The Impact of Family Structure on Utilization of Preventive Care Services among Children under National Health Insurance in Taiwan

This study investigates the role of family structure in children's access to preventive services in the context of a National Health Insurance (NHI) system. We analyzed the 2005 National Health Interview Survey in Taiwan to evaluate the impact of family structure on the utilization of preventive services, including well-child visits and non-free vaccinations. The extended family and single-father family were found to have a significant impact on care use in the unadjusted model even under NHI. However, after controlling for various health, demographic and socio-economic factors, our findings suggest that family structure does not influence the non-free use of vaccines, and financial constraints, instead, play an important role in making parents decide to have non-free vaccines. To further enhance the health and welfare of the children, our findings suggest that the NHI coverage of children's vaccines might not be adequate and that non-free vaccines should be provided free to those families who cannot afford them. © 2012 Springer Science+Business Media, LLC.