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, I. Jen Wang*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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 outpa-tient 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 pedia-tricians would negatively affect therapeutic outcomes. Regression analysis showed that the pre-dicted 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.

Original languageEnglish
Article number3600
JournalInternational journal of environmental research and public health
Issue number7
StatePublished - 1 Apr 2021


  • Asthma
  • Continuity of care
  • National health insurance
  • Pediatric care
  • Willingness to pay


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