scholarly journals Comparison of colorectal cancer screening between people with and without disability: a nationwide matched cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chun-Ming Liao ◽  
Wen-Hao Huang ◽  
Pei-Tseng Kung ◽  
Li-Ting Chiu ◽  
Wen-Chen Tsai
Keyword(s):  
Colorectal Cancer ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Conditional Logistic Regression ◽  
World Health ◽  
Research Database ◽  
Crc Screening ◽  
The World ◽  
People With Disability

Abstract Background The World Health Organization has recognized that people with disability are among the most marginalized in the world. This study’s objective was to investigate the differences in the probability of colorectal cancer (CRC) screening with faecal immunochemical testing (FIT) between people with disability and without disability in Taiwan. Methods The study participants included people with and without disability from the Disability Registration Database (2012) and the National Health Insurance Research Database (2009–2012). The study included 50- to 69-year-olds with and without disability who were screened from 2011 to 2012 and were alive in 2012. There were 16 categories of disability. After propensity score matching (PSM) between the two groups, conditional logistic regression analysis with control variables was used to investigate the odds ratio (OR) that people with or without disability would undergo CRC screening. Results The percentage of people with disability receiving CRC screening was 21.84%, and the highest rate of those receiving CRC screening (38.72%) was found in people with intractable epilepsy, whose OR was 1.47 times that of people with moving functional limitation (95% confidence interval (CI) = 1.17–1.85). The results showed that the probability of CRC screening in people with disability was lower than that in people without disability (OR = 0.88, 95%CI = 0.87–0.89). The probability of receiving CRC screening differed between people with different categories of disability. Conclusions Although the probability of CRC screening in the four categories of disability was higher than that in the general population, overall, people with disability were less likely than people without disability to undergo CRC screening. Health inequalities still exist under National Health Insurance in Taiwan.

scholarly journals Association of gout and colorectal cancer in Taiwan: a nationwide population-based cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028892
Author(s):  
Jen-Pin Chuang ◽  
Jenq-Chang Lee ◽  
Tzeng-Horng Leu ◽  
Atik Choirul Hidajah ◽  
Ya-Hui Chang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Insurance ◽  
Incidence Rate ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Secondary Outcome ◽  
Research Database ◽  
Increased Risk

ObjectivesThis study aimed to determine colorectal cancer (CRC) risks among patients with gout through a follow-up study on a nationwide population-based cohort that included patients with gout and the general population in Taiwan.ParticipantFrom the Taiwan National Health Insurance Research Database, we identified 28 061 patients who were newly diagnosed with gout between 2000 and 2010 as the study cohort. We randomly selected 84 248 subjects matching in gender, age and baseline year as comparison cohort. The cohorts were followed up until CRC occurrence, withdrawal from the system of National Health Insurance, or Dec. 31, 2013.Primary and secondary outcome measuresCumulative incidences and incidence rate ratios (IRRs) of CRC between two cohorts were examined. The Cox proportional hazards model was used to evaluate risk factors associated with CRC development.ResultsDuring the 13-year follow-up, the incidence rate of CRC development in the gout cohort reached 2.44 per 1000 person-years, which was higher than the 2.13 per 1000 person-years in the control cohort (IRR=1.15; 95% CI 1.04 to 1.26). After adjusting for age, gender, urbanisation status and comorbidities, including hypertension, diabetes and hyperlipidaemia, gout showed no significant association with increased risk of CRC occurrence (adjusted HR=1.03; 95% CI 0.93 to 1.14).ConclusionsSimilar risks of CRC incidence were observed in patients with and without gout in Taiwan. Allopurinol and colchicine are commonly used as urate-lowering drug and anti-inflammation medication in Taiwan and had been shown to reduce the risk of CRC incidence. Thus, further pharmaco-epidemiological studies should be carried out to specifically assess the role of allopurinol in the relationship between gout and CRC.

scholarly journals Hyperlipidemia Is a Risk Factor of Adhesive Capsulitis: Real-World Evidence Using the Taiwanese National Health Insurance Research Database

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712098680
Author(s):  
Jr-Yi Wang ◽  
Chen-Kun Liaw ◽  
Chi-Chang Huang ◽  
Tsan-Hon Liou ◽  
Hui-Wen Lin ◽  
...  
Keyword(s):  
Risk Factor ◽  
Health Insurance ◽  
Propensity Score ◽  
National Health Insurance ◽  
National Health ◽  
Glenohumeral Joint ◽  
Adhesive Capsulitis ◽  
Small Sample ◽  
Research Database ◽  
Statin Use

Background: Patients with adhesive capsulitis are evaluated for pain and progressive contracture of the glenohumeral joint. Whether endocrine, immune, or inflammatory processes are involved in its definite pathogenesis is still under debate. Some cross-sectional studies with a small sample size have noted that hyperlipidemia is a possible risk factor for frozen shoulders. Purpose/Hypothesis: The purpose was to conduct a longitudinal population-based study to investigate the risk of adhesive capsulitis among patients with hyperlipidemia. It was hypothesized that patients with hyperlipidemia would have a higher risk of adhesive capsulitis and that the use of statin drugs could reduce the rate. Study Design: Cohort study; Level of evidence, 3. Methods: Using data from the National Health Insurance Research Database (NHIRD) of Taiwan, the authors obtained the records of patients with hyperlipidemia who received a diagnosis between 2004 and 2005 and were followed up until the end of 2010. The control cohort comprised age- and sex-matched patients without hyperlipidemia. Propensity score matching was performed for the other comorbidities. A Cox multivariate proportional hazards model was applied to analyze the risk factors of adhesive capsulitis. The hazard ratio (HR) and adjusted HR were estimated between the study and control cohorts after adjustment for confounders. The effects of statin use on adhesive capsulitis risk were also analyzed. Results: The NHIRD records of 28,748 patients and 114,992 propensity score–matched controls were evaluated. A higher incidence rate of adhesive capsulitis was revealed in the hyperlipidemia cohort, with a crude HR of 1.70 (95% CI, 1.61-1.79; P < .001) and adjusted HR of 1.50 (95% CI, 1.41-1.59; P < .001). Patients with hyperlipidemia who used a statin still had higher crude and adjusted HRs compared with controls. Statin use did not exert protective effects on patients with hyperlipidemia. Conclusion: Patients with hyperlipidemia had a 1.5-fold higher risk of adhesive capsulitis than did healthy controls. Statin use did not provide protection against adhesive capsulitis in patients with hyperlipidemia.

Iatrogenic Vocal Fold Paralysis: A Population-Based Cohort Study in Taiwan

2021 ◽  
pp. 000348942110412
Author(s):  
Ying-Ta Lai ◽  
Pin-Zhir Chao ◽  
Yu-Kang Chang ◽  
Yu-Chun Yen ◽  
Yu-Ting Shen ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cervical Spine ◽  
National Health Insurance ◽  
National Health ◽  
Vocal Fold ◽  
Population Based ◽  
Vocal Fold Paralysis ◽  
Research Database ◽  
Bilateral Vocal Fold Paralysis ◽  
Co Morbidity

Objective: Iatrogenic vocal fold paralysis is an important issue in laryngology, yet there are few population-based studies regarding the epidemiology. This study used a nationwide population-based claims database (the National Health Insurance Research Database) to investigate the epidemiology of iatrogenic unilateral and bilateral vocal fold paralysis (UVFP/BVFP) among the general adult population in Taiwan. Method: This study analyzed patients (20-90 years old) who underwent thyroid, parathyroid, thoracic, cardiac, or anterior cervical spine operations with vocal fold paralysis among adults in Taiwan from January 1, 2007 to December 31, 2013. The codes for vocal fold paralysis were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Claims data in the Taiwan National Health Insurance Research Database were used. Results: The most commonly performed operations which were related to vocal fold paralysis in Taiwan were, in descending order of frequency, thyroid, cervical spine, cardiac, thoracic (esophagectomy), and parathyroid operations. The operations that put laryngeal nerves at risk (ONRs) most commonly associated with a diagnosis of UVFP were, in descending order of frequency, thoracic, thyroid, parathyroid, cardiac, and cervical spine. For both UVFP and BVFP, the most commonly associated age group was 51 to 60. For both UVFP and BVFP, the more commonly associated sex was women. Increased length of stay was associated with a higher incidence of UVFP and BVFP. Charlson medical co-morbidity index (CCI) was not associated with UVFP but BVFP was associated with higher Charlson medical co-morbidity scores. Conclusions: Thyroid operations, age 51 to 60, longer hospital stays are associated with vocal fold paralysis. Overall women are more surgically affected than men. This is the first population-based study of iatrogenic vocal fold paralysis.

scholarly journals Rates and characteristics of lower limb amputations in Taiwan, 1997

2002 ◽  
Vol 26 (1) ◽  
pp. 7-14 ◽  
Author(s):  
S. Y. Chen ◽  
W. C. Chie ◽  
C. Lan ◽  
M. C. Lin ◽  
J. S. Lai ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Lower Limb ◽  
The United States ◽  
Research Database ◽  
The United Kingdom ◽  
Female Rate ◽  
Insurance Programme ◽  
National Health Insurance Programme

This study aims to describe the national incidence rate and characteristics of lower limb amputations (LLA) in 1997 from an island-wide database of the national health insurance programme in Taiwan. Some 117,647 discharge records from a sampled database (1 in 20) of the National Health Insurance Research Database were analysed. This study included records (n=171) containing LLA procedures. The LLA procedure rates were obtained by multiplying the number of identified procedures by 20 as the numerator and mid-year total population of Taiwan in 1997 as the denominator. Each procedure was further analysed according to the demographic characteristics of the patients, cause and level of amputation. Summarised gender ratios of LLA procedure rates were obtained by Poisson regression analysis. The crude LLA procedure rate was 18.1 per 100,000 population per year and the crude major LLA procedure rate was 8.8 per 100,000 population per year in Taiwan in 1997. The major cause of LLA procedures was peripheral vascular disease (72%), and the toe was most frequently amputated (48%). The LLA procedure rates, which increased logarithmically with age of patients, were significantly higher in men with a summarised male to female rate ratio of 1.65. The age-standardised LLA procedure rate in Taiwan was lower than that reported in the United States, Finland, the Netherlands, the United Kingdom (Leeds, Middlesborough, and Newcastle), but higher than Spain, Italy, and Japan. The trend of an increasing proportion of PVD-related LLA procedures will prompt the health professionals to develop strategies for LLA prevention.

scholarly journals Consensus on Control of Risky Nonvariceal Upper Gastrointestinal Bleeding in Taiwan with National Health Insurance

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Bor-Shyang Sheu ◽  
Chun-Ying Wu ◽  
Ming-Shiang Wu ◽  
Cheng-Tang Chiu ◽  
Chun-Che Lin ◽  
...  
Keyword(s):  
Health Insurance ◽  
High Risk ◽  
Gastrointestinal Bleeding ◽  
National Health Insurance ◽  
National Health ◽  
Upper Gastrointestinal Bleeding ◽  
Ulcer Bleeding ◽  
Chronic Obstructive ◽  
Research Database ◽  
Upper Gastrointestinal

Background and Aims. To compose upper gastrointestinal bleeding (UGIB) consensus from a nationwide scale to improve the control of UGIB, especially for the high-risk comorbidity group.Methods. The steering committee defined the consensus scope to cover preendoscopy, endoscopy, postendoscopy, and overview from Taiwan National Health Insurance Research Database (NHIRD) assessments for UGIB. The expert group comprised thirty-two Taiwan experts of UGIB to conduct the consensus conference by a modified Delphi process through two separate iterations to modify the draft statements and to vote anonymously to reach consensus with an agreement ≥80% for each statement and to set the recommendation grade.Results. The consensus included 17 statements to highlight that patients with comorbidities, including liver cirrhosis, end-stage renal disease, probable chronic obstructive pulmonary disease, and diabetes, are at high risk of peptic ulcer bleeding and rebleeding. Special considerations are recommended for such risky patients, including raising hematocrit to 30% in uremia or acute myocardial infarction, aggressive acid secretory control in high Rockall scores, monitoring delayed rebleeding in uremia or cirrhosis, considering cycloxygenase-2 inhibitors plus PPI for pain control, and early resumption of antiplatelets plus PPI in coronary artery disease or stroke.Conclusions. The consensus comprises recommendations to improve care of UGIB, especially for high-risk comorbidities.

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