Feasibility of prisoners enrolling in National Health Insurance

Wen Chen Tsai, Pei Tseng Kung, Chia Hui Liao, Wu Long Chang, Cheng Chieh Lin, Nan Yung Hsu, Chy Hsuei Lee

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Objectives: This study explored inmates' attitudes toward enrolling in National Health Insurance (NHI), as well as the willingness of hospitals to provide medical care to inmates. Methods: Inmates from 48 correctional facilities and all 515 hospitals were surveyed. The effective sample sizes for inmates and hospitals were 2,849 and 194, respectively. Logistic regression analysis was performed to examine factors associated with the willingness of inmates to enroll in NHI. Results: Of the inmates surveyed, 80.87% expressed willingness to enroll in NHI during the term of imprisonment. The main reason for willingness to enroll was a desire to reduce the inmate's medical cost burden. The requirement to pay insurance premiums was the main reason for unwillingness to enroll. If enrolling in NHI, 51.10% of inmates agreed to join. Forty percent of inmates believed that they could afford the insurance premium. If inmates were insured only for inpatient care, 66.75% of inmates were willing to enroll. Factors associated with willingness to enroll in NHI included the inmate's sex, length of stay in prison, need for regular physician visits, out-of-pocket payment for physician visits, perception of reasonableness of NHI premiums, whether the inmate was qualified for NHI, and whether payments were deducted from inmates' money under custody. Of the hospitals surveyed, 76.29% were willing to provide outpatient services to inmates, whereas only 59.07% were willing to provide inpatient services. Conclusions: A high percentage of inmates expressed willingness to enroll in NHI. The ability to pay the insurance premiums was the major obstacle needing to be overcome.

Original languageEnglish
Pages (from-to)198-213
Number of pages16
JournalTaiwan Journal of Public Health
Issue number3
Publication statusPublished - Jun 2008
Externally publishedYes


  • Health insurance
  • Inmates
  • National health insurance
  • Prisoners

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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