The Objective Palliative Prognostic Score consists of six objective predictors for the estimation of seven-day survival among patients with advanced cancer and showed a relatively high accuracy, specificity, and negative predictive value. Objective signs, such as vital signs and blood test results, may help clinicians make decisions at the end of life.
Objectives: This study aimed to examine the association between fluvastatin use and acute pancreatitis in Taiwan.Methods: Using the database from the Taiwan National Health Insurance (NHI) Program, we designed a case-control study which consisted of 3501 individuals aged 20-84 with new at-the-time diagnoses acute pancreatitis as the case group and 8373 randomly selected individuals without acute pancreatitis as the control group during the period of 1998-2011. Both groups were matched for sex, age, and index year of being diagnosed with acute pancreatitis. “Current use” of fluvastatin was defined as individuals whose last remaining tablet of fluvastatin was noted ≤ 7 days before the date of their being diagnosed with acute pancreatitis. “Late use” of fluvastatin was defined as individuals whose last remaining tablet of fluvastatin was noted within 8-30 days before the date of their being diagnosed with acute pancreatitis. “No use” of fluvastatin was defined as individuals who had never had a fluvastatin prescription. The odds ratio (OR) and 95% confidence interval (CI) for acute pancreatitis associated with fluvastatin use was examined using a multivariable unconditional logistic regression analysis.Results: After adjustment for potential confounders, the multivariable analysis showed that the adjusted ORs of acute pancreatitis were 1.17 for individuals with “current use” of fluvastatin (95% CI 0.69, 1.97) and 1.82 for individuals with “late use” of fluvastatin (95% CI 0.41, 8.19), but there was no statistical significance when compared with individuals with “no use” of fluvastatin.Conclusions: In this this study, no association was detected between fluvastatin use and acute pancreatitis.
Background Hospital admission and emergency department(ED) visits are a massive burden in medical expenditures. In 2003, the Taiwanese government developed Family Physician Integrated Care Program (FPIC) to increase the quality of primary care and decrease medical expenditures. This study’s goals were to determine whether FPIC decreased hospital admissions and ED visits and identify the factors influencing the outcomes. Methods This nationwide retrospective cohort study was conducted for the period between 2006 and 2013 by using data obtained from the Taiwan National Health Insurance Research Database. A total of 68,218 individuals were divided into those who joined FPIC and those who did not. We used propensity score matching at a ratio of 1:1 and logistic regression with the generalized estimating equation (GEE) model having a difference-in-difference design to investigate the effects of the FPIC policy on hospital admissions and ED visits in 7 years. Results Using logistic regression with the GEE model with the difference-in-difference design, we found no reduction in ED visits and hospital admissions between the two groups. The participants’ risk of hospital admissions increased in the first year after joining FPIC (OR: 1.11, 95% CI: 1.03–1.20, P < .05). However, participants who joined FPIC showed an 8% lower risk of hospital admissions in the sixth and seventh years after joining FPIC, compared with those who did not join FPIC (OR: 0.92, 95% CI: 0.85–1.00, P < .05). Conclusions FPIC in Taiwan could not decrease medical utilization initially but might reduce hospital admissions in the long term.
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