Strengthening Alignments between National Health Financing System and Primary Health Care: Lessons from Taiwan

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Background: To tackle the demographic and epidemiologic challenges, countries around the world need to build a health system centered on primary health care (PHC) in which a supportive financing system is a premise. In this study, the Taiwanese PHC system is taken as a key example. It represents a system that the study can analyze to identify best practice and, additionally, draw out lessons that other systems can consider, replicate and apply for their own primary healthcare delivery needs. Methods: This study used a qualitative research approach to explore stakeholders’ perspectives on the role that the National Health Insurance (NHI) of Taiwan plays in the delivery of PHC. The qualitative data was two-fold: (1) 21 in-depth interviews with local and national health insurance administrators, hospital and health centers’ administrative managers, and service providers at private and hospital levels; and (2) participatory on-site observations of PHC delivery in health facilities and communities. Results: Nvivo 12 was used to conduct data analysis. The data revealed five main themes: (1) Payment method system reform; (2) integrated care services to improve PHC delivery; (3) E-health and technology’s role in regulation and care delivery; (4) leadership support; and (5) education for both service users and providers. Conclusions: The study’s findings include a need to refine the payment methods while keeping geographic disparities and effective incentives in mind; strengthen leadership support at different levels; improve the feasibility and performance of e-health tools; improve the transparency and accountability of the regulation policies; and continuously work on health education.






Liu, Yangyujin (2020). Strengthening Alignments between National Health Financing System and Primary Health Care: Lessons from Taiwan. Master's thesis, Duke University. Retrieved from


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