Presentation (CTI)

OBJECTIVES: Countries around the world are committed to achieving universal health coverage, ensuring that people can access medical services without facing financial hardship. Despite these efforts, household health expenditures continue to rise. In Taiwan, there is a lack of comprehensive studies examining household’s out-of-pocket (OOP) health expenditures. This study aims to evaluate the equity of OOP spending and the distribution of catastrophic healthcare expenditures in Taiwan, and identify the key factors that influence these expenditures.
METHODS: This study utilizes data from Taiwan’s Survey of Family Income and Expenditure from 2014 to 2023. The distribution of absolute household OOP health expenditures is analyzed using the Concentration Index. Subsequently, the Kakwani Index is employed to examine the income-proportional distribution of these expenditures. Finally, a decomposition analysis is conducted to identify and quantify the determinants of OOP health expenses in Taiwan.
RESULTS: Our findings indicate that the proportion of households in Taiwan experiencing catastrophic healthcare expenditures increased from 9.01% in 2014 to 12.21% in 2023. The Concentration Index averaged 0.265. However, the trend in OOP health expenditures has been regressive over the past decade, with the Kakwani index decreased from -0.04 in 2014 to -0.036 in 2023. Additionally, factors such as family composition and the socioeconomic status of the household head had the largest contribution to this inequality.
CONCLUSIONS: This study provides the most recent post-COVID analysis of the OOP in Taiwan. While high-income households incur higher absolute OOP health expenditures, these expenditures still pose a significant burden on low-income households due to the regressive nature of OOP. In addition, there is still a considerable number of households experiencing catastrophic health expenditure. Therefore, despite the presence of the National Health Insurance, policies are required to strengthen financial protection for low-income households and improve the equity of OOP health expenditures in Taiwan.