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Student Number 984204008
Author Yu-ping Kao(高譽萍)
Author's Email Address No Public.
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Department Graduate Institute of Industrial Economics
Year 2010
Semester 2
Degree Master
Type of Document Master's Thesis
Language zh-TW.Big5 Chinese
Title The Empirical Relationship between Medical Spending and The value of Life-the Case of liver cancer patients in Taiwan
Date of Defense 2011-06-21
Page Count 80
Keyword
  • medical spending
  • survival analysis
  • value of a life-year
  • value of life
  • Abstract To estimate the value of lives by virtue of medical spending, the liver cancer patients in Taiwan were taken as subjects on this study. The data used in this paper were taken from the National Health Insurance Bureau claims data during 1996 till 2007. The analyses were performed both in hospital’s approach and the patients’ approach. First, an analysis between hospital expenses and hospital mortality was held, from which the value of life was estimated. Then, the value of a life-year was derived from another analysis between patients’ spending and patients’ survival time.
      In the hospital’s approach , cross section data and panel data were taken , and underwent 2SLS, random effect and fixed effect respectively for regression. In the patients’ approach, the survival analysis with Cox proportional hazard model was held, as well as 3 parametric models including log-logistic, log-normal, and Gamma distributions. From which, the marginal effect was derived and the value of a life-year estimated.
      As the results shown, the hospital expenses and hospital mortality are negatively related. And the value of life for the liver cancer patients ranges from 25 millions to 390 millions NTD. In the patients’ approach, patient’s spending and patient’s survival time are positively related, and the survival time decreases with age. In this study, annual value of survival gains in 1997-2006 is 2.8-3.6 millions NTD, lifetime value of survival gains is 8.2-11 millions NTD, that implied value of a life year is 2.8-3.5 millions NTD.
    Table of Content 目錄
    摘要i
    ABSTRACTii
    誌謝iii
    目錄iv
    表目錄v
    圖目錄vi
    第一節 研究動機1
    第二節 研究目的3
    第二章 文獻回顧5
    第一節 生命價值的衡量5
    第二節 生命價值與醫療支出8
    第三章 理論與實證模型13
    第一節 理論模型13
    第二節 存活分析介紹15
    第三節 實證模型介紹21
    第四章 資料來源與變數說明24
    第一節 資料來源24
    第二節 變數說明與基本統計分析25
    第五章 實證分析42
    第一節 醫院角度42
    第二節 病患角度47
    第六章 結論62
    第一節 結論62
    第二節 研究限制與建議63
    參考文獻65
    Reference 網站
    行政院衛生署:http://www.doh.gov.tw/CHT2006/index_populace.aspx
    英文書
    1.Kleinbaum, David G. and Klein, Mitchel, Survival analysis A self-learning text, second edition, New York, 2005. P.266-268 & P.463-508
    2.Rabe-Hesketh, Sophia and Everitt, Brian, A Handbook of Statistical Analyses using Stata, fourth edition, Boca Raton, 2007. P.149-167
    中文書
    1.林建甫,存活分析,一版,雙葉書廊,台灣,民國九十七年。
    英文文獻
    1.Cutler, David M., Allison B. Rosen, and Sandeep Vijan. 2006. “The Value of Medical Spending in the United States, 1960 –2000.” The New England Journal of Medicine, 355: 920-927.
    2.Felder, Stefan, Markus Meier, and Horst Schmitt. 2000. “Health Care Expenditure in the Last Months of Life.” Journal of Health Economies19: 679-695.
    3.Goebbels, Adrienne F. G., and Andre J. H. A. Ament. 2008. “Estimating the Implicit Value of Statistical Life Based on Public Interventions Implemented in The Netherlands.” International Journal of Technology Assessment in Health Care, 24(4): 495-501.
    4.Hall, Robert E., and Charles I. Jones. 2007. “The Value of Life and the Rise in Health Spending.” The Quarterly Journal of Economics: 39-72.
    5.Hammitt, James K. 2000.“Valuing Mortality Risk: Theory and Practice.” Environmental Science & Technology, 34(8): 1396-1400.
    6.Hammitt, James K. 2007. “Valuing Changes in Mortality Risk: Lives Saved Versus Life Years Saved.”Review of Environment Economics and Policy, 1(2): 228-240.
    7.Keeler, Emmett B. 2001“The Value of Remaining Lifetime is Close to Estimated Values of Life.” Journal of Health Economics 20: 141-143.
    8.Lakdawallac, Darius N., Eric C. Suna, Anupam B. Jenab, Carolina M. Reyesd, Dana P. Goldmanc, and Tomas J. Philipsone. 2010. “An Economic Evaluation of the War on Cancer.” Journal of Health Economics, 29: 333-346.
    9.Murphy, Kevin M., and Robert H. Topel. 2005. “Black-White Differences in the Economic Value of Improving Health.” Perspectives in Biology and Medicine, 48(1): S176-S194.
    10.Murphy, Kevin M., and Robert H. Topel. 2006. “The Value of Health and Longevity.” Journal of Political Economy, 114(51): 871-904.
    11.Rosen, Sherwin. 1988“The Value of Changes in Life Expectancy.” Journal of Risk and Uncertainty, 1: 285-304.
    中文文獻
    1.連賢明,「如何使用健保資料進行研究」,經濟論文叢刊36(1): 115-143,國立台灣大學經濟學系,2008。
    2.賴亦晨,「醫院權屬別與醫療結果的關聯性—以台灣的肝癌病患為例」,國立中央大學產業經濟研究所碩士論文,2010。
    Advisor
  • Jin-long Liu(劉錦龍)
  • Wei-der Tsai(蔡偉德)
  • Files
  • 984204008.pdf
  • approve in 2 years
    Date of Submission 2011-07-26

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