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Abstract #159461

Tsung-Yi Wang¹, Li-Kwang Chen, PhD², Shin-Yi Chou, PhD¹, Michael Grossman, PhD³, and Jin-Tan Liu, PhD⁴. (1) College of Business and Economics, Lehigh University, 621 Taylor St, Bethlehem, PA 18015, (610) 758-3000, tyw204@lehigh.edu, (2) National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County, 350, Taiwan, (3) City University of New York Graduate Center, 365 Fifth Avenue, Fifth floor, New York, NY 10016, (4) Department of Economics, National Taiwan University, 21 Hsu-Chow Road, Taipei, 100, Taiwan

One important goal of a universal health insurance is to improve the health outcomes of the population. This paper aims to estimate the impact of the introduction of the National Health Insurance (NHI) in Taiwan in 1995 on maternal health behaviors and infant health outcomes. The NHI provides the same health insurance for the entire population of Taiwan, where only government employees and their dependents had similar coverage before the NHI was implemented. We pool five household-based surveys with detailed information on infant birthweight, number of prenatal care visits and other maternal health behaviors including the receipt of prenatal examinations such as ultrasound and amniocentesis; maternal cigarette smoking; and the likelihood of breastfeeding. Information on sector of employment in these surveys enables us to create control and treatment groups. We employ a difference-in-differences estimation methodology to sort out the effects of NHI from unobserved trends. We also use the interactions between county and time dummies as instruments to predict the choice of treatment status. Overall, our results suggest that the NHI has no significant impact on maternal health behaviors and infant health outcomes.

Learning Objectives:

• Evaluate the impact of the introduction of the National Health Insurance (NHI) in Taiwan on maternal health behaviors and infant health outcomes.
• Construct control and treatment groups from this natural experiment in Taiwan based on sector employment information.
• Apply a difference-in-differences estimation methodology to sort out the effects of NHI from unobserved trends.

Keywords: National Health Insurance, Health Behavior

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.