Factors related to dissatisfaction with the National Health Insurance among primary care physicians in Taiwan

Background: Few studies were found that evaluated dissatisfaction with the National Health Insurance (NHI) by primary care physicians in Taiwan. Therefore, the purpose of this study was to identify factors related to dissatisfaction with the NHI among primary care physicians. Methods: A structured questionnaire was developed through a literature review, a panel discussion, and 5 focus group interviews. In total, 9336 primary care physicians were surveyed. A logistic regression analysis was employed to identify factors related to dissatisfaction with the NHI by primary care physicians. Results: There were 1822 surveys returned, yielding a 19.5% response rate. They showed that 5.7% of respondents were very dissatisfied and 22.3% were dissatisfied with the current medical environment under the NHI. The dissatisfaction of primary care physicians was significantly related to age (OR= 1.029, p<0.05) and dissatisfaction with the following aspects: malpractice claims (OR = 1.744, p < 0.001), complexity of medical claims (OR = 1.454, p < 0.01), excessive work hours (OR = 1.790, p < 0.001), decreased income (OR = 2.812, p<0.001), difficulty in finding nurses (OR = 1.379, p<0.05), and the separation of dispensing medicine from medical practice (OR= 1.389, p < 0.05). Conclusions: These results can provide valuable information to help policy makers identify areas for improvement and intervention in order to reduce levels of dissatisfaction of primary care physicians under the NHI.