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Abstract
Research Background: Due to the increase of transnational marriages in Taiwan in recent years, the number of children born to mothers of foreign nationality now account for one-ninth of the nation's total live births. Yet while the addition of births by foreign spouses may potentially counter the imbalance in domestic demography, foreign spouses nonetheless face notable challenges in language, culture, and living habits in Taiwan. The effects on the upbringing and health care of their children have caught the government's attention. Due to the lack of a comprehensive research based on the National Health Insurance Research Database discussing foreign spouses' utilization of National Health Insurance (NHI) for the medical care on their children, the focus of this thesis is to contribute to this gap.
Research Objectives:This thesis aims to analyze and investigate the differences between how mothers of Taiwanese and foreign nationality, namely from Southeast Asia, Hong Kong, Macau, and Mainland China, take advantage of NHI to provide medical care to their children.
Research Method: This research adopts a retrospective cross-sectional study of data taken from the insurance coverage database of the Bureau of National Health Insurance (BNHI) Taipei Division. A secondary analysis is conducted on the data of children to mothers of Southeast Asian, Hong Kong, Macau, and Mainland Chinese nationality, born between January 2007 and December 2012, and as control samples, also on the same number of randomly chosen data of children to mothers of Taiwanese nationality born within the parallel timeframe. The samples' personal identification numbers are used to retrieve their respective medical history throughout 2012 from NHI outpatient and inpatient care records. Descriptive statistics, t-test, and multiple regression analysis is then performed on statistical package SPSS 12.0 (Chinese Edition) to investigate how mothers' nationality has on the utilization of NHI outpatient and inpatient services for children six and under.
Research Findings: 1. Children born of mothers of Taiwanese nationality on average pay more outpatient visits and higher medical bills than those born of foreign spouses. 2. There is no significant difference among children of mothers of different nationalities with regard to average hospitalization frequency, hospitalization days, hospitalization expense. 3. Boys on average utilize both more NHI inpatient and outpatient services than girls. 4. Children between three and six years of age commonly use more NHI inpatient and outpatient services than those under three. 5. No significant discrepancy is found concerning the use of inpatient and outpatient care between the city and rural population within the scope of the BNHI Taipei Division. 6. Children whose parents belong to the fifth category (low-income households) under the NHI insured classification are on average the most frequent users of both inpatient and outpatient services, while those of the sixth category (unemployed or veterans) make the least use of both medical services.
Suggestions: 1. State: The government should act more proactively concerning the health of the New Taiwanese children. For the sake of a healthy future generation, the government should conduct foreign spouse offshore screening, as well as enforcing health examinations and placing limitations on the health conditions of male nationals wishing to wed foreign females. A task force should also be formed to follow up on and track the growth and development of the New Taiwanese children. Founding TV channels and radio stations in the mother language of foreign spouses may also prove instrumental in promoting domestic medical policies and distributing service information, in addition to facilitating adaptation and easing homesickness. 2. Medical Institutes: Healthcare workers should consciously avoid stereotypes when serving foreign spouses and their children. A friendly attitude with the sensitivity to detect potential and existing problems will lead to early treatment, while timely care and health education will give children a better chance to receive the necessary medical assistance. Lectures related to health prevention, eugenic health, flu prevention, parenting, NHI medical information, etc., and health hotlines will help foreign spouses stay informed. 3. Research: Future research on the same topic is advised to incorporate the parents' premium ratable wage, disease profile, disability, and socio-economic status into discussion for a more thorough understanding of the different parameters affecting NHI utilization.
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