This study compared the evolution of public dental expenditures, reimbursement standards, and policy shifts between Taiwan’s National Health Insurance (NHI) Global Budget system and 38 OECD countries over 2010–2025. The analysis used a longitudinal comparative policy framework combining interrupted time-series (ITS) and panel data regression with fixed effects to evaluate temporal trends and policy impacts.
Analyses used national-level data from the OECD Health Statistics database (2010–2025) and Taiwan Ministry of Health and Welfare (MOHW) NHI Administration annual reports and reimbursement fee schedules (2010–2025). Financial figures were adjusted using healthcare-specific Purchasing Power Parity (PPP) and the Consumer Price Index (CPI) to permit cross-country and temporal comparability. The geographic scope encompassed Taiwan and 38 OECD member countries.
Primary outcomes reported were:
Secondary outcomes included:
From 2010 to 2025, Taiwan’s public dental expenditure as a share of GDP remained between 0.52% and 0.68%. In contrast, the OECD country range was higher, between 0.89% and 1.08% of GDP. The study highlights that Taiwan’s dental share of GDP is substantially lower than the OECD average, noting the OECD figures correspond to roughly 5%–7% of total health expenditure in those countries.
Taiwan’s per capita dental spending (PPP-adjusted) increased from PPP$145 in 2010 to PPP$198 in 2025. Over the same period the OECD average per capita dental spending rose from PPP$289 to PPP$412. These comparisons underscore persistent gaps in per capita public dental investment between Taiwan and OECD peers despite growth in Taiwan’s nominal and real spending.
A PPP-adjusted reimbursement comparison for standardized procedures indicated that Taiwan’s compensation for complex treatments—specifically molar endodontics—was approximately 35%–37% of the levels reported in Japan and Germany. The analysis covered the four standard procedures listed above; absolute fee schedules and year-by-year fee trajectories were derived from Taiwan’s NHI fee schedules and international PPP-adjusted comparisons.
The ITS analysis detected a statistically significant immediate decline in dental claims volume following the onset of the COVID-19 pandemic (Q2 2020). The source text confirms statistical significance for the immediate decline but did not provide the exact p-value or full effect-size estimate in the excerpt provided. Panel regression with fixed effects was used to assess longitudinal associations and policy intervention effects across countries, but detailed coefficient estimates and model diagnostics are not reported in the available summary.
The authors interpret the NHI Global Budget system as effective in achieving cost containment while maintaining high accessibility to dental services. However, they caution that part of this cost containment may depend on implicit labour-cost subsidies from dental professionals—meaning lower real reimbursement levels that could effectively shift costs onto providers.
As Taiwan transitions to a super-aged society, the study raises concerns that the current volume-based payment model may face increasing sustainability pressures. An ageing population commonly increases demand for complex and preventive dental care, and low relative reimbursement for complex procedures could pose access or quality risks if providers face financial constraints.
To address equity, quality, and sustainability, the study suggests considering reforms including:
These options are presented as potential ways to support equity and maintain care quality beyond 2025.
The source summary does not report some specific statistical details. For example, the exact p-value and effect size for the ITS-identified decline in claims volume after Q2 2020 were not provided in the excerpt. Detailed regression coefficients, standard errors, and model diagnostics for the panel fixed-effects analyses were also not reported in the available text. Where such specifics are required, readers should consult the full article for complete statistical tables and supplementary materials.
Between 2010 and 2025, Taiwan maintained lower public dental expenditure as a share of GDP and lower per capita dental spending than the OECD average, while achieving apparent cost containment and broad access under the NHI Global Budget. PPP-adjusted reimbursement for complex procedures remained notably lower than comparator countries. Given demographic ageing and potential provider-side cost pressures, policy shifts toward value-based payment, targeted reimbursement floors for complex care, and expanded geriatric dental benefits are proposed to strengthen sustainability, equity, and quality of care. Specific statistical details and full model results were not reported in the provided summary and should be reviewed in the full publication if needed.