Factors Associated with Access to Healthcare for Infertility Problems under Taiwan’s National Health Insurance Program

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Department of Health Promotion and Health Education National Taiwan Normal University


In Taiwan, there is little study on how many women seek consultation or treatment from the National Health Insurance system and the characteristicsof these women so far. Our study aims to estimate the number of women who seek consultation or treatment for infertility, analyzed their comorbidities and investigated the factors that are associated with infertility care seeking in Taiwan. We used the 2005 Longitudinal Health Insurance Database. Those women who aged between 20 to 49 years old on January 1, 2015 were included in our analysis and the total sample size was 191,917. We identified the infertility cases using the ICD9-CM 628 diagnosed by OB/GYN physicians from outpatient care (CD) and inpatient (DD) claims data. We estimated the number of women who have sought for help due to infertility problems, analyzed their related comorbidities, and used the logistic regression model to investigate the factors associated with the access to healthcare for infertility problems. The results showed that more than 133,000 Taiwanese women sought consultation and/or treatment for infertility from 2005 to 2009. The top three diseases associated with infertility included disorders of menstruation and other abnormal bleeding from the female genital tract, ovarian dysfunction, and the inflammatory disease of cervix, vagina and vulva. Those who had a higher socioeconomic status were more likely to seek consultation and/or treatments for infertility. There is a pressing need from women who desire to have children in Taiwan in spite of the decreasing fertility rate. Health promotion programs or patient education for women should focus more on reproductive health andprevention of diseases related to infertility or emphasize the importance of healthy behaviours for reproductive health. More research on investigating whether infertile couples have childbirth is suggested.