Construct a needs-based formula to allocate regional ambulatory global budgets

[[abstract]]Scarcity is the mother of allocation. Therefore, allocating healthcare resources to satisfy need is always a persistent challenge for health policy planners. The principle of distribution according to need has gained generally recognition in the health care field. The purpose of present study is to construct a needs-based formula to allocate regional ambulatory budget of National Health Insurance in Taiwan. The results can provide some evidences to modify the existing allocating mechanism for the best interest.We defined health need from preventive and treatment dimensions. According to the subjects and frequency of preventive services currently covered by National Health Insurance, we calculated preventive health need based on the geographic popularity in six medical regions. Using National Health Insurance claim data, we present regional morbidity rates and national average expenditures by diseases, gender-age groups to demonstrate the treatment health need of popularity in six regions. The study results showed that people in six medical regions have different health needs with unique health problems. Needs-based allocations and the actual declared expenditures were significantly different. Needs-based allocations ranged from 9.18% higher than actual expenditures in Kaoping Division to 9.13% lower in Northern Division. It reveals that current mechanism to allocate ambulatory global budget under the national health insurance system does not reflect the rational situation based on health needs.The contents of the resource allocation formula should be tested or amend over time. Establishing health policies to meet the needs of the local people, and rationing resource according to health needs would improve equity in the distribution of healthcare services and result in an achievement of goals that everyone can enjoy the highest level of health