A Study of Dental Services in Taiwan before and after Global Budgeting

The Taiwanese government has implemented National Health Insurance (NHI) for nine years since March 1, 1995. The government began to have deficits since March of 1998 because medical expenditures exceeded income to the insurance program. Political problems have prevented increasing the funding for the NHI. In order to control medical expenditures, the government began to implement the Global Budgeting System (GBS) in July of 1998. The resultant decreases in funding to the NHI have hindered its work. Because the dentists practiced only outpatient care, and 92 % of their services are primary services, they were the first group that the government regulated. The purpose of this study is to evaluate how GBS has affected dental service fees and the quality of dental care. The main dental procedures are scaling (primary care), filling teeth (secondary care), and root canal repair and extraction of teeth (tertiary care). This study evaluates these procedures according to their prices, number of procedures performed, materials chosen by dentists in different regions, and the dental care institutions, in order to determine if GBS has actually improved dental services. Most data for this study come from reimbursement data for dental services performed from 1996 to 2001. They include the cases, service fees, materials used in different procedures, dental care institutions, and regions of all contracted providers. Statistical methods are used to develop a model to determine how GBS can direct its funds to provide the best dental care. Results of the proposed model can be a reference for NHI to plan budget.