The rural - urban divide in ambulatory care of gastrointestinal diseases in Taiwan

Lin, Yi; Tseng, Yu Ting; Chen, Yi Chun; Lin, Ming Hwai; Chou, Li Fang; Chen, Tzeng Ji; Hwang, Shinn Jang

doi:10.1186/1472-698x-13-15

Cited by 19 publications

(11 citation statements)

References 26 publications

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“…Medical resources for the diagnosis of pediatric psychiatric problems are relatively poor in rural areas. Urban-rural health-care disparities in Taiwan are apparently (Lin et al, 2007;Lin et al, 2013;Wang et al, 2013). Study proved neurologists are better at diagnosing epilepsy than non-specialists with misdiagnosis rate 5.6% versus 18.9% (Leach et al, 2005).…”

Section: Discussionmentioning

confidence: 91%

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Prevalence and neuro-psychiatric comorbidities of pediatric epilepsy in Taiwan: A national population-based study

Chiang

Cheng

2014

Epilepsy Research

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Section: Discussionmentioning

confidence: 91%

“…All 359 townships in Taiwan have been classified by the NHRI into seven clusters. Based on these criteria, the townships were categorized as rural (Levels 5-7), suburban (Levels 3 and 4), or urban (Levels 1 and 2), as described previously (Lin et al, 2013).…”

Section: Urbanizationmentioning

confidence: 99%

Prevalence and neuro-psychiatric comorbidities of pediatric epilepsy in Taiwan: A national population-based study

Chiang

Cheng

2014

Epilepsy Research

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“…Many countries have been trying to increase the accessibility to health care resources and provide better healthcare services for their people. Studies regarding the health inequality issue have found influences of racial/ethnic [ 1 - 3 ], socioeconomic [ 4 , 5 ] and geographic [ 6 - 8 ] factors on health status (e.g., disease status [ 5 , 9 ] or mortality [ 10 , 11 ]), healthcare resources utilization [ 8 , 12 , 13 ], and outcomes (e.g., postoperative mortality rates [ 14 ]). Most of the results from these studies have pointed to positive relationships between the indicators of social status and various health outcomes [ 15 - 17 ].…”

Section: Introductionmentioning

confidence: 99%

Do low-income coronary artery bypass surgery patients have equal opportunity to access excellent quality of care and enjoy good outcome in Taiwan?

Hou

Chung

2014

Int J Equity Health

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BackgroundEquity is an important issue in the healthcare research field. Many studies have focused on the relationship between patient characteristics and outcomes of care. These studies, however, have seldom examined whether patients’ characteristics affected their access to quality healthcare, which further affected the care outcome. The purposes of this study were to determine whether low-income coronary artery bypass surgery (CABG) patients receive healthcare services with poorer quality, and if such differences in treatment result in different outcomes.MethodsA retrospective multilevel study design was conducted using claims data from Taiwan’s universal health insurance scheme for 2005-2008. Patients who underwent their CABG surgery between 2006 and 2008 were included in this study. CABG patients who were under 18 years of age or had unknown gender or insured classifications were excluded. Hospital and surgeon’s performance indicators in the previous one year were used to evaluate the level of quality via k-means clustering algorithm. Baron and Kenny’s procedures for mediation effect were conducted to explore the relationship among patient’s income, quality of CABG care, and inpatient mortality.ResultsA total of 10,320 patients were included in the study. The results showed that 5.65% of the low-income patients received excellent quality of care, which was lower than that of patients not in the low-income group (5.65% vs.11.48%). The mortality rate of low-income patients (12.10%) was also higher than patients not in the low-income group (5.25%). Also, the mortality of patients who received excellent care was half as low as patients receiving non-excellent care (2.63% vs. 5.68%). Finally, after the procedure of mediation effect testing, the results showed that the relationship between patient income level and CABG mortality was partially mediated by patterns of quality of care.ConclusionsThe results of the current study implied that worse outcome in low-income CABG patients might be associated with poorer quality of received services. Health authorities should pay attention to this issue, and propose appropriate solutions.

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“…The E-codes (external cause of injury) included in our review were E810–E819 (MV traffic accidents), fall (E880–E888), and others (the rest of the E-codes). Urbanization levels of acute admissions were divided into metropolitan areas with satellite cities and rural areas [ 30 ]. Thus, we stratified all patients with SCI and tetraplegia by gender, age, E-code, and urbanization level.…”

Section: Methodsmentioning

confidence: 99%

The association between economic indicators and the incidence of tetraplegia from traumatic spinal cord injury in Taiwan

Lien

Wang

et al. 2021

BMC Neurol

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Background Economic performance may affect public health parameters. This study aimed to determine the time trend of incidence of traumatic spinal cord injury (SCI) and its association with income, presented by GDP (gross domestic product) per capita. Methods This study was a retrospective observational study in Taiwan. Newly diagnosed SCI patients with moderate to severe disability from 2002 to 2015 were identified from the reimbursement database of the National Health Insurance (NHI) system (1998–2015). CIR16–99 (cumulative incidence rate, aged 16–99 years, per 103 person-years) and CIR16–59 (aged 16–59 years) of SCI from 2002 to 2015 were measured. Results There were 5048 newly diagnosed SCI patients during the study period. After controlling the factors of sex, urbanization level, literacy, income inequality, and global financial crisis (mixed effects models), the CIR16–99 of SCI, traumatic SCI, motor vehicle (MV)-related SCI, fall-related SCI, tetraplegia, traumatic tetraplegia, MV-related tetraplegia, and fall-related tetraplegia were inversely associated with GDP per capita; the β coefficients ranged from − 4.85 (95% confidence interval − 7.09 to − 2.6) for total SCI to − 0.8 (− 1.3 to − 0.29) for fall-related tetraplegia. We restricted our comparison to Taipei City and the 4 lowest densely populated counties, which also corroborated with the above results. The income elasticity analysis revealed when GDP per capita increased by 1%, the total SCI decreased by 1.39‰; which was also associated with a decrease of 1.34‰, 1.55‰, 1.36‰, 1.46‰, 1.54‰, 1.54‰, and 1.62‰ for traumatic SCI, MV-related SCI, fall-related SCI, tetraplegia, traumatic tetraplegia, MV-related tetraplegia, and fall-related tetraplegia respectively. The β coefficients show that the compared areas of urbanization level were also inversely correlated with CIR16–59 in the SCI population. Conclusions We conclude that the incidence of tetraplegia of traumatic SCI in Taiwan decreases with good economic performance, which may be resulted from the provision of public goods and services, possibly through improvements in the infrastructure of transportation and construction.

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The rural - urban divide in ambulatory care of gastrointestinal diseases in Taiwan

Cited by 19 publications

References 26 publications

Prevalence and neuro-psychiatric comorbidities of pediatric epilepsy in Taiwan: A national population-based study

Prevalence and neuro-psychiatric comorbidities of pediatric epilepsy in Taiwan: A national population-based study

Do low-income coronary artery bypass surgery patients have equal opportunity to access excellent quality of care and enjoy good outcome in Taiwan?

The association between economic indicators and the incidence of tetraplegia from traumatic spinal cord injury in Taiwan

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