Nearly 15% of all emergency department visits were nonemergent an additional 20% were emergent-preventable with primary care. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits. The data contained 43,384 visits, of which 83.89% could be classified. A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits. Tsai, Jeffrey Che-Hung Chen, Wen-Yi Liang, Yia-Wun Nonemergent emergency department visits under the National Health Insurance in Taiwan. Inequities will continue to call for further redistribution, reduction in conditional grants and downsizing, much of which could have been avoided if fiscal and wage policy choices had been optimal. Simultaneous application of policies of fiscal constraint, redistribution and substantial real wage growth has resulted in substantial downsizing with limited inroads into inequities. Disjointed fiscal and wage policy has affected health services. The major cause of downsizing was wage growth, particularly following the 1996 wage agreement. Substantial interprovincial inequities remain.
Expenditure analysis revealed a 39.7% real rise in the average cost of health personnel. The net effect of financing changes was that the DOH's allocation in real terms was similar in 2002//96, which suggests that financing changes are not the major cause of downsizing.
This was offset by the DOH's share of the WC budget increasing from 25.6% to 29.6%, mainly because of an increase in national health conditional grants. Total aggregate provincial transfers (all provinces) remained fairly constant in real terms. Downsizing involving 9,282 health workers (27.9%) and closure of 3,601 hospital beds (24.4%) over 5 years. Western Cape (WC) Department of Health (DOH). Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy.
Downsizing of a provincial department of health-causes and implications for fiscal policy.
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