臺灣醫療保健支出之探討──分量迴歸模型應用

The Study of Healthcare Expenditure in Taiwan: An Application of Quantile Regression

本研究以臺灣1990年至2021年家庭收支調查報告為依據，探討臺灣經歷了三階段的快速經濟發展後，對臺灣醫療保健支出的可能影響因素及影響效果，研究變數包括：平均可支配所得、扶老比、扶幼比、通貨膨脹率、失業率、經濟成長率及全民健保的實施，並使用分量迴歸（Quantile Regression）探討影響醫療保健支出之因素是否因醫療保健支出高低（醫療保健發展程度）不同而有所差異。實證結果顯示：第一、平均而言，平均可支配所得、扶老比、通貨膨脹率、失業率及全民健保的實施對醫療保健支出皆有顯著正向影響，而扶幼比對醫療保健支出為顯著負向影響，經濟成長率則對醫療保健支出不具影響性。第二、無論醫療保健高度或低度發展，平均可支配所得、扶老比、扶幼比及失業率均為決定醫療保健支出之因素，而影響的效果也隨著發展程度不同而有所差異。當醫療保健發展到一定程度時（中度或高度），通貨膨脹率將對醫療保健支出產生顯著正向影響，並且隨著發展程度愈高，正向影響效果愈大。第三、全民健康保險的實施僅對醫療保健高度發展有顯著正向影響。

This study, based on Taiwan's Household Income and Expenditure Survey reports from 1990 to 2021, investigates the potential factors influencing healthcare expenditure in Taiwan following three stages of rapid economic development, as well as the effects of these factors. The variables studied include average disposable income, old-age dependency ratio, child dependency ratio, inflation rate, unemployment rate, economic growth rate, and the implementation of National Health Insurance (NHI). Quantile regression is used to explore whether the factors affecting healthcare expenditure vary depending on the level of healthcare expenditure (degree of healthcare development). The empirical results indicate the following: First, on average, average disposable income, old-age dependency ratio, inflation rate, unemployment rate, and the implementation of NHI all have significant positive impacts on healthcare expenditure, while the child dependency ratio has a significant negative impact. Economic growth rate, however, does not significantly affect healthcare expenditure. Second, regardless of the level of healthcare development, average disposable income, old-age dependency ratio, child dependency ratio, and unemployment rate are determinants of healthcare expenditure, with the impact varying according to the level of development. When healthcare development reaches a certain level (moderate or high), the inflation rate significantly positively impacts healthcare expenditure, with the positive effect increasing as the level of development rises. Third, the implementation of NHI significantly positively impacts healthcare expenditure only in societies with highly developed healthcare systems.