Effects of the Universal Health Insurance Program on the Health Outcomes of Children and Adolescents-The Experience of Taiwan

Purposes Before Taiwan established, in 1995, the universal National Health Insurance (NHI) program with comprehensive health benefits for all its citizens, more than 85% of children and adolescents were uninsured. Little is known about the effects of the NHI program on the health outcomesof children and adolescents. Methods We conducted a nationwide interrupted timeseries (Joinpoint) analysis to examine the effects of the NHIprogram on amenable mortality among children and adolescentsfor the period1981-2005. Age and gender standardized cause-specific mortality rates were calculated from the death and population registry data maintained by the Ministry of Health and Welfare, and the Ministry of the Interior. Results Our study found the implementation of the NHI program in Taiwan was associated with a significant reduction in deaths from causes amenable to health care, which surpassed the underlying decline in other causes. Two inflection points resulting in three distinct trend periods were identified usingJoinpoint