Perception and Willingness to Maintain Continuity of Care by Parents of Children with Asthma in Taiwan

Christy Pu, Yu-Chen Tseng, Gau-Jun Tang, Yen-Hsiung Lin, Chien-Heng Lin and I-Jen Wang
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Christy Pu: Institute of Public Health, National Yang Ming Yang Ming Chiao Tung University, Taipei 112304, Taiwan
Yu-Chen Tseng: Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
Gau-Jun Tang: Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
Yen-Hsiung Lin: Hengchun Tourism Hospital, Ministry of Health and Welfare, Hengchun 946, Taiwan
Chien-Heng Lin: Division of Pediatric Pulmonology, Children’s Hospital, China Medical University, Taichung 404, Taiwan
I-Jen Wang: Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, Taipei 242033, Taiwan

IJERPH, 2021, vol. 18, issue 7, 1-11

Abstract: To investigate caregivers’ attitudes toward continuity of care (COC) and their willingness to maintain continuity for their children with asthma under a national health insurance (NHI) system without strict referral management. We sampled 825 individuals from six pediatric outpatient departments in different parts of Taiwan from 2017 to 2018. We used a contingent valuation with a payment card method. Post-stratification weighting adjustment and coarsened exact matching were utilized. Multiple logistic regression was used to compare the willingness to pay and spend extra time maintaining continuity by parents. More than 80% of caregivers in the asthma group believed having a primary pediatrician was important for children’s health. Only 27.5% and 15.8% of caregivers in the asthma and control groups, respectively, believed changing pediatricians would negatively affect therapeutic outcomes. Regression analysis showed that the predicted willingness to pay for the asthma and non-asthma groups were NT$508 (SD = 196) and NT$402 (SD = 172), respectively, and there was a significant positive dose–response relationship between household income and willingness to pay for maintaining health care provider continuity. Caregivers’ free choices among health care providers may reduce willingness to spend extra effort to maintain high COC. Caregivers should be educated on the importance of COC.

Keywords: asthma; pediatric care; continuity of care; willingness to pay; national health insurance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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