,行政院環境保護署,EPA-84-1404-09-30,台灣大學經濟系。
    劉錦添、陳宜廷 (1996),「罹病減輕的願付金額估計-台灣都會區與石化專業區的比較」,經濟論文,24卷,3期,397-431。
    蕭代基、蕭新煌、王俊秀、邱裕鈞、邱耀初、林楨家、徐世榮、馮正民、黃書禮、劉錦添、劉錦龍、謝雨生 (2003),「電力設施社會經濟影響研究」,台灣電力公司,中央研究院經濟研究所。
    中央健康保險局 (2001),90年西醫門診感冒醫療利用情形及層級就醫費用差異原因,台北:中央健康保險局。
    Alberini, A., M. Cropper, T.T. Fu, A. Krupnick, J.T. Liu, D. Shaw and W. Harrington (1996), “What is the Value of Reduced Morbidity in Taiwan?” in The Economics of Pollution Control in the Asian Pacific, Robert Mendelsohn and Daigee Shaw (eds.), London, U.K: Edward Elgar Publishing Ltd.
    Arrow, K., R. Solow, P.R. Portney, E.E. Leamer, R. Radner and H. Schuman (1993), “Report of the NOAA Panel on Contingent Valuation,” Federal Register, 58:10, 4601-4614.
    Bishop, R.C. and T.A. Heberlein (1979), “Measuring Values of Extra-Market Goods: Are Indirect Measures Biased?” American Journal of Agricultural Economics, 61:5, 926-930.
    Bishop, R.C. and T.A. Heberlein (1990), “The Contingent Valuation Method,” in Johnson, R. L. and G. V. Johnson, eds., Economic Valuation of Natural Resources. Boulder, CO: Westview Press. 81-204.
    Brookshire, D.S., R.C. d’Arge, W.D. Schulze and M.A. Thayer (1979), “Experiments in valuing non-market goods: A case study of alternative benefit measures of air pollution control in the south coast sir basin of Southern California,” vol. 2 of Methods of Development for Assessing Air Pollution Costs and Benefits, Washington: Environmental Protection Agency.
    Cameron, T.A. and M.D. James (1987), “Efficient Estimation Methods for ‘Closed-Ended’ Contingent Valuation Surveys,” Review of Economics and Statistics, 69:2, 269-276.
    Carson, R.T. (1985), Three Essays on Contingent Valuation (Welfare Economics, Non-Market Goods, Water Quality), Ph.D. dissertation, Department of Agricultural and Resource Economics, University of California, Berkeley.
    Carson, R.T., N.E. Flores, K.M. Martin and J.L. Wright (1996), “Contingent Valuation and Revealed Preference Methodologies: Comparing the Estimates for Quasi-publc Goods,” Land Economics, 72, February, 80-99.
    Carson, R.T., R.C. Mitchell, W.M. Hanemann, R.J. Kopp, S. Presser and P.A. Ruud (1992), A Contingent Valuation Study of Lost Passive Use Values Resulting from the Exxon Valdez Oil Spill. A report to the Attorney General of the state of Alaska, November 10.
    Ciriacy-Wantrup, S.V. (1947), “Capital Returns from Soil-Conservation Practices,” Journal of Farm Economics, 29, 1181-1196.
    Cochran, W.G. and G.M. Cox (1957), Experimental Designs (2nd ed.), New York: John Wiley & Sons.
    Cooper, J. and W.M. Hanemann (1995), “Referendum Contingent Valuation: How Many Bounds Are Enough?” USDA Economic Research Service, Food and Consumer Economics Division, working paper, May.
    Davis, R. (1963), “Recreation Planning as an Economic Problem,” Natural Resources Journal, 3, 239-249.
    Dickie, M., S. Gerking, D. Brookshire, D. Coursey, W. Schulze, A. Coulson and D. Tashkin (1987), “Reconciling Averting Behavior and Contingent Valuation Benefit Estimates of Reducing Symptoms of Ozone Exposure,” Improving Accuracy and Reducing Costs of Environmental Benefit Assessments. Washington, DC: EPA.
    Grossman, M.(1972), “On the Concept of Health Capital and the Demand for Health,” Journal of Political Economy, 80, 223-255.
    Hanemann, W.M. (1984), “Welfare Evaluations in Contingent Valuation Experiments with Discrete Responses,” American Journal of Agricultural Economics, 66, 332-341.
    Hanemann, W.M. (1985), “Some Issues in Continuous- and Discrete-Response Contingent Valuation Studies,” Northeastern Journal of Agricultural Economics, 14, 5-13.
    Hanemann, W.M., J.B. Loomis and B.J. Kanninen (1991), “Statistical Efficiency of Double-Bounded Dichotomous Choice Contingent Valuation,” American Journal of Agricultural Economics, 73:4, 1255-1263.
    Harrington, W. and P.R. Portney (1987), “Valuing the Benefits of Health and Safety Regulation,” Journal of Urban Economics, 22:1, 101-112.
    Lachaine, J., C. Laurier and A.P. Contandriopoulos (2003), “Defining Monetary Values for Quality of Life Improvements: An Exploratory Study,” Pharmacoeconomics, 21:12, 865-874.
    Knetsch, J.L. and R.K. Davis (1966), “Comparisons of Methods for Recreation Evaluation,” in Kneese A.V. and S.C. Smith, eds., Water Research, Baltimore: Resources for the Future Inc., Johns Hopkins Press, 125-142.
    Krupnick, A., K. Harrison, E. Nickell and M. Toman (1993), “The Benefits of Ambient Air Quality Improvements in Central and Eastern Europe: A Preliminary Assessment,” Resources for the Future Discussion Paper #ENR93-19, Washington, DC: Resources for the Future.
    Liu, J.T., J.K. Hammitt, J.D. Wang and J.L. Liu (2000), “Mother’s Willingness to Pay for Her Own and Her Child’s Health: A Contingent Valuation Study in Taiwan,” Health Economics, 9, 319-326.
    Loehman, E.T., S.V. Berg, A.A. Arroyo, R.A. Hedinger, J.M. Schwarty, M.E. Shaw, R.W. Fahien, V.H. De, R.P. Fishe, D.E. Rio, W.F. Rossley and A.E.S. Green (1979), “Distributional Analysis of Regional Benefits and Cost of Air Quality Control,” Journal of Environmental Economics and Management, 6, 222-243.
    Loehman, E.T., D. Boldt and K. Chaikin (1984), “Measuring the Benefits of Air Quality Improvements in the San Francisco Bay Area,” U.S. EPA Report.
    Loehman, E.T. and V.H. De (1982), “Application of Stochastic Choice Modeling to Policy Analysis of Public Goods: A Case Study of Air Quality Improvements,” Review of Economics and Statistics, 64, 474-480.
    Mitchell, R.C. and R.T. Carson (1981), “An Experiment in Determining Willingness to Pay for National Water Quality Improvements,” Report to the U.S. EPA, Washington, DC, June.
    Mitchell, R.C. and R.T. Carson (1989), Using Surveys to Value Public Goods: The Contingent Valuation Method, Washington, DC: Resources for the Future.
    Navrud, S. (2001), “Valuing Health Impacts from Air Pollution in Europe: New Empirical Evidence on Morbidity,” Environmental and Resource Economics, 20:4, 305-329
    Randall, A., B.C. Ives and C. Eastman (1974), “Bidding games for valuation of aesthetic environmental improvements,” Journal of Environmental Economics and Management, 1, 132-149.
    Ready, R.C., S. Navrud and W.R. Dubourg (2001), “How Do Respondents with Uncertain Willingness to Pay Answer Contingent Valuation Questions?” Land Economics, 77:3, 315-326.
    Rowe, R. and L. Chestnut (1985), “Oxidants and Asthmatics in Los Angeles: A Benefit Analysis,” U.S. EPA Report.
    Satterthwaite, F.W. (1946), “An Approximate Distribution of Estimates of Variance Components,” Biometrics Bulletin, 2, 110-114.
    Steel, R.G.D. and J.H. Torrie (1980), Principles and Procedures of Statistics (2nd ed.),New York: McGraw-Hill.
    Tolley, G., L. Babcook, M. Berger, A. Bilotti, G. Blomquist, M. Brien, R. Fabian, G. Fishelson, C. Kahn, A. Kelly, D. Kenkel, R. Krumm, T. Miller, R. Oshfeldt, S. Rosen, W. Webb, W. Wilson and M. Zelder (1986), “Valuation of Reductions in Human Health Symptoms and Risks,” Report for U.S. EPA grant #CR-811053-01-0, U.S. EPA, Washington, DC.
    Tolley, G., D. Kenkel and R. Fabian (1994), Valuing Health for Policy: An Economic Approach, Chicago: University of Chicago Press.
    Welsh, M.P. and R.C. Bishop (1993), “Multiple Bounded Discrete Choice Models,” in W-133 Benefits and Costs Transfer in Natural Resource Planning, Western Regional Research Publication compiled by J.Bergstrom, Dept. of Ag. And Applied Economics, University of Georgia, September.
    Yoo, S.H., S.J. Kwak and T.Y. Kim (2001), “Modeling Willingness to Pay Responses from Dichotomous Choice Contingent Valuation Surveys with Zero Observations,” Applied Economics, 33, 523-529.

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