Copayment Adjustments Under Bundled and Two-Tiered Pricing: Welfare Implications for Outpatient Care in Taiwanese Hospitals.

This study investigates the welfare implications of copayment adjustments on non-prescription drug services and prescription drugs provided through outpatient care in Taiwan's hospitals under the bundled and 2-tiered pricing scheme. The novelty of this study lies in its analysis of the welfare effec...

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Publicado en:Inquiry (00469580) Vol. 62; pp. 1 - 16
Autor principal: Chen, Wen-Yi
Formato: Artículo
Publicado: Sage Publications Inc. 8/31/2025
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Acceso en línea:Ver este registro en EBSCOhost
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        atl: Copayment Adjustments Under Bundled and Two-Tiered Pricing: Welfare Implications for Outpatient Care in Taiwanese Hospitals.
      aug:
        au: Chen, Wen-Yi
        affil: National Taichung University of Science and Technology, Taiwan
      su:
        Public welfare -- Economic aspects
        Outpatient services in hospitals
        Human services programs
        Research funding
        Scientific observation
        Cost analysis
        Health policy
        Hospitals
        Time series analysis
        Structural equation modeling
        Descriptive statistics
        Confidence intervals
        Drugs
        Medical care costs
        Nonprescription drugs
        Medical referrals
        Poverty
        Patients' attitudes
        Economics
        Taiwan
      sug:
        subj:
          Taiwan
          Public welfare -- Economic aspects
          Outpatient services in hospitals
          Human services programs
          Research funding
          Scientific observation
          Cost analysis
          Health policy
          Hospitals
          Time series analysis
          Structural equation modeling
          Descriptive statistics
          Confidence intervals
          Drugs
          Medical care costs
          Nonprescription drugs
          Medical referrals
          Poverty
          Patients' attitudes
          Economics
      keyword:
        bundle pricing
        compensated variation
        copayment adjustments
        deadweight loss
        outpatient prescription drugs
        Taiwan National Health Insurance
        two-tiered pricing
        welfare analysis
        willingness-to-pay
      ab: This study investigates the welfare implications of copayment adjustments on non-prescription drug services and prescription drugs provided through outpatient care in Taiwan's hospitals under the bundled and 2-tiered pricing scheme. The novelty of this study lies in its analysis of the welfare effects of outpatient copayments under this pricing structure. Structural change models were employed to estimate the welfare effects of copayment adjustments. The analysis reveals that higher copayments prior to physician consultations may lead to a pricing-out effect for low-income individuals in medical centers, while the impact is negligible in regional hospitals. The estimated willingness-to-pay (WTP) for an outpatient visit involving regular and refillable prescription drugs in medical centers is approximately NT$2024 (95% CI: [1978, 2072]) and NT$2312 (95% CI: [2267, 2357]), respectively. These values are 1.71 to 1.87 times higher than the WTP for comparable outpatient visits in regional hospitals, with estimates for regular (NT$1078; 95% CI: [1045, 1111]) and refillable prescription drugs (NT$1353; 95% CI: [1304, 1400]). The WTP for prescription drugs bundled within an outpatient visit ranges from NT$939 (95% CI: [908, 971]) to NT$1210 (95% CI: [1174, 1244]) in medical centers and from NT$308 (95% CI: [293, 322]) to NT$544 (95% CI: [514, 574]) in regional hospitals. Additionally, the share of deadweight loss (DWL) per outpatient visit attributable to regular prescription drugs (with a cost-sharing scheme) ranges from 14.58% to 31.15%, which is significantly lower than that attributable to refillable prescription drugs (without a cost-sharing scheme), ranging from 17.32% to 42.80%. Our findings highlight the underestimation of welfare effects from copayment policy changes and emphasize the 2-tiered scheme as an effective approach to mitigating DWL in outpatient care utilization in Taiwan's hospitals.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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