The impact of national health insurance on the volume and severity of emergency department use

National Health Insurance (NHI) was introduced in Taiwan on March 1, 1995. To evaluate the influence of NHI on the volume and severity of emergency department (ED) visits, a retrospective analysis was conducted. The results showed that NHI did not result in a substantial increase in ED volume (P> .05), but the severity as measured by triage nurses did increase (P< .01). There was no change in the number of admissions to the intensive care units of patients transferred from smaller hospitals, but its percentage significantly decreased (P< .05), which may be a result of the significant increase in the total number of interhospital transfers. It was hypothesized that the universal coverage and a copayment contributed to these changes.