Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 30;24(1):1148.
doi: 10.1186/s12913-024-11640-6.

Impact of NHI copayment adjustments on healthcare seeking behavior: the mediating role of health facility identification

Liang-Hsi Kung #  1 , Chih-Ming Kung #  2 , Chien Chih Chen #  3 , Yu-Hua Yan  4
Affiliations

Impact of NHI copayment adjustments on healthcare seeking behavior: the mediating role of health facility identification

Liang-Hsi Kung et al. BMC Health Serv Res. .

Abstract

Objective: This study investigates the impact of healthcare consumers' involvement, price perception, and attitude toward National Health Insurance (NHI) copayment adjustments on their healthcare-seeking behavior, focusing on the mediating role of health facility identification.

Methods: A questionnaire survey was conducted among outpatient customers in Taiwan from October 2023 to March 2024, resulting in 746 valid responses. The survey included demographic variables, involvement, price perception, attitude, health facility identification, and healthcare-seeking behavior. Data were analyzed using descriptive statistics, correlation analysis, and multiple regression analysis with SPSS 20.0.

Results: The study found that involvement, price perception, and attitude significantly influence healthcare-seeking behavior. Health facility identification was identified as a significant mediator in the relationship between copayment perception and healthcare-seeking behavior. The regression analysis also highlighted the impact of demographic factors such as age, education level, marital status, and annual income on healthcare-seeking behavior. The path model illustrated the complex interplay between perceptual factors and their influence on healthcare-seeking behavior.

Conclusion: This study emphasizes the importance of consumer involvement, price perception, and attitude in shaping healthcare utilization patterns. Health facility identification plays a crucial mediating role, suggesting that stronger patient-provider relationships can mitigate potential negative impacts of copayment adjustments. Policymakers and healthcare providers should enhance patient engagement, foster strong patient-facility identification, and provide targeted support for vulnerable groups to ensure equitable access to healthcare services despite copayment changes.

Keywords: Attitude; Health facility identification; Healthcare-seeking behavior; Involvement; NHI copayment adjustment; Price perception; Taiwan.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Path model of this study
See this image and copyright information in PMC

References

    1. Ministry of Health and Welfare. Review of the effectiveness of hierarchical medical care and future planning report in 2017. https://www.mohw.gov.tw/dl-41171-93842b9f-b5ba-4a4c-b3c1-b8e385fda501.html. [Accessed 2023 Aug 31].
    1. Yan YH, Kung CM, Yeh HM. The impacts of the hierarchical medical system on national health insurance on the resident’s health-seeking behavior in Taiwan: a case study on the policy to reduce hospital visits. Int J Environ Res Public Health. 2019;16(17):3167. - PMC - PubMed
    1. Ministry of Health and Welfare. Global budget and its distribution in 2018. https://dep.mohw.gov.tw/NHIC/cp-1661-39043-116.html. [Accessed 2024 Mar 12].
    1. Lu YT. Prevent Wuhan pneumonia! NHIA cancels outpatient reduction in hospitals. https://heho.com.tw/archives/65644. [Accessed 2019 Aug 21].
    1. Lin YL, Chen WY, Shieh SH. Age structural transitions and copayment policy effectiveness: evidence from Taiwan’s national health insurance system. Int J Environ Res Public Health. 2020;17(12):4183. - PMC - PubMed

LinkOut - more resources