Background and Purpose: There are limited data from Taiwan about the accuracyof National HealthInsurance (NHI) claimsdata. This study assessed the accuracyof NHI claimsdata for diabetes and its associated factors.
Methods: Insuranceclaimsdata for patients with a diagnosisofdiabetes were extracted from the records of the Bureau of National HealthInsurance, including detailed files of the outpatient, emergency, inpatient and pharmacy treatment records from January 1, 2000 to December 31, 2000. A stratified, 2-staged, probability proportional to size and equal probability method was used to sample 9000 diabetes patients. The accuracyof the diabetesdiagnosis was assessed based on patient responses to questionaire items. Subjects with negative or uncertain questionaire answers who had hypoglycemic agents in pharmacy claimsdata were also classified as diabetic.
Experimental and theoretical study of the spin coating deposition of thin and ultrathin films from dilute solutions of four conjugated polymers, including poly[2-methoxy-5-(2V-ethylhexyloxy)-1,4-phenylenevinylene] (MEH-PPV), regioregular poly(3-hexylthiophene), poly(9,9-dioctylfluorenyl-2,7-yleneethynylene), and poly(2,2V-(3,3V-dioctyl-2,2V-bithienylene)-6,6V-bis(4-phenylquinoline)), is reported.
Dilute solutions (0.3–2.0 wt.%) of the four conjugated polymers in chloroform were found to be Newtonian fluids with viscosities of 0.7–27.9 cp. The measured film thickness (h f ) of the conjugated polymers was found to be well correlated to the initial solution concentration (x 1,0 ) and the spin speed (x) by the simple expression, h f =k x 1,0 x h . The exponent b is 0.5 for MEH-PPV but is reduced to 0.4 for the other three conjugated polymers. The difference in the b values can be explained by the effect of the accelerative period on the spin coating of less viscous dilute polymer solutions as verified by numerical simulation. A modified Meyerhofer’s model was also found to well correlate the film thickness with the fundamental physical properties of the polymers and solvent. These experimental and theoretical results provide a basis for understanding and optimizing the preparation of thin and ultrathin films of conjugated polymers by spin coating.
Blackwell Publishing IncMalden, USAVHEValue inHealth1098-30152006 Blackwell Publishing200694275**Letter to the Editor Letter to the EditorLetter to the Editor
Applying the Grid Computation in Long-Term Retrospective HealthInsuranceData Analysis
To the Editor—Long-term retrospective healthinsurancedata have been a very useful objective resource in medical and health-care research [1,2]. InTaiwan, started from 10 years ago, a health information database, the National HealthInsurance Research Database (NHIRD), has been created to collect complete national claim data including disease diagnosis, treatment, inpatient and outpatient claims, and details of prescription dispensed. Recently, more and more researchers try to discover and solve prob- lems ofhealth policy and epidemiology by analyzing NHIRD in their studies [3,4].
severity ofdiabetes patients were also adjusted in the survival analysis model. The ﬁrst covariate is the number of compli- cations or comorbidities. The use of the claimsdata set allows us to measure the presence of seven different dia- betic complications or comorbidities deﬁned by Newton and her colleagues , including cardiovascular disease, essential hypertension, foot/lower-extremity problems, peripheral vas- cular disease, cerebrovascular disease, renal disease and eye disease. We further generated a summation index for diabetic complications or comorbidities by adding up the total number of individual complications or comorbidities with an equal weight across all ambulatory visits during the time window where we calculated the UPC scores. The second covariate is the total number of visits for diabetes treatment per year. We assumed that the greater the number of visits per year might indicate more severity for a diabetic patient, therefore increasing the risk of hospitalizations. The third covariate is the type of practice setting of the patients’ usual provider, including medical centers, regional hospitals, district hospitals and primary care clinics. We assumed that the visit of different settings may be associated with different levels of complexity in their diabetes conditions. In this study, we focused on subjects who were newly diagnosed with diabetes.
There were several limitations to this study. First, there were no biochemical data to confirm the diagnosisofdiabetes or its severity. Therefore, this study adopted an algorithm used in other studies to identify patients with diabetes (25,42) and used the existence ofdiabetes-related comorbidities and diabetes duration as proxies for diabetes severity. Second, the actual consumption of prescribed antidiabetic drugs was not available; therefore, a commonly used indicator, the MPR, was adopted. As more than 90% of hospitals and clinics are contracted by the NHIA, NHI claimsdata were a proper source to estimate the possession of medications by patients. Third, this was not a prospective cohort study; therefore no
Diabetes is a common and important problem in terms of clinic and population health. Medical expenditures related to diabetes represent about 10% of
expenditures inTaiwan National HealthInsurance. The purposes of this research were to analyze health service utilization and outcomes in different medical care seeking behavior. In addition to referring related literatures, the study pays more attention to discuss care-seeking behavior. The independent variable made by investigating the care-seeking behavior ofdiabetes patients. And construct and compare the path affected models of the purpose toward changes number of complication, severity of disease and usability of resource. The source of the data came from claimsdataof all set of sampled registry of beneficiaries of National HealthInsurance from 1996 to 2003. ICD-9-CM with initial three codes as A181 or 250 were selected from the panel database. Excluded the cases go to the hospital under three times and Retained the cases in 1996 to 2003 have looked examined document. A total of 4694 persons in western medicine, and the cases because the diabetes goes see western medicine have 4669 persons were identified in the final analysis. The major results of this study were as follows:
departments, etc. However, we try our best to solve this discrepancy by reviewing
the medical records and image results of cases not linked to TSR to confirm whether
their AIS diagnoses were true. Finally, we retrieved only the first AIS episode for
patients with multiple hospitalizations for AIS to avoid old strokes miscoded as acute
Breast cancer is the most prevalent cancer in women around the world, and it has been the leading incidence of cancer in Taiwanese females for 25 years .
From 2004, the Department ofHealth has provided free breast mammograms once every two years for women aged between 50 and 69 years old, but only 12 % of all eligible women take advantage of this screening service . In comparison with other developed countries, Taiwanese women have lower awareness of the danger of breast cancer ; approximately 85 to 96 % of patients discovered the symptoms for breast cancer by themselves, not via breast screening [3-5].
Using Taiwan' National HealthInsurance research data base in 1996,2000,and 2005,this study applies "Direct Standardization Method" to examine the impact of change in population structure on the increase in medical expenditures. In the meantime, such an influence is also extended to future situation inTaiwan.
Due to the rapid change ofTaiwan?s society, public health management has transformed from mere epidemic prevention to more diverse and complicated issues. In addition, the needs and wants of the public vary according to the public health condition and the composition of the population in individual city or county. The ?Community HealthDiagnosis? can play a prominent role in achieving effective and efficient health promotion and disease prevention under limited resources. This study evaluates the public?s health condition in three counties and one city in central Taiwan. The results of the study are expected to become the basis for the Fourth-Phase Plan of Medical Care Net: The New Century Health Passport, a plan to incorporate diverse resources and advance the quality of medical care.
This study, using the NHI database, has several limitations. First, the data came from hospitalization records, so the intussusception cases that only pre- sented to an emergency department or an outpa- tient clinic would not be included. This limitation may underestimate the occurrences of intussuscep- tion. However, as the yearly incidence rate ofin- tussusception reported in current paper is similar to other countries, we think such estimation is ac- ceptable. Second, the NHI reimbursement database is not originally collected for academic research, so we did not have all the clinical information, such as types of enema reduction, dataof viral isolation or the pathology report for the surgical cases. Third, mortality due to intussusception could not be iden- tified because case ID numbers were encrypted, preventing us from linking the mortality file to the national statistics. However, mortality from intus- susception is generally rare and may be ignored. In spite of the limitations of the data used in this study, the NHI database still provides useful information for studying disease incidence on a national scale.
The study focuses on the medical utilization of low-income families inTaiwan?s National HealthInsurance, in terms of the attendance rate, the number of medical treatment, hospitalization days and medical expenses. Their medical uses are then compared with those of an average insured person one by one, particularly, on five major injuries and chronic diseases such as cancer, renal dialysis, mental illness, diabetes and high blood pressure. The data come from the sample file of 2004 National HealthInsurance Research database, in which 1,843 low-income people are selected randomly, and their relevant
2010). In South Korea, Kim et al. (2011) estimated the prevalence of ASDs to be 2.64%; with 1.89%, the male-to-female ratios were 2.5:1 and 5.1:1 in the general-population sample and 0.75% in the high-probability group.
Age, gender and geographical disparities exist in the autistic population inTaiwan. A logistic regression analysis in the present study found that the inﬂuence factors of autistic occurrence include age, gender, residence urbanization level and BNHI regional division. ASD varied geographical region. Similarly, Roelfsema et al. (2011) found that ASD was more prevalent in an information-technology region based on a school-based study of three regions in the Netherlands. Our previous study reported the administrative prevalence of ASD among various age groups inTaiwan from 2000 to 2007 as follows: 2.4–7.8/
Shu-Ching Hsieh 1,2 , I-Hsin Lin 3 , Wei-Lum Tseng 4 , Chang-Hsing Lee 2,5 and Jung-Der Wang* 2,6
Address: 1 Division ofHealth Technology Assessment, Center for Drug Evaluation, Taiwan, 2 Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, 3 Committee on Chinese Medicine and Pharmacy, Department ofHealth, Executive Yuan, Taipei, Taiwan, 4 Emergency Department of Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan, 5 Department of Occupational Medicine, Ton Yen General Hospital, Hsinchu, Taiwan and 6 Department of Internal Medicine and the Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
1 Subramanian S, Khandker RK, Roth D. Long-term resource use and cost of percutaneous transluminal coronary angioplasty versus stenting in the elderly: a retrospective claimsdata analysis. Value Health 2003;6:534–41. 2 Henriques C, Schultz D, Milanette T, et al. Using retrospective claimsdata to design clinical safety surveillance of thiazolidinedione drugs. Value Health 2001; 4:111. 3 Lin HC, Lee HC, Chao PZ, Wu CS. The effects of weather on the incidence of sudden sensorineural hearing loss: a 5-year population-based study. Audiol Neurootol 2006;11:165–71.
Since the medical system inTaiwan is more unique than that in other countries, people inTaiwan have more rights over choosing their own medical care
providers. Besides, with the immaturity of both the family physician system and the referral system inTaiwan, this unique system is characterized by the large average number of outpatient visits, the high rate of hospital attendance (especially the medical center attendance), and the high frequency of changing physicians and health care facilities. In this context, the issue of frequent
After taking additional demographic factors, lifestyle behaviors, physiological factors and biomarkers into account, the differences in AUCs among these three ROCs were not significant in either men or women. Especially, when biomarkers were added to the model with ADART only, there was no improvement in the prediction of 3-year incidence in both men and women. Because ADART plus biomarkers at baseline did not improve the prediction of the three-year incidence of pre-diabetes and diabetes, compared with ADART only, this may indicate that ADART alone can be applied to the general population for screening pre- diabetes and diabetes, or it may indicate that our study did not Table 2. The ability of ADART plus lifestyle behaviors and biomarkers at baseline for predicting 3-year incidence of pre-diabetes and diabetes.