全民健康保險保險費的收取，是以「量出為入」的方式為主，因此對醫療費用的掌握，是保險財務的重要工作。衛生署於民國81年4月至6月進行「國民醫療保健支出調查」，藉此蒐集相關資料。本調查以全台灣地區現住戶為母全體，共抽樣5500戶，採結構式問卷面訪調查，共計完訪4994戶，21,617人。結果發現：中低收入家庭對醫藥支出有較大的經濟壓力，約42%的受訪戶認為，全年醫藥支出占全家總收入5%~10%時，會影響家庭現有經濟狀況。對於醫療供給的便利性與服務品質，受訪者較多正面評價，但對醫療價格則較多負面評價。西醫門診是民眾最常利用的醫療服務。回推母群體後，15歲以上有保險者各類醫療利用次數皆較無保險者高，其中住院與中醫門診兩類相差約2倍。年齡愈大醫療利用次數愈頻繁，女性平均較男性利用次數高。除中醫門診外，無保險者比有保險者需自付較高的費用，以住院費用差距60%最多。推算民國81年台灣地區民眾自付醫療費用共約為1,300億元，65歲以上老人每人每年自付費用為10,088元，是全人口平均自付費用6,340元的1.6倍。

The amount of National Health Insurance premium will be based on payments to all medical providers, therefore it is very important to proximate the health care expenditure. The 1992 National Medical Expenditure Survey was held from April to June by Department of Health. All households in Taiwan were assumed as population, from which 5,500 households were randomly selected. A total of 4,994 households and 21,617 individuals were completely interviewed. Low income households suffer more from the medical expenses. 5% to 10% of total family income spent on the medical bill will influence their daily living, expressed by 42% of the sample households. People of age 15 and above with insurance use both outpatient and inpatient services more often than those without insurance, visits of inpatient and traditional Chinese outpatient services of the former are both about two times more of the latter. Besides, the older use more than the younger, women use more than men. Except traditional Chinese medicine outpatient service, the uninsured pay higher out-of-pocket expenses than the insured. The estimate for 1992 national out-of-pocket medical expenditures is 130 billion NT dollars. Per capita annual expense for the old (65 and above) is 10,088 NT dollars, which is 1.6 times more than the national average.

自付醫療支出 ； 健康保險 ； 醫療利用

Medical Expenditure , Health Insurance , utilization