Sample records for taiwan national health

  1. Nonemergent emergency department visits under the National Health Insurance in Taiwan.

    PubMed

    Tsai, Jeffrey Che-Hung; Chen, Wen-Yi; Liang, Yia-Wun

    2011-05-01

    To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits. A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.89% could be classified. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits. Nearly 15% of all emergency department visits were nonemergent; an additional 20% were emergent-preventable with primary care. Patients likely to make nonemergent emergency department visits were older, female, categorized as a Taiwan National Health Insurance Category IV beneficiary, and without major illness. Hospital accreditation level, teaching status, and location were associated with an increased likelihood of nonemergent emergency department visits. Understanding the factors leading to nonemergent emergency department visits can assist in evaluating the overall quality of a health care system and help reduce the use of the emergency department for nonemergent conditions. Policy makers desiring cost-effective care should assess emergency department visit rates in light of available resources for specific populations. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  2. Assessing health information technology in a national health care system--an example from Taiwan.

    PubMed

    Chi, Chunhuei; Lee, Jwo-Leun; Schoon, Rebecca

    2012-01-01

    The purpose of this article is to investigate one core research question: How can health information technology (HIT) be assessed in a national health care system context? We examine this question by taking a systematic approach within a national care system, in which the purpose of HIT is to contribute to a common national health care system's goal. to promote population health in an efficient way. Based on this approach we first develop a framework and our criteria of assessment, and then using Taiwan as a case study, demonstrate how one can apply this framework to assess a national system's HIT. The five criteria we developed are how well does the HIT (1) provide accessible and accurate public health and health care information to the population; (2) collect and provide population health and health care data for government and researchers to analyze population health and processes and outcomes of health care services, (3) provide accessible and timely information that helps to improve provision of cost-effective health care at an institutional level and promotes system-wide efficiency; (4) minimize transaction and administrative costs of the health care system; and (5) establish channels for population participation in governance while also protecting individual privacy. The results indicate that Taiwan has high levels of achievement in two criteria while falling short in the other three. Major lessons we learned from this study are that HIT exists to serve a health care system, and the national health care system context dictates how one assesses its HIT. There is a large body of literature published on the implementation of HIT and its impact on the quality and cost of health care delivery. The vast majority of the literature, however, is focused on a micro institutional level such as a hospital or a bit higher up, on an HMO or health insurance firm. Few have gone further to evaluate the implementation of HIT and its impact on a national health care system

  3. Willingness to pay to sustain and expand National Health Insurance services in Taiwan.

    PubMed

    Lang, Hui-Chu; Lai, Mei-Shu

    2008-12-17

    The purpose of the present study was to investigate people's willingness to pay to sustain the current National Health Insurance (NHI) program in Taiwan and to extend that program to cover long-term care services. A survey was administered to 1800 inpatients and 1800 outpatients, selected from health care facilities across all accreditation levels that were operating under the supervision of six different regional branches of Taiwan's Bureau of National Health Insurance (BNHI). We used a contingent valuation method with closed-ended questions to elicit participants' willingness to pay for continued national heath insurance and additional institutional long-term care services. We divided participants into six subgroups and asked individuals in these groups referendum-like yes-no questions about whether they were willing to pay one of six price bids: New Taiwan Dollar (NT$) 50, NT$100, NT$200, NT$300, NT$400, or NT$500. Logistic regression was used to analyze willingness to pay. We found maximum willingness to pay for continued coverage by the NHI program and additional institutional long-term care services to be NT$66 and NT$137 dollars per month, respectively. We found that people were willing to pay more for their insurance coverage. With regard to methodology, we also found that using a contingent valuation method to elicit peoples' willingness to pay for health policy issues is valid. The results of the present referendum-like study can serve as a reference for future policy decision making.

  4. Willingness to pay to sustain and expand National Health Insurance services in Taiwan

    PubMed Central

    Lang, Hui-Chu; Lai, Mei-Shu

    2008-01-01

    Background The purpose of the present study was to investigate people's willingness to pay to sustain the current National Health Insurance (NHI) program in Taiwan and to extend that program to cover long-term care services. Methods A survey was administered to 1800 inpatients and 1800 outpatients, selected from health care facilities across all accreditation levels that were operating under the supervision of six different regional branches of Taiwan's Bureau of National Health Insurance (BNHI). We used a contingent valuation method with closed-ended questions to elicit participants' willingness to pay for continued national heath insurance and additional institutional long-term care services. We divided participants into six subgroups and asked individuals in these groups referendum-like yes-no questions about whether they were willing to pay one of six price bids: New Taiwan Dollar (NT$) 50, NT$100, NT$200, NT$300, NT$400, or NT$500. Logistic regression was used to analyze willingness to pay. Results We found maximum willingness to pay for continued coverage by the NHI program and additional institutional long-term care services to be NT$66 and NT$137 dollars per month, respectively. Conclusion We found that people were willing to pay more for their insurance coverage. With regard to methodology, we also found that using a contingent valuation method to elicit peoples' willingness to pay for health policy issues is valid. The results of the present referendum-like study can serve as a reference for future policy decision making. PMID:19091093

  5. The impact of national health insurance on the utilization of health care services by pregnant women: the case in Taiwan.

    PubMed

    Chen, L M; Wen, S W; Li, C Y

    2001-03-01

    Substantially increased funding for health care services occurred in Taiwan after the implementation of a national health insurance plan in 1995. This study attempts to examine the impact of this national health insurance plan on the utilization of prenatal and intrapartum care services. Nationally representative surveys of all pregnant women in Taiwan in 1989 (1,662 participants) and in 1996 (3,626 participants) were included in the analysis. We first compared the distribution of birth characteristics between the two surveys. We then calculated the rate of utilization of various prenatal and intrapartum care services in the two surveys in the overall sample and in subsamples, stratified by maternal education, age, and parity. The utilization of most prenatal and intrapartum care services, especially the complicated laboratory tests, increased in 1996 compared to 1989. For example, the proportion of women who received amniocentesis increased from 1.62% in 1989 to 5.60% in 1996 and German measles testing increased from 5.96% to 27.11%. By contrast, the proportion of women who received consultation services was stable over time, or for family planning, consultation declined from 33.21% to 27.00%. These changes in utilization over time were consistently observed across different maternal education, age, and parity groups. The utilization of prenatal and intrapartum care services, especially for the more expensive services, has substantially increased in Taiwan since the implementation of the national health insurance. For countries considering similar national health insurance plan, it may be helpful to consider cost-containing measures before the implementation of such a plan.

  6. [The evolution of national health and the development of the nursing practice in Taiwan].

    PubMed

    Yin, Teresa J C

    2014-08-01

    Nursing is an applied science. While there is a wide range of nursing theories and nursing care models, resolving the health problems and meeting the health needs of clients is the common objective of all in the nursing profession. The nursing profession may be subdivided into hospital clinical nursing and community health nursing (CHN). CHN is further subdivided into public health nursing, school health nursing, and industrial health nursing. The past 60 years has been a period of significant growth and improvement in Taiwan that has enhanced the nation's socioeconomic condition, general living standards, and general public health. The nursing profession has seen profound progress as well, not only in terms of content but also in terms of nursing care models, which are increasingly framed around core public health needs and take into consideration different health perspectives. Nursing in Taiwan has gradually established its own professional function and autonomy.

  7. The Taiwan National Health Insurance program and full infant immunization coverage.

    PubMed

    Chen, Chin-Shyan; Liu, Tsai-Ching

    2005-02-01

    We compared hospital-born infants and well-baby care use associated with complete immunizations in Taiwan before and after institution of National Health Insurance (NHI). We used logistic regression to analyze data from 1989 and 1996 National Maternal and Infant Health Surveys of 1398 and 3185 1-year-old infants, respectively. Infants born in hospitals were found to receive fewer immunizations than those born elsewhere before NHI but significantly more after NHI. Use of well-baby care correlates strongly and positively with the probability that a child will receive a full course of immunization after NHI. The NHI policy of including hospitals as immunization providers facilitates access to immunization services for children born in those facilities. Through NHI provision of free well-baby care, health planners have stimulated the demand for immunization.

  8. The Taiwan National Health Insurance Program and Full Infant Immunization Coverage

    PubMed Central

    Chen, Chin-Shyan; Liu, Tsai-Ching

    2005-01-01

    Objectives. We compared hospital-born infants and well-baby care use associated with complete immunizations in Taiwan before and after institution of National Health Insurance (NHI). Methods. We used logistic regression to analyze data from 1989 and 1996 National Maternal and Infant Health Surveys of 1398 and 3185 1-year-old infants, respectively. Results. Infants born in hospitals were found to receive fewer immunizations than those born elsewhere before NHI but significantly more after NHI. Use of well-baby care correlates strongly and positively with the probability that a child will receive a full course of immunization after NHI. Conclusions. The NHI policy of including hospitals as immunization providers facilitates access to immunization services for children born in those facilities. Through NHI provision of free well-baby care, health planners have stimulated the demand for immunization. PMID:15671469

  9. Perioperative medicine and Taiwan National Health Insurance Research Database.

    PubMed

    Chang, C C; Liao, C C; Chen, T L

    2016-09-01

    "Big data", characterized by 'volume', 'velocity', 'variety', and 'veracity', being routinely collected in huge amounts of clinical and administrative healthcare-related data are becoming common and generating promising viewpoints for a better understanding of the complexity for medical situations. Taiwan National Health Insurance Research Database (NHIRD), one of large and comprehensive nationwide population reimbursement databases in the world, provides the strength of sample size avoiding selection and participation bias. Abundant with the demographics, clinical diagnoses, and capable of linking diverse laboratory and imaging information allowing for integrated analysis, NHIRD studies could inform us of the incidence, prevalence, managements, correlations and associations of clinical outcomes and diseases, under the universal coverage of healthcare used. Perioperative medicine has emerged as an important clinical research field over the past decade, moving the categorization of the specialty of "Anesthesiology and Perioperative Medicine". Many studies concerning perioperative medicine based on retrospective cohort analyses have been published in the top-ranked journal, but studies utilizing Taiwan NHIRD were still not fully visualized. As the prominent growth curve of NHIRD studies, we have contributed the studies covering surgical adverse outcomes, trauma, stroke, diabetes, and healthcare inequality, etc., to this ever growing field for the past five years. It will definitely become a trend of research using Taiwan NHIRD and contributing to the progress of perioperative medicine with the recruitment of devotion from more research groups and become a famous doctrine. Copyright © 2016. Published by Elsevier B.V.

  10. The National Health Insurance system as one type of new typology: the case of South Korea and Taiwan.

    PubMed

    Lee, Sang-Yi; Chun, Chang-Bae; Lee, Yong-Gab; Seo, Nam Kyu

    2008-01-01

    A typology is the useful way of understanding the key frameworks of health care system. With many different criteria of health care system, several typologies have been introduced and applied to each country's health care system. Among those, National Health Service (NHS), Social Health Insurance (SHI), and Private Health Insurance (PHI) are three most well-known types of health care system in the 3-model typology. Differentiated from the existing 3-model typology of health care system, South Korea and Taiwan implemented new concept of National Health Insurance (NHI) system. Since none of previous typologies can be applied to these countries' NHI to explain its unique features in a proper manner, a new typology needs to be introduced. Therefore, this paper introduces a new typology with two crucial variables that are 'state administration for health care financing' and 'main body for health care provision'. With these two variables, the world's national health care systems can be divided into four types of model: NHS, SHI, NHI, and PHI (Liberal model). This research outlines the rationale of developing new typology and introduces main features and frameworks of the NHI that South Korea and Taiwan implemented in the 1990 s.

  11. Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

    PubMed

    Lan, Jesse Yu-Chen

    2017-12-01

    The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

  12. Patterns of outpatient care utilization by seniors under the National Health Insurance in Taiwan.

    PubMed

    Hsu, Wen-Chin; Hsu, Yi-Ping

    2016-05-01

    Taiwan has one of the fastest growing aging populations in the world, which makes the effective allocation of scarce medical resources a key issue. This paper investigates patterns in the use of outpatient services by elderly individuals in Taiwan under the National Health Insurance (NHI) program. We assembled a random sample from the NHI Research Database in Taiwan, comprising 50% of all claims made for elderly people (65 years old) in 2010 (n 1,239,836 beneficiaries) including 14 variables. In 2010, individuals aged 65 years or older comprised 10.74% of the population of Taiwan, and accounted for 11.39% of all physician and outpatient visits. The rate of medical care visits was 28.54 ± 21.23 (Standard deviation) times per person per annum, with a higher rate for women, those in the 80-84 age group, low-income beneficiaries, and the inhabitants of offshore islands. The three most frequent diagnoses for elderly patients were hypertension, diabetes, and acute upper respiratory infections. The mean insured medical costs per person per annum were US Dollars 1,132, with higher expenses for men, those in the 80-84 age group, and those inhabiting urban areas. This study employed nationally representative data in the detection of patterns in outpatient care utilization by elderly individuals in Taiwan. Medical care providers and policymakers should be fully aware of the complex patterns unique to older patients. The results of this study could be used as a benchmark with which to assess the impact of future medical care policy on elderly people. Copyright © 2015. Published by Elsevier B.V.

  13. Redistributive effects of the National Health Insurance on physicians in Taiwan: a natural experiment time series study.

    PubMed

    Yang, Chiang-Hsing; Huang, Yu-Tung A; Hsueh, Ya-Seng A

    2013-02-04

    Previous studies have evaluated the effects of various health manpower policies but did not include full consideration of the effect of universal health insurance on physician re-distribution. This study examines the effects of implementing National Health Insurance (NHI) on the problem of geographic mal-distribution of health providers in Taiwan. Data on health providers and population between 1971 and 2001 are obtained from relevant governmental publications in Taiwan. Gini coefficients derived from the Lorenz curve are used under a spline regression model to examine the impact of the NHI on the geographic distribution of health providers. The geographic distribution equality of the three key health providers has improved significantly after the implementation of NHI program. After accounting for the influences of other confounding factors, Gini coefficients of the three key providers have a net reduction of 1.248% for dentists, 0.365% for western medicine physicians, and 0.311% for Chinese medicine physicians. Overall, the absolute values of the three key providers' Gini coefficients also become close to one another. This study found that NHI's offering universal health coverage to all citizens and with proper financial incentives have resulted in more equal geographic distributions among the key health care providers in Taiwan.

  14. Redistributive effects of the National Health Insurance on physicians in Taiwan: a natural experiment time series study

    PubMed Central

    2013-01-01

    Background Previous studies have evaluated the effects of various health manpower policies but did not include full consideration of the effect of universal health insurance on physician re-distribution. This study examines the effects of implementing National Health Insurance (NHI) on the problem of geographic mal-distribution of health providers in Taiwan. Methods Data on health providers and population between 1971 and 2001 are obtained from relevant governmental publications in Taiwan. Gini coefficients derived from the Lorenz curve are used under a spline regression model to examine the impact of the NHI on the geographic distribution of health providers. Results The geographic distribution equality of the three key health providers has improved significantly after the implementation of NHI program. After accounting for the influences of other confounding factors, Gini coefficients of the three key providers have a net reduction of 1.248% for dentists, 0.365% for western medicine physicians, and 0.311% for Chinese medicine physicians. Overall, the absolute values of the three key providers’ Gini coefficients also become close to one another. Conclusions This study found that NHI’s offering universal health coverage to all citizens and with proper financial incentives have resulted in more equal geographic distributions among the key health care providers in Taiwan. PMID:23374629

  15. Growing concerns and controversies to Taiwan's National Health Insurance-what are the lessons from mainland China, South Korea and Singapore?

    PubMed

    Lee, Yen-Han; Ang, Ting Fang Alvin; Chiang, Timothy C; Kaplan, Warren A

    2018-01-01

    It has been over 20 years since Taiwan's implementation of its National Health Insurance (NHI) program. Under this program, the health insurance coverage rate has reached approximately 99% of the population. Despite guaranteeing the residents of Taiwan equal access regardless of socioeconomic status and background, critical problems and controversies persist, and they continue to challenge the NHI. We analyze the primary issues facing the NHI program with emphasis on financial and consumer behavioral aspects. Furthermore, we apply models from mainland China, South Korea and Singapore to discuss what Taiwan could learn from the systems employed by these countries to modify the NHI. Targeting the needs of the NHI, we have three policy recommendations: separating the NHI scheme into different target populations, strengthening the NHI referral system and regulating the access of overseas citizens to health services while in Taiwan. After two decades in existence, problems persist and there is a continuing need to improve Taiwan's NHI. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  16. [Glocalization: the outlook for Taiwan evidence based health care].

    PubMed

    Chen, Chiehfeng

    2014-12-01

    Public attention to evidence-based health care (EBHC) has increased significantly in recent years. Key problems related to applying EBHC in current healthcare practice include the timely update of up-to-date knowledge and skills and the methodology used to implement EBHC in clinical settings. EBHC has been introduced to the Taiwan healthcare system for the past two decades. The annual EBM (Evidence based medicine) National Competition is a unique and important EBHC activity in Taiwan. EBHC has been promoted widely in medicine, nursing, pharmacy, public health and other professions, and EBHC-related organizations such as the Taiwan Evidence Based Medicine Association (TEBMA), and Taiwan Evidence Based Nursing Association (TEBNA), have increased in number and grown in membership. In addition to domestic developments, Taiwan is also actively involved in global organizations, such as the Cochrane Collaboration, East Asian Cochrane Alliance (EACA), and the International Society for Evidence Based Health Care (ISEHC). In Taiwan, most medical professionals work cooperatively to promote EBHC, which facilitates the gradual improvement of healthcare quality.

  17. Health Expenditure Growth under Single-Payer Systems: Comparing South Korea and Taiwan.

    PubMed

    Cheng, Shou-Hsia; Jin, Hyun-Hyo; Yang, Bong-Min; Blank, Robert H

    2018-05-03

    Achieving universal health coverage has been an important goal for many countries worldwide. However, the rapid growth of health expenditures has challenged all nations, both those with and without such universal coverage. Single-payer systems are considered more efficient for administrative affairs and may be more effective for containing costs than multipayer systems. However, South Korea, which has a typical single-payer scheme, has almost the highest growth rate in health expenditures among industrialized countries. The aim of the present study is to explicate this situation by comparing South Korea with Taiwan. This study analyzed statistical reports published by government departments in South Korea and Taiwan from 2001 to 2015, including population and economic statistics, health statistics, health expenditures, and social health insurance reports. Between 2001 and 2015, the per capita national health expenditure (NHE) in South Korea grew 292%, whereas the corresponding growth of per capita NHE in Taiwan was only 83%. We find that the national health insurance (NHI) global budget cap in Taiwan may have restricted the growth of health expenditures. Less comprehensive benefit coverage for essential diagnosis/treatment services under the South Korean NHI program may have contributed to the growth of out-of-pocket payments. The expansion of insurance coverage for vulnerable individuals may also contribute to higher growth in NHE in South Korea. Explicit regulation of health care resource distribution may also lead to more limited provisioning and utilization of health services in Taiwan. Under analogous single-payer systems, South Korea had a much higher growth in health spending than Taiwan. The annual budget cap for total reimbursement, more comprehensive coverage for essential diagnosis and treatment services, and the regulation of health care resource distribution are important factors associated with the growth of health expenditures. Copyright © 2018

  18. Disability and Hospital Care Expenses among National Health Insurance Beneficiaries: Analyses of Population-Based Data in Taiwan

    ERIC Educational Resources Information Center

    Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM…

  19. Household out-of-pocket medical expenditures and national health insurance in Taiwan: income and regional inequality

    PubMed Central

    Chu, Tu-Bin; Liu, Tsai-Ching; Chen, Chin-Shyan; Tsai, Yi-Wen; Chiu, Wen-Ta

    2005-01-01

    Background Unequal geographical distribution of medical care resources and insufficient healthcare coverage have been two long-standing problems with Taiwan's public health system. The implementation of National Health Insurance (NHI) attempted to mitigate the inequality in health care use. This study examines the degree to which Taiwan's National Health Insurance (NHI) has reduced out-of-pocket medical expenditures in households in different regions and varying levels of income. Methods Data used in this study were drawn from the 1994 and 1996 Surveys of Family Income and Expenditure. We pooled the data from 1994 and 1996 and included a year dummy variable (NHI), equal to 1 if the household data came from 1996 in order to assess the impact of NHI on household out-of-pocket medical care expenditures shortly after its implementation in 1995. Results An individual who was older, female, married, unemployed, better educated, richer, head of a larger family household, or living in the central and eastern areas was more likely to have greater household out-of-pocket medical expenditures. NHI was found to have effectively reduced household out-of-pocket medical expenditures by 23.08%, particularly for more affluent households. With the implementation of NHI, lower and middle income quintiles had smaller decreases in out-of-pocket medical expenditure. NHI was also found to have reduced household out-of-pocket medical expenditures more for households in eastern Taiwan. Conclusion Although NHI was established to create free medical care for all, further effort is needed to reduce the medical costs for certain disadvantaged groups, particularly the poor and aborigines, if equality is to be achieved. PMID:16137336

  20. The influence of medical cost controls implemented by Taiwan's national health insurance program on doctor-patient relationships.

    PubMed

    Chiu, Jhih-Ling

    2015-01-01

    To prevent medical costs from rising, the National Health Insurance administration implemented the global budget system for financial reform, effective 1 July 2004. Since the implementation of this system, patients have been required to pay for some medicines to limit costs to the system. More recently, as they have faced constant increases in health insurance fees and also faced an increase in the number of medical expenses they must pay during an economic recession and a rise in unemployment, would the economic burden on the people of Taiwan not be increased? Even though National Health Insurance is a form of social insurance, does it guarantee social equality? The value of the healthcare industry is irreplaceable, so the most critical concern is whether worsening doctor-patient relationships will worsen healthcare quality. In short, while the global budget system saves on National Health Insurance costs, whether its implementation has affected healthcare quality is also worth exploring. This commentary also hopes to serve as a reference for the implementation of national health insurance in the United States. Copyright © 2014 John Wiley & Sons, Ltd.

  1. Validity of cancer diagnosis in the National Health Insurance database compared with the linked National Cancer Registry in Taiwan.

    PubMed

    Kao, Wei-Heng; Hong, Ji-Hong; See, Lai-Chu; Yu, Huang-Ping; Hsu, Jun-Te; Chou, I-Jun; Chou, Wen-Chi; Chiou, Meng-Jiun; Wang, Chun-Chieh; Kuo, Chang-Fu

    2017-08-16

    We aimed to evaluate the validity of cancer diagnosis in the National Health Insurance (NHI) database, which has routinely collected the health information of almost the entire Taiwanese population since 1995, compared with the Taiwan National Cancer Registry (NCR). There were 26,542,445 active participants registered in the NHI database between 2001 and 2012. National Cancer Registry and NHI database records were compared for cancer diagnosis; date of cancer diagnosis; and 1, 2, and 5 year survival. In addition, the 10 leading causes of cancer deaths in Taiwan were analyzed. There were 908,986 cancer diagnoses in NCR and NHI database and 782,775 (86.1%) in both, with 53,192 (5.9%) in the NHI database only and 73,019 (8.0%) in the NCR only. The positive predictive value of the NHI database cancer diagnoses was 94% for all cancers; the positive predictive value of the 10 specific cancers ranged from 95% (lung cancer) to 82% (cervical cancer). The date of diagnosis in the NHI database was generally delayed by a median of 15 days (interquartile range 8-18) compared with the NCR. The 1, 2, and 5 year survival rates were 71.21%, 60.85%, and 47.44% using the NHI database and were 71.18%, 60.17%, and 46.09% using NCR data. Recording of cancer diagnoses and survival estimates based on these diagnosis codes in the NHI database are generally consistent with the NCR. Studies using NHI database data must pay careful attention to eligibility and record linkage; use of both sources is recommended. Copyright © 2017 John Wiley & Sons, Ltd.

  2. Agency problems of global budget system in Taiwan's National Health Insurance.

    PubMed

    Yan, Yu-Hua; Yang, Chen-Wei; Fang, Shih-Chieh

    2014-05-01

    The main purpose of this study was to investigate the agency problem presented by the global budget system followed by hospitals in Taiwan. In this study, we examine empirically the interaction between the principal: Bureau of National Health Insurance (BNHI) and agency: medical service providers (hospitals); we also describe actual medical service provider and hospital governance conditions from a agency theory perspective. This study identified a positive correlation between aversion to agency hazard (self-interest behavior, asymmetric information, and risk hedging) and agency problem risks (disregard of medical ethics, pursuit of extra-contract profit, disregard of professionalism, and cost orientation). Agency costs refer to BNHI auditing and monitoring expenditures used to prevent hospitals from deviating from NHI policy goals. This study also found agency costs negatively moderate the relationship between agency hazards and agency problems The main contribution of this study is its use of agency theory to clarify agency problems and several potential factors caused by the NHI system. This study also contributes to the field of health policy study by clarifying the nature and importance of agency problems in the health care sector. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. National health insurance, physician financial incentives, and primary cesarean deliveries in Taiwan.

    PubMed

    Tsai, Yi-Wen; Hu, Teh-Wei

    2002-09-01

    Taiwan's National Health Insurance Program (NHI) was implemented on March 1, 1995. This study analyzed the influences of the Case Payment method of reimbursement for inpatient care and of physician financial incentives on a woman's choice for primary cesarean delivery. Logistic regressions were used to analyze 11 788 first-time deliveries in a nonprofit hospital system between March 1, 1994, and February 29, 1996. After implementation of the NHI's Case Payment scheme, the likelihood that a woman would choose primary cesarean delivery increased by four to five times compared with the choice behavior of uninsured individuals prior to NHI (P <.0001). Out-of-pocket payment discourages the selection of primary cesarean delivery. No robust statistics were found relating physician financial incentives to delivery choice.

  4. Health, Healthcare Utilization and Psychiatric Disorder in People with Intellectual Disability in Taiwan

    ERIC Educational Resources Information Center

    Lin, J. D.; Yen, C. F.; Li, C. W.; Wu, J. L.

    2005-01-01

    The aims of the present study were to examine health characteristics and healthcare utilization in relation to people with intellectual disability (ID) having psychiatric disorders in Taiwan. A cross-sectional study was employed; study subjects were recruited from the National Disability Registration Database. Taiwan, stratified by administrative…

  5. Cancer studies based on secondary data analysis of the Taiwan's National Health Insurance Research Database: A computational text analysis and visualization study.

    PubMed

    Chiang, Jui-Kun; Lin, Chih-Wen; Wang, Chun-Lung; Koo, Malcolm; Kao, Yee-Hsin

    2017-04-01

    There has been a surge in the academic publication output based on secondary analyses of the data from the Taiwan's National Health Insurance claim records. It has become a challenge to comprehend such a rapid expansion of the literature. Therefore, this study aimed to explore the conceptual content of National Health Insurance Research Database-based cancer research, using the abstract of articles extracted from PubMed between 2002 and 2015. Search terms including "National Health Insurance Research Database (NHIRD) AND Taiwan," "Taiwan AND population-based," and "Taiwan AND nationwide" were used to search in PubMed with the publication date limited to between 1997 and 2015. The retrieved articles were manually screened to retain only those that were cancer-related and were based on secondary data analysis of the NHIRD. A total 589 articles were selected for subsequent text mining using the R software. Among the 589 articles, the top 5 most studied cancer types were breast (16.3%), lung (11.4%), colorectal (10.4%), liver (8.3%), and prostate (7.5%). The articles that received the highest number of citations by PubMed Central articles were cited 92 times. The top 3 most frequently occurred keywords in the abstracts of the 589 articles were cancer, patient, and risk, with 3670, 2535, and 1652 times, respectively. Analysis of key conception indicated that the most common conceptions were diabetes, survival, breast cancer, lung cancer, and colorectal cancer. In conclusion, in this study of 589 published articles on secondary data analysis of the NHIRD, indexed by PubMed between 2002 and 2015, we found that while the risk factors of cancer, treatment of cancer, and survival of cancer patients were popular research topics, end-of-life cancer care issues were less studied. Further studies should explore these areas since they are as important as treatment of the disease itself for many patients.

  6. Assessing the relationship between healthcare market competition and medical care quality under Taiwan's National Health Insurance programme.

    PubMed

    Liao, Chih-Hsien; Lu, Ning; Tang, Chao-Hsiun; Chang, Hui-Chih; Huang, Kuo-Cherh

    2018-06-04

    There is still significant uncertainty as to whether market competition raises or lowers clinical quality in publicly funded healthcare systems. We attempted to assess the effects of market competition on inpatient care quality of stroke patients in a retrospective study of the universal single-payer health insurance system in Taiwan. In this 11-year population-based study, we conducted a pooled time-series cross-sectional analysis with a fixed-effects model and the Hausman test approach by utilizing two nationwide datasets: the National Health Insurance Research Database and the National Hospital and Services Survey in Taiwan. Patients who were admitted to a hospital for ischemic or hemorrhagic stroke were enrolled. After excluding patients with a previous history of stroke and those with different types of stroke, 247 379 ischemic and 79 741 hemorrhagic stroke patients were included in our analysis. Four outcome indicators were applied: the in-hospital mortality rate, 30-day post-operative complication rate, 14-day re-admission rate and 30-day re-admission rate. Market competition exerted a negative or negligible effect on the medical care quality of stroke patients. Compared to hospitals located in a highly competitive market, in-hospital mortality rates for hemorrhagic stroke patients were significantly lower in moderately (β = -0.05, P < 0.01) and less competitive markets (β = -0.05, P < 0.01). Conversely, the impact of market competition on the quality of care of ischemic stroke patients was insignificant. Simply fostering market competition might not achieve the objective of improving the quality of health care. Other health policy actions need to be contemplated.

  7. Treated prevalence and incidence of dementia among National Health Insurance enrollees in Taiwan, 1996-2003.

    PubMed

    Chien, I-Chia; Lin, Yu-Chung; Chou, Yiing-Jenq; Lin, Ching-Heng; Bih, Shin-Huey; Lee, Cheng-Hua; Chou, Pesus

    2008-06-01

    The National Health Insurance database to determine the treated prevalence and incidence of dementia in Taiwan was used in this study. A population-based random sample of 22 118 subjects aged 65 or older was obtained as a dynamic cohort. Those study subjects who had filed at least one service claim from 1996 to 2003 for either outpatient care or inpatient care with a principal diagnosis of dementia were identified. The annual treated prevalence increased from 0.71% to 1.92% from 1996 to 2003. The annual treated incidence rates were around 0.76% to 1.04% per year from 1997 to 2003. The annual treated incidence rates for the 5-year age groups, from 65 to 90 years and older, were 0.44%, 0.65%, 0.98%, 1.46%, 1.81%, and 1.80%, respectively. Both the treated prevalence and incidence rates of dementia in National Health Insurance were lower than those of community studies.

  8. The effect of cigarette price increase on the cigarette consumption in Taiwan: evidence from the National Health Interview Surveys on cigarette consumption.

    PubMed

    Lee, Jie-Min; Hwang, Tsorng-Chyi; Ye, Chun-Yuan; Chen, Sheng-Hong

    2004-12-14

    This study uses cigarette price elasticity to evaluate the effect of a new excise tax increase on cigarette consumption and to investigate responses from various types of smokers. Our sample consisted of current smokers between 17 and 69 years old interviewed during an annual face-to-face survey conducted by Taiwan National Health Research Institutes between 2000 to 2003. We used Ordinary Least Squares (OLS) procedure to estimate double logarithmic function of cigarette demand and cigarette price elasticity. In 2002, after Taiwan had enacted the new tax scheme, cigarette price elasticity in Taiwan was found to be -0.5274. The new tax scheme brought about an average annual 13.27 packs/person (10.5%) reduction in cigarette consumption. Using the cigarette price elasticity estimate from -0.309 in 2003, we calculated that if the Health and Welfare Tax were increased by another NT 3 dollars per pack and cigarette producers shifted this increase to the consumers, cigarette consumption would be reduced by 2.47 packs/person (2.2%). The value of the estimated cigarette price elasticity is smaller than one, meaning that the tax will not only reduce cigarette consumption but it will also generate additional tax revenues. Male smokers who had no income or who smoked light cigarettes were found to be more responsive to changes in cigarette price. An additional tax added to the cost of cigarettes would bring about a reduction in cigarette consumption and increased tax revenues. It would also help reduce incidents smoking-related illnesses. The additional tax revenues generated by the tax increase could be used to offset the current financial deficiency of Taiwan's National Health Insurance program and provide better public services.

  9. The influences of Taiwan's National Health Insurance on women's choice of prenatal care facility: Investigation of differences between rural and non-rural areas

    PubMed Central

    Chen, Likwang; Chen, Chi-Liang; Yang, Wei-Chih

    2008-01-01

    Background Taiwan's National Health Insurance (NHI), implemented in 1995, substantially increased the number of health care facilities that can deliver free prenatal care. Because of the increase in such facilities, it is usually assumed that women would have more choices regarding prenatal care facilities and thus experience reduction in travel cost. Nevertheless, there has been no research exploring these issues in the literature. This study compares how Taiwan's NHI program may have influenced choice of prenatal care facility and perception regarding convenience in transportation for obtaining such care for women in rural and non-rural areas in Taiwan. Methods Based on data collected by a national survey conducted by Taiwan's National Health Research Institutes (NHRI) in 2000, we tried to compare how women chose prenatal care facility before and after Taiwan's National Health Insurance program was implemented. Basing our analysis on how women answered questionnaire items regarding "the type of major health care facility used and convenience of transportation to and from prenatal care facility," we investigated whether there were disparities in how women in rural and non-rural areas chose prenatal care facilities and felt about the transportation, and whether the NHI had different influences for the two groups of women. Results After NHI, women in rural areas were more likely than before to choose large hospitals for prenatal care services. For women in rural areas, the relative probability of choosing large hospitals to choosing non-hospital settings in 1998–1999 was about 6.54 times of that in 1990–1992. In contrast, no such change was found in women in non-rural areas. For a woman in a non-rural area, she was significantly more likely to perceive the transportation to and from prenatal care facilities to be very convenient between 1998 and 1999 than in the period between 1990 and 1992. No such improvement was found for women in rural areas. Conclusion We

  10. The influences of Taiwan's National Health Insurance on women's choice of prenatal care facility: Investigation of differences between rural and non-rural areas.

    PubMed

    Chen, Likwang; Chen, Chi-Liang; Yang, Wei-Chih

    2008-03-29

    Taiwan's National Health Insurance (NHI), implemented in 1995, substantially increased the number of health care facilities that can deliver free prenatal care. Because of the increase in such facilities, it is usually assumed that women would have more choices regarding prenatal care facilities and thus experience reduction in travel cost. Nevertheless, there has been no research exploring these issues in the literature. This study compares how Taiwan's NHI program may have influenced choice of prenatal care facility and perception regarding convenience in transportation for obtaining such care for women in rural and non-rural areas in Taiwan. Based on data collected by a national survey conducted by Taiwan's National Health Research Institutes (NHRI) in 2000, we tried to compare how women chose prenatal care facility before and after Taiwan's National Health Insurance program was implemented. Basing our analysis on how women answered questionnaire items regarding "the type of major health care facility used and convenience of transportation to and from prenatal care facility," we investigated whether there were disparities in how women in rural and non-rural areas chose prenatal care facilities and felt about the transportation, and whether the NHI had different influences for the two groups of women. After NHI, women in rural areas were more likely than before to choose large hospitals for prenatal care services. For women in rural areas, the relative probability of choosing large hospitals to choosing non-hospital settings in 1998-1999 was about 6.54 times of that in 1990-1992. In contrast, no such change was found in women in non-rural areas. For a woman in a non-rural area, she was significantly more likely to perceive the transportation to and from prenatal care facilities to be very convenient between 1998 and 1999 than in the period between 1990 and 1992. No such improvement was found for women in rural areas. We concluded that women in rural areas were

  11. Drugs Cheaper Than Threepenny: The Market of Extremely Low-Priced Drugs within the National Health Insurance in Taiwan

    PubMed Central

    Chou, Li-Fang

    2014-01-01

    While most drug policy researches paid attention to the financial impact of expensive drugs, the market situation of low-priced drugs in a country was seldom analyzed. We used the nationally representative claims datasets to explore the status within the National Health Insurance (NHI) in Taiwan. In 2007, a total of 12,443 distinct drug items had been prescribed 853,250,147 times with total expenditure of 105,216,950,198 new Taiwan dollars (NTD). Among them, 7,366 oral drug items accounted for 701,353,383 prescribed items and 68,133,988,960 NTD. Besides, 2,887 items (39.2% of oral drug items) belonged to cheap drugs with the unit price ≤1 NTD (about 0.03 of US dollar). While the top one item among all oral drugs had already a market share of 5.0%, 30 items 30.3% and 107 items 50.0%, the cheap drugs with aggregate 332,893,462 prescribed items (47.5% of all prescribed oral drug items) only accounted for 2,750,725,433 NTD (4.0% of expenditure for oral drugs and 2.6% of total drug expenditure). The drug market of Taiwan's NHI was abundant in cheap drugs. The unreasonably low prices of drugs might not guarantee the quality of pharmaceutical care and the sustainability of a healthy pharmaceutical industry in the long run. PMID:24719568

  12. Drugs cheaper than threepenny: the market of extremely low-priced drugs within the National Health Insurance in Taiwan.

    PubMed

    Wang, Bih-Ru; Chou, Chia-Lin; Hsu, Chia-Chen; Chou, Yueh-Ching; Chen, Tzeng-Ji; Chou, Li-Fang

    2014-01-01

    While most drug policy researches paid attention to the financial impact of expensive drugs, the market situation of low-priced drugs in a country was seldom analyzed. We used the nationally representative claims datasets to explore the status within the National Health Insurance (NHI) in Taiwan. In 2007, a total of 12,443 distinct drug items had been prescribed 853,250,147 times with total expenditure of 105,216,950,198 new Taiwan dollars (NTD). Among them, 7,366 oral drug items accounted for 701,353,383 prescribed items and 68,133,988,960 NTD. Besides, 2,887 items (39.2% of oral drug items) belonged to cheap drugs with the unit price ≤ 1 NTD (about 0.03 of US dollar). While the top one item among all oral drugs had already a market share of 5.0%, 30 items 30.3% and 107 items 50.0%, the cheap drugs with aggregate 332,893,462 prescribed items (47.5% of all prescribed oral drug items) only accounted for 2,750,725,433 NTD (4.0% of expenditure for oral drugs and 2.6% of total drug expenditure). The drug market of Taiwan's NHI was abundant in cheap drugs. The unreasonably low prices of drugs might not guarantee the quality of pharmaceutical care and the sustainability of a healthy pharmaceutical industry in the long run.

  13. Validity of EQ-5D in general population of Taiwan: results of the 2009 National Health Interview and Drug Abuse Survey of Taiwan.

    PubMed

    Yu, Sheng-Tsung; Chang, Hsing-Yi; Yao, Kai-Ping; Lin, Yu-Hsuan; Hurng, Baai-Shyun

    2015-10-01

    The aim of this study was to examine the validity of the EuroQOL five dimensions questionnaire (EQ-5D) using a nationally representative data from the National Health Interview Survey (NHIS) through comparison with short-form 36 (SF-36). Data for this study came from the 2009 NHIS in Taiwan. The study sample was the 4007 participants aged 20-64 years who completed the survey. We used SUDAAN 10.0 (SAS-Callable) to carry out weighed estimation and statistical inference. The EQ index was estimated using norm values from a Taiwanese study as well as from Japan and the United Kingdom (UK). The SF-36 score was standardized using American norm values. In terms of concurrent validity, the EQ-5D met the five hypotheses. The results did not fulfill hypothesis that women would have lower visual analogue scale (EQ-VAS) scores. In terms of discriminant validity, the EQ-5D fulfilled two hypotheses. Our results approached but did not fulfill hypothesis that there would be a weak association between the physical and psychological dimensions of the EQ-5D and the mental component summary score of the SF-36. Results were comparable regardless of whether the Japanese or UK norm value sets were used. We were able to fulfill many, not all of our validity hypotheses regardless of whether the established Japanese or UK norm value sets or the Taiwanese norm values were used. The EQ-5D is an effective and simple instrument for assessing health-related quality of life of general population in Taiwan.

  14. Preliminary physician and pharmacist survey of the National Health Insurance PharmaCloud system in Taiwan.

    PubMed

    Tseng, Yu-Ting; Chang, Elizabeth H; Kuo, Li-Na; Shen, Wan-Chen; Bai, Kuan-Jen; Wang, Chih-Chi; Chen, Hsiang-Yin

    2017-10-01

    The PharmaCloud system, a cloud-based medication system, was launched by the Taiwan National Health Insurance Administration (NHIA) in 2013 to integrate patients' medication lists among different medical institutions. The aim of the preliminary study was to evaluate satisfaction with this system among physicians and pharmacists at the early stage of system implementation. A questionnaire was developed through a review of the literature and discussion in 6 focus groups to understand the level of satisfaction, attitudes, and intentions of physicians and pharmacists using the PharmaCloud system. It was then administered nationally in Taiwan in July to September 2015. Descriptive statistics and multiple regression were performed to identify variables influencing satisfaction and intention to use the system. In total, 895 pharmacist and 105 physician questionnaires were valid for analysis. The results showed that satisfaction with system quality warranted improvement. Positive attitudes toward medication reconciliation among physicians and pharmacists, which were significant predictors of the intention to use the system (β= 0.223, p < 0.001). Most physicians and pharmacists agreed that obtaining signed patient consent was needed but preferred that it be conducted by the NHIA rather than by individual medical institutions (4.02 ± 1.19 vs. 3.49 ± 1.40, p < 0.01). The preliminary study results indicated a moderate satisfaction toward the PharmaCloud system. Hospital pharmacists had a high satisfaction rate, but neither are physicians and community pharmacists. Continuously improvement on system quality has been performing based on the results of this preliminary survey. Policies and standardization processes, including privacy protection, are still warranted further actions to make the Taiwan PharmaCloud system a convenient platform for medication reconciliation. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. The effect of Taiwan's national health insurance on mortality of the elderly: revisited.

    PubMed

    Chang, Simon

    2012-11-01

    A recent paper estimates the effects of Taiwan's National Health Insurance (NHI) on the elderly and concludes that NHI greatly increased the medical care utilization of the elderly but did not reduce their mortality. Using more recent and more accurate mortality data of the same group of elderly, this note re-estimates the NHI effect on mortality and finds that the mortality hazard of the previously uninsured elderly in the post-NHI period was on average 24% lower than it would have been in the absence of NHI. However, the NHI effect on the mortality hazard is only evident in the first 6 years following the enactment of NHI, suggesting that it may be difficult to undo the damage caused by the lack of insurance in early life. Copyright © 2011 John Wiley & Sons, Ltd.

  16. Building a national electronic medical record exchange system - experiences in Taiwan.

    PubMed

    Li, Yu-Chuan Jack; Yen, Ju-Chuan; Chiu, Wen-Ta; Jian, Wen-Shan; Syed-Abdul, Shabbir; Hsu, Min-Huei

    2015-08-01

    There are currently 501 hospitals and about 20,000 clinics in Taiwan. The National Health Insurance (NHI) system, which is operated by the NHI Administration, uses a single-payer system and covers 99.9% of the nation's total population of 23,000,000. Taiwan's NHI provides people with a high degree of freedom in choosing their medical care options. However, there is the potential concern that the available medical resources will be overused. The number of doctor consultations per person per year is about 15. Duplication of laboratory tests and prescriptions are not rare either. Building an electronic medical record exchange system is a good method of solving these problems and of improving continuity in health care. In November 2009, Taiwan's Executive Yuan passed the 'Plan for accelerating the implementation of electronic medical record systems in medical institutions' (2010-2012; a 3-year plan). According to this plan, a patient can, at any hospital in Taiwan, by using his/her health insurance IC card and physician's medical professional IC card, upon signing a written agreement, retrieve all important medical records for the past 6 months from other participating hospitals. The focus of this plan is to establish the National Electronic Medical Record Exchange Centre (EEC). A hospital's information system will be connected to the EEC through an electronic medical record (EMR) gateway. The hospital will convert the medical records for the past 6 months in its EMR system into standardized files and save them on the EMR gateway. The most important functions of the EEC are to generate an index of all the XML files on the EMR gateways of all hospitals, and to provide search and retrieval services for hospitals and clinics. The EEC provides four standard inter-institution EMR retrieval services covering medical imaging reports, laboratory test reports, discharge summaries, and outpatient records. In this system, we adopted the Health Level 7 (HL7) Clinical Document

  17. The effect of cigarette price increase on the cigarette consumption in Taiwan: evidence from the National Health Interview Surveys on cigarette consumption

    PubMed Central

    Lee, Jie-Min; Hwang, Tsorng-Chyi; Ye, Chun-Yuan; Chen, Sheng-Hong

    2004-01-01

    Background This study uses cigarette price elasticity to evaluate the effect of a new excise tax increase on cigarette consumption and to investigate responses from various types of smokers. Methods Our sample consisted of current smokers between 17 and 69 years old interviewed during an annual face-to-face survey conducted by Taiwan National Health Research Institutes between 2000 to 2003. We used Ordinary Least Squares (OLS) procedure to estimate double logarithmic function of cigarette demand and cigarette price elasticity. Results In 2002, after Taiwan had enacted the new tax scheme, cigarette price elasticity in Taiwan was found to be -0.5274. The new tax scheme brought about an average annual 13.27 packs/person (10.5%) reduction in cigarette consumption. Using the cigarette price elasticity estimate from -0.309 in 2003, we calculated that if the Health and Welfare Tax were increased by another NT$ 3 per pack and cigarette producers shifted this increase to the consumers, cigarette consumption would be reduced by 2.47 packs/person (2.2%). The value of the estimated cigarette price elasticity is smaller than one, meaning that the tax will not only reduce cigarette consumption but it will also generate additional tax revenues. Male smokers who had no income or who smoked light cigarettes were found to be more responsive to changes in cigarette price. Conclusions An additional tax added to the cost of cigarettes would bring about a reduction in cigarette consumption and increased tax revenues. It would also help reduce incidents smoking-related illnesses. The additional tax revenues generated by the tax increase could be used to offset the current financial deficiency of Taiwan's National Health Insurance program and provide better public services. PMID:15598345

  18. Prescriptions of Chinese herbal medicine for constipation under the national health insurance in Taiwan.

    PubMed

    Jong, Maw-Shiou; Hwang, Shinn-Jang; Chen, Yu-Chun; Chen, Tzeng-Ji; Chen, Fun-Jou; Chen, Fang-Pey

    2010-07-01

    Constipation is a common gastrointestinal problem worldwide. The aim of this study was to determine the frequency of use and prescriptive patterns of Chinese herbal medicine (CHM) in treating constipation by analyzing the claims data of traditional Chinese medicine (TCM) from the National Health Insurance (NHI) in Taiwan. The computerized claims dataset of the TCM office visits and the corresponding prescription files in 2004 compiled by the NHI Research Institute in Taiwan were linked and processed. Visit files with the single diagnostic coding of constipation (ICD-9-CM code 564.0) were extracted to analyze the frequency and pattern of corresponding CHM prescriptions. The association rule was applied to analyze the co-prescription of CHM in treating constipation. There were 152,564 subjects who visited TCM clinics only for constipation in Taiwan during 2004 and received a total of 387,268 CHM prescriptions. Subjects between 20 and 29 years of age comprised the largest number of those treated (25.5%). Female subjects used CHM for constipation more frequently than male subjects (female:male = 3.31:1). There was an average of 4.6 items of single Chinese herbs or formula in a single prescription for constipation. Ma-zi-renwan was the most commonly prescribed herbal formula, while Da-huang (Rheum palmatum) was the most commonly used single Chinese herb. According to the association rule, the most common prescribed pattern of 2-drug combination of CHM for treating constipation was Ban-xia-xie-xin-tang plus Ma-zi-ren-wan, while the 3-drug combination of CHM was Fang-feng-tong-sheng-san, Rheum palmatum and Ma-zi-ren-wan. This study showed the pattern of single Chinese herbs or herbal formulae used in treating constipation in Taiwan. Further clinical trials are needed to evaluate the efficacy and safety of these CHMs in treating constipation. 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

  19. Ophthalmic plastic and orbital surgery in Taiwan.

    PubMed

    Hsu, Chi-Hsin; Lin, I-Chan; Shen, Yun-Dun; Hsu, Wen-Ming

    2014-06-01

    We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery. Copyright © 2014. Published by Elsevier B.V.

  20. Health care satisfaction among foreign residents in Taiwan - An assessment and improvement.

    PubMed

    Kumar, Ajit; Maskara, Sanjeev; Chiang, I-Jen

    2014-01-21

    In 2012, almost half-million foreigners (2.3% of the total population) from 160 countries were estimated to live in Taiwan. In 2010, approximately eighty-seven percent of the population expressed high satisfaction in the national health care system of Taiwan. However, satisfaction level among foreign residents towards the Taiwanese health care system has not been clearly documented in the literature.OBJECTIVE: In this study, we assessed satisfaction level among foreign residents for receiving healthcare facility in Taiwanese hospital. In addition, the study came out with some potential solutions to improve health care received by them. Human-Centered Design (HCD) approach was deployed, which included three phases: observation, pattern recognition, and ideation and delivery. Each phase involved various steps. Techniques, such as ethnography, interview, discussion, and survey were used in accomplishing various steps within each phase. Four participants and two facilitators from Taiwan took part in the study. The study revealed various stories, insights, and themes about the health care received by the foreigners in Taiwan. In addition, some potential solutions and immediate available opportunities were recommended to improve their health care. The results provided a deeper understanding into the satisfaction level among foreign residents in Taiwan. For instance, this study pointed out the need to improve English proficiency of hospital's administrative staffs because a lack of English language proficiencies was found to be a major barrier in delivering quality health care to foreign residents. Therefore, adoption of various training modalities, such as English training using mobile device based games, role-play, and hospital's workflow depiction using English posters were recommended.

  1. Health care satisfaction among foreign residents in Taiwan--an assessment and improvement.

    PubMed

    Kumar, Ajit; Maskara, Sanjeev; Chiang, I-Jen

    2014-01-01

    In 2012, almost half-million foreigners (2.3% of the total population) from 160 countries were estimated to live in Taiwan. In 2010, approximately eighty-seven percent of the population expressed high satisfaction in the national health care system of Taiwan. However, satisfaction level among foreign residents towards the Taiwanese health care system has not been clearly documented in the literature. In this study, we assessed satisfaction level among foreign residents for receiving healthcare facility in Taiwanese hospital. In addition, the study came out with some potential solutions to improve health care received by them. Human-Centered Design (HCD) approach was deployed, which included three phases: observation, pattern recognition, and ideation and delivery. Each phase involved various steps. Techniques, such as ethnography, interview, discussion, and survey were used in accomplishing various steps within each phase. Four participants and two facilitators from Taiwan took part in the study. The study revealed various stories, insights, and themes about the health care received by the foreigners in Taiwan. In addition, some potential solutions and immediate available opportunities were recommended to improve their health care. The results provided a deeper understanding into the satisfaction level among foreign residents in Taiwan. For instance, this study pointed out the need to improve English proficiency of hospital's administrative staffs because a lack of English language proficiencies was found to be a major barrier in delivering quality health care to foreign residents. Therefore, adoption of various training modalities, such as English training using mobile device based games, role-play, and hospital's workflow depiction using English posters were recommended.

  2. National Program for e-Learning in Taiwan

    ERIC Educational Resources Information Center

    Chang, Maiga; Wang, Chin-Yeh; Chen, Gwo-Dong

    2009-01-01

    Taiwan government has initiated a five-year program since 2002: the National Science and Technology Program for e-Learning. The national program started from 2003 and was completed at the end of year 2007, involving thirteen government agencies. This paper describes the results that the national program has accomplished at its first phase, 2003 to…

  3. Predictors of Internet use for health information among male and female Internet users: Findings from the 2009 Taiwan National Health Interview Survey.

    PubMed

    Koo, Malcolm; Lu, Ming-Chi; Lin, Shih-Chun

    2016-10-01

    The Internet is an increasingly important source of health information for the general population. Both preventive health behavior and Internet use are known to be different between men and women. However, few studies have compared predictors of Internet use for health information between the sexes. To investigate the prevalence and predictors of Internet use for health information among male and female adult Internet users using data from a population-based survey in Taiwan. Respondents between the ages of 20-65 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome variable of the study, the utilization of the Internet for health information, was ascertained by asking whether the respondent had ever used the Internet to search for health information or obtain health services. Univariate and multivariate logistic regression analyses were conducted separately for men and women to evaluate factors associated with the use of Internet for health information. Of the 2741 adults aged 20-65 years who had ever used the Internet, 1766 (64.4%) of them had used it for health information or services. Multivariate logistic regression analyses showed that a higher educational level (adjusted odds ratio [AOR]=3.60, P<0.001), living alone (AOR=1.77, P=0.019), had exercised in the past two weeks (AOR=2.41, P<0.001), residing in city or urban district (AOR=1.28, P=0.049), with a perceived health status of extremely good, very good, or good (AOR=1.34, P=0.022), and had used Western medicine services in the past month (AOR=1.51, P=0.005) were significantly associated with health information use in male Internet users. On the other hand, age between 20-44.9 years (AOR=1.87, P<0.001), a higher educational level (AOR=3.57, P<0.001), being married (AOR=1.68, P=0.001), had exercised in the past two weeks (AOR=1.56, P<0.001), and had a mean monthly personal income of NT$ 20,000 and above were significant factors in female Internet users

  4. Chinese herbal prescriptions for osteoarthritis in Taiwan: analysis of national health insurance dataset

    PubMed Central

    2014-01-01

    Background Chinese herbal medicine (CHM) has been commonly used for treating osteoarthritis in Asia for centuries. This study aimed to conduct a large-scale pharmaco-epidemiologic study and evaluate the frequency and patterns of CHM used in treating osteoarthritis in Taiwan. Methods A complete database (total 22,520,776 beneficiaries) of traditional Chinese medicine (TCM) outpatient claims offered by the National Health Insurance program in Taiwan for the year 2002 was employed for this research. Patients with osteoarthritis were identified according to the diagnostic code of the International Classification of Disease among claimed visiting files. Corresponding prescription files were analyzed, and an association rule was applied to evaluate the co-prescription of CHM for treating osteoarthritis. Results There were 20,059 subjects who visited TCM clinics for osteoarthritis and received a total of 32,050 CHM prescriptions. Subjects between 40 and 49 years of age comprised the largest number of those treated (19.2%), followed by 50-59 years (18.8%) and 60-69 years group (18.2%). In addition, female subjects used CHMs for osteoarthritis more frequently than male subjects (female: male = 1.89: l). There was an average of 5.2 items prescribed in the form of either an individual Chinese herb or formula in a single CHM prescription for osteoarthritis. Du-zhong (Eucommia bark) was the most commonly prescribed Chinese single herb, while Du-huo-ji-sheng-tang was the most commonly prescribed Chinese herbal formula for osteoarthritis. According to the association rule, the most commonly prescribed formula was Du-huo-ji-sheng-tang plus Shen-tong-zhu-yu-tang, and the most commonly prescribed triple-drug combination was Du-huo-ji-sheng-tang, Gu-sui-pu (Drynaria fortune (Kunze) J. Sm.), and Xu-Duan (Himalaya teasel). Nevertheless, further clinical trials are needed to evaluate the efficacy and safety of these CHMs for treating osteoarthritis. Conclusions This study

  5. Is a diabetes pay-for-performance program cost-effective under the National Health Insurance in Taiwan?

    PubMed

    Tan, Elise Chia-Hui; Pwu, Raoh-Fang; Chen, Duan-Rung; Yang, Ming-Chin

    2014-03-01

    In October 2001, a pay-for-performance (P4P) program for diabetes was implemented by the National Health Insurance (NHI), a single-payer program, in Taiwan. However, only limited information is available regarding the influence of this program on the patient's health-related quality of life. The aim of this study was to estimate the costs and consequences of enrolling patients in the P4P program from a single-payer perspective. A retrospective observational study of 529 diabetic patients was conducted between 2004 and 2005. The data used in the study were obtained from the National Health Interview Survey (NHIS) in Taiwan. Direct cost data were obtained from NHI claims data, which were linked to respondents in the NHIS using scrambled individual identification. The generic SF36 health instrument was employed to measure the quality-of-life-related health status and transformed into a utility index. Patients enrolled in the P4P program for at least 3 months were categorized as the P4P group. Following propensity score matching, 260 patients were included in the study. Outcomes included life-years, quality-adjusted life-years (QALYs), diabetes-related medical costs, overall medical costs, and incremental cost-effectiveness ratios (ICERs). A single-payer perspective was assumed, and costs were expressed in US dollars. Nonparametric bootstrapping was conducted to estimate confidence intervals for cost-effectiveness ratios. Following matching, no significant difference was noted between two groups with regard to the patients' age, gender, education, family income, smoking status, BMI, or whether insulin was used. The P4P group had an increase of 0.08 (95 % CI 0.077-0.080) in QALYs, and the additional diabetes-related medical cost was US$422.74 (95 % CI US$413.58-US$435.05), yielding an ICER of US$5413.93 (95 % CI US$5226.83-US$5562.97) per QALY gained. Our results provides decision makers with valuable information regarding the impact of the P4P program of diabetes care

  6. Vertical equity of healthcare in Taiwan: health services were distributed according to need.

    PubMed

    Wang, Shiow-Ing; Yaung, Chih-Liang

    2013-01-31

    To test the hypothesis that the distribution of healthcare services is according to health need can be achieved under a rather open access system. The 2001 National Health Interview Survey of Taiwan and National Health Insurance claims data were linked in the study. Health need was defined by self-perceived health status. We used Concentration index to measure need-related inequality in healthcare utilization and expenditure. People with greater health need received more healthcare services, indicating a pro-need character of healthcare distribution, conforming to the meaning of vertical equity. For outpatient service, subjects with the highest health need had higher proportion of ever use in a year than those who had the least health need and consumed more outpatient visits and expenditures per person per year. Similar patterns were observed for emergency services and hospitalization. The concentration indices of utilization for outpatient, emergency services, and hospitalization suggest that the distribution of utilization was related to health need, whereas the preventive service was less related to need. The universal coverage plus healthcare networking system makes it possible for healthcare to be utilized according to need. Taiwan's experience can serve as a reference for health reform.

  7. Cancer Incidence in Physicians: A Taiwan National Population-based Cohort Study.

    PubMed

    Lee, Yu-Sung; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

    2015-11-01

    Cancer has been the leading cause of death in Taiwan since 1982. Physicians have many health-related risk factors which may contribute to cancer, such as rotating night shift, radiation, poor lifestyle, and higher exposure risk to infection and potential carcinogenic drugs. However, the cancer risk in physicians is not clear. In Taiwan's National Health Insurance Research Database, we identified 14,889 physicians as the study cohort and randomly selected 29,778 nonmedical staff patients as the comparison cohort for this national population-based cohort study. Cox proportional-hazard regression was used to compare the cancer risk between physicians and comparisons. Physician subgroups were also analyzed. Physicians had a lower all-cancer risk than did the comparisons (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.76-0.97). In the sex-based analysis, male physicians had a lower all-cancer risk than did male comparisons (HR 0.82, 95% CI 0.73-0.94); and female physicians did not (HR 1.29, 95% CI 0.88-1.91). In the cancer-type analysis, male physicians had a higher risk of prostate cancer (HR 1.72, 95% CI 1.12-2.65) and female physicians had twice the risk of breast cancer (HR 2.00, 95% CI 1.11-3.62) than did comparisons. Cancer risk was not significantly associated with physician specialties. Physicians in Taiwan had a lower all-cancer risk but higher risks for prostate and breast cancer than did the general population. These new epidemiological findings require additional study to clarify possible mechanisms.

  8. Estimating the Economic Burden of Rheumatoid Arthritis in Taiwan Using the National Health Insurance Database.

    PubMed

    Wang, Bruce C M; Hsu, Ping-Ning; Furnback, Wesley; Ney, John; Yang, Ya-Wen; Fang, Chi-Hui; Tang, Chao-Hsiun

    2016-03-01

    Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and destruction of the joints. This research aims to estimate the economic burden of RA in Taiwan. The National Health Insurance Research Database (NHIRD), a claims-based dataset encompassing 99 % of Taiwan's population, was applied. We used a micro-costing approach for direct healthcare costs and indirect social costs by estimating the quantities and prices of cost categories. Direct costs included surgeries, hospitalizations, medical devices and materials, laboratory tests, and drugs. The costs and quantities of the direct economic burden were calculated based on 2011 data of NHIRD. We identified RA patients and a control cohort matched 1:4 on demographic and clinical covariates to calculate the incremental cost related to RA. Indirect costs were evaluated by missed work (absenteeism) and worker productivity (presenteeism). For the indirect burden, we estimated the rate of absenteeism and presenteeism from a patient survey. Costs were presented in US dollars (US$1 = 30 TWD). A total of 41,269 RA patients were included in the database with incremental total direct cost of US$86,413,971 and indirect cost of US$138,492,987. This resulted in an average incremental direct cost of US$2050 per RA patient. Within direct costs, the largest burdens were associated with drugs (US$73,028,944), laboratory tests (US$6,132,395), and hospitalizations (US$3,208,559). For indirect costs, absenteeism costs and presenteeism costs were US$16,059,681 and US$114,291,687, respectively. The economic burden of RA in Taiwan is driven by indirect healthcare costs, most notably presenteeism.

  9. Estimating the Economic Burden of Rheumatoid Arthritis in Taiwan Using the National Health Insurance Database.

    PubMed

    Wang, Bruce C M; Hsu, Ping-Ning; Furnback, Wesley; Ney, John; Yang, Ya-Wen; Fang, Chi-Hui; Tang, Chao-Hsiun

    Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and destruction of the joints. This research aims to estimate the economic burden of RA in Taiwan. The National Health Insurance Research Database (NHIRD), a claims-based dataset encompassing 99 % of Taiwan's population, was applied. We used a micro-costing approach for direct healthcare costs and indirect social costs by estimating the quantities and prices of cost categories. Direct costs included surgeries, hospitalizations, medical devices and materials, laboratory tests, and drugs. The costs and quantities of the direct economic burden were calculated based on 2011 data of NHIRD. We identified RA patients and a control cohort matched 1:4 on demographic and clinical covariates to calculate the incremental cost related to RA. Indirect costs were evaluated by missed work (absenteeism) and worker productivity (presenteeism). For the indirect burden, we estimated the rate of absenteeism and presenteeism from a patient survey. Costs were presented in US dollars (US$1 = 30 TWD). A total of 41,269 RA patients were included in the database with incremental total direct cost of US$86,413,971 and indirect cost of US$138,492,987. This resulted in an average incremental direct cost of US$2050 per RA patient. Within direct costs, the largest burdens were associated with drugs (US$73,028,944), laboratory tests (US$6,132,395), and hospitalizations (US$3,208,559). For indirect costs, absenteeism costs and presenteeism costs were US$16,059,681 and US$114,291,687, respectively. The economic burden of RA in Taiwan is driven by indirect healthcare costs, most notably presenteeism.

  10. The epidemiology and burden of Alzheimer’s disease in Taiwan utilizing data from the National Health Insurance Research Database

    PubMed Central

    Hung, Yen-Ni; Kadziola, Zbigniew; Brnabic, Alan JM; Yeh, Ju-Fen; Fuh, Jong-Ling; Hwang, Jen-Ping; Montgomery, William

    2016-01-01

    Purpose The objectives of this study were to estimate the incidence, cumulative incidence, and economic burden of Alzheimer’s disease (AD) in Taiwan, using data from the National Health Insurance Research Database (NHIRD). Materials and methods This was a retrospective, longitudinal, observational study using data from the Longitudinal Health Insurance Database of the NHIRD. Patients were included in this study if they were 50 years of age or older and their records included a primary or secondary diagnosis of AD. New patients who met inclusion criteria were followed up longitudinally from 2005 to 2010. Costs were calculated for the first year following the diagnosis of AD. Results Overall, a higher percentage of women than men were diagnosed with AD (54% vs 46%, respectively). The first AD diagnosis occurred most frequently in the age of 75–84 years. The person-year incidence rate increased from 5.63/1,000 persons (95% CI, 5.32–5.94) in 2005 to 8.17/1,000 persons (95% CI, 7.78–8.57) in 2010. The cumulative incidence rate was 33.54/1,000 persons (95% CI, 32.76–34.33) in 2005–2010. The total mean inflated annual costs per patient in new Taiwan dollars (NT$) in the first year of diagnosis ranged from NT$205,413 (2009) to NT$227,110 (2005), with hospitalization representing the largest component. Conclusion AD represents a substantial burden in Taiwan, and based on the observed increase in incidence rate over time, it is likely that this burden will continue to increase. The findings reported here are consistent with previous research. The NHIRD contains extensive real-world information that can be used to conduct research, allowing us to expand our understanding of the incidence, prevalence, and burden of disease in Taiwan. PMID:27536149

  11. [Nursing manpower and solutions in Taiwan].

    PubMed

    Teng, Su-Wen

    2014-04-01

    The shortage of nursing manpower is a long-term problem worldwide that affects Taiwan despite this country's internationally admired achievements in terms of its healthcare and national health insurance systems. This article reviews discussions related to the nursing shortage issue published by the World Health Organization, International Council of Nurses, and Taiwan Ministry of Health and Welfare. Next, an overview is given of the nursing workforce profile, causal factors behind the nursing shortage, and demand for and supply of nursing manpower. Finally, problems, resolutions, and expected outcomes for the nursing shortage in Taiwan are analyzed.

  12. Use and disclosure of health information and protection of patient privacy in Taiwan.

    PubMed

    Liu, Han-Hsi

    2010-03-01

    This paper examines Taiwan's current regulatory system for the use of healthcare information from the viewpoint of patient privacy protection. The author proposes a patient-centered, cooperative system centered on the "traffic light theory", as a solution to the potential conflict between the use of healthcare information and the protection of patient privacy. Taiwan, a country with a national healthcare insurance program and state-of-the-art electronic technology, takes a distinctive approach to the protection of patient privacy. On January 1st, 2004, the Bureau of National Health Insurance (BNHI) implemented a comprehensive embedded integrated circuit (IC) card, which puts the wide-ranging health information of its 22 million beneficiaries online to facilitate review of use and disclosure. It is well understood that healthcare information is of a personal and sensitive nature, demanding stringent privacy protection. Nevertheless, there is no denying the potential benefit of using personal health information (PHI) to achieve public good, especially in the area of cost containment. The comprehensive e-health system in Taiwan greatly facilitates copying, transmission, and use of PHI, but does the regulatory system provide enough safeguards for patient privacy? Because the law in Taiwan does not provide clear standards for the use and disclosure of healthcare information, healthcare providers are either too conservative or too aggressive. While most healthcare providers keep their oath of confidentiality, some rogue members severely abuse patient privacy. This paper proposes a "traffic-light system" to remedy this situation. Flashing yellow lights allow aggressive drivers to ignore others, while causing overly cautious drivers to be too hesitant. The author contends that clear standards should have been established for healthcare providers. Like car drivers, healthcare providers need red and green traffic signals. The law should indicate, through workable privacy

  13. Does the universal health insurance program affect urban-rural differences in health service utilization among the elderly? Evidence from a longitudinal study in taiwan.

    PubMed

    Liao, Pei-An; Chang, Hung-Hao; Yang, Fang-An

    2012-01-01

    To assess the impact of the introduction of Taiwan's National Health Insurance (NHI) on urban-rural inequality in health service utilization among the elderly. A longitudinal data set of 1,504 individuals aged 65 and older was constructed from the Survey of Health and Living Status of the Elderly. A difference-in-differences model was employed and estimated by the random-effect probit method. The introduction of universal NHI in Taiwan heterogeneously affected outpatient and inpatient health service utilization among the elderly in urban and rural areas. The introduction of NHI reduced the disparity of outpatient (inpatient) utilization between the previously uninsured and insured older urban residents by 12.9 (22.0) percentage points. However, there was no significant reduction in the utilization disparity between the previously uninsured and insured elderly among rural residents. Our study on Taiwan's experience should provide a valuable lesson to countries that are in an initial stage of proposing a universal health insurance system. Although NHI is designed to ensure the equitable right to access health care, it may result in differential impacts on health service utilization among the elderly across areas. The rural elderly tend to confront more challenges in accessing health care associated with spatial distance, transportation, social isolation, poverty, and a lack of health care providers, especially medical specialists. © 2011 National Rural Health Association.

  14. Burden experienced by community health volunteers in Taiwan: a survey

    PubMed Central

    2013-01-01

    Background Volunteers in Taiwan complement the delivery of health services by paid health professionals. However, in doing so, community health volunteers experience burdens associated with their activities. The reasons for these burdens and degree to which they are experienced are explored in this paper. Our study adds to international research regarding the burden experienced by volunteers. This project is the first to assess how community health volunteers in Taiwan experience burden. Methods The 20 item Burden on Community Health Volunteer (BCHV) instrument, specifically designed for this project, was administered to 435 volunteers attached to Community Health Promotion Development Centres in northern Taiwan. Results The overall burden experienced by volunteers is relatively low. However, a multivariate adjusted regression analysis revealed significant differences in volunteer burden depending on the number of people each volunteer served on average per week, as well as the volunteer’s marital status and their perceptions about personal health. Volunteers who served many people and who perceived their own health as poor experienced a higher level of burden. Those who were a widow or a widower felt less burdened than others. Conclusions The results of the study identify areas where burden is high and where strategies can be developed to reduce the level of burden experienced by community health volunteers in Taiwan. Community health volunteers in Taiwan complement the role of nurses and other health care providers so their retention is important to ongoing service delivery. PMID:23687966

  15. Heterogeneous impact of Taiwan's national health insurance on labor force participation of married women by income and family structures.

    PubMed

    Liao, Pei-An

    2011-02-01

    In this study, I investigate how the impact of the National Health Insurance (NHI) introduction in Taiwan in 1995 on the labor force participation (LFP) decisions of married women varies with income and family structures. Employing the difference-in-differences (DID) approach, I find that the NHI introduction reduced LFP of married women in the twenty-fifth to fiftieth percentiles of the income distribution between 17.8 and 21.7 percentage points (33%-40%). The difference-in-differences-in-differences (DIDID) results suggest that married women in different family structures (the presence of children under 3 or less healthy elderly household members) did not respond differently to the NHI introduction.

  16. Taiwan's Travel and Border Health Measures in Response to Zika.

    PubMed

    Ho, Li-Li; Tsai, Yu-Hui; Lee, Wang-Ping; Liao, Szu-Tsai; Wu, Li-Gin; Wu, Yi-Chun

    Zika virus has recently emerged as a worldwide public health concern. Travel and border health measures stand as one of the main strategies and frontline defenses in responding to international epidemics. As of October 31, 2016, Taiwan has reported 13 imported cases, 5 of which were detected through routine entry screening and active monitoring at international airports. This article shares Taiwan's disease surveillance activities at designated points of entry and travel and border health measures in response to Zika. The Taiwan government collaborates with its tourism industry to disseminate information about precautionary measures and encourages tour guides to report suspected individuals or events to activate early response measures. Taiwan also engages in vector control activities at points of entry, including targeting aircraft from countries where vector-borne diseases are endemic, implementing mosquito sweep measures, and collecting vector surveillance data. In future emerging and reemerging disease events, entry surveillance at designated points of entry may enable early detection of diseases of international origin and more rapid activation of public health preparedness activities and international collaboration. Taiwan will continue to maximize border and travel health measures in compliance with IHR (2005) requirements, which rely on continued risk assessment, practical implementation activities, and engagement with all stakeholders.

  17. Taiwan's Travel and Border Health Measures in Response to Zika

    PubMed Central

    Ho, Li-Li; Tsai, Yu-Hui; Lee, Wang-Ping; Liao, Szu-Tsai; Wu, Li-Gin

    2017-01-01

    Zika virus has recently emerged as a worldwide public health concern. Travel and border health measures stand as one of the main strategies and frontline defenses in responding to international epidemics. As of October 31, 2016, Taiwan has reported 13 imported cases, 5 of which were detected through routine entry screening and active monitoring at international airports. This article shares Taiwan's disease surveillance activities at designated points of entry and travel and border health measures in response to Zika. The Taiwan government collaborates with its tourism industry to disseminate information about precautionary measures and encourages tour guides to report suspected individuals or events to activate early response measures. Taiwan also engages in vector control activities at points of entry, including targeting aircraft from countries where vector-borne diseases are endemic, implementing mosquito sweep measures, and collecting vector surveillance data. In future emerging and reemerging disease events, entry surveillance at designated points of entry may enable early detection of diseases of international origin and more rapid activation of public health preparedness activities and international collaboration. Taiwan will continue to maximize border and travel health measures in compliance with IHR (2005) requirements, which rely on continued risk assessment, practical implementation activities, and engagement with all stakeholders. PMID:28418744

  18. Health-promoting educational settings in Taiwan: development and evaluation of the Health-Promoting School Accreditation System.

    PubMed

    Chen, Fu-Li; Lee, Albert

    2016-03-01

    The Taiwan Ministry of Health and Welfare and Ministry of Education launched the Health-Promoting School (HPS) program in 2002. One of the most significant barriers to evaluating HPS is the absence of adequate instruments. The main aim of this study is to develop the Taiwan Health-Promoting School Accreditation System (HPSAS) framework and then evaluate its accreditation effectiveness. The HPSAS accreditation standards were derived mainly from the World Health Organization (WHO) publication, WHO Health Promoting Schools: A Framework for Action in 2008 and the Taiwan School Health Act. Delphi technique and pilot test were used to confirm the availability and acceptability of the standards and procedures for HPSAS in 2011. After that, two rounds of school evaluations were completed in 2012 (214 participant schools) and 2014 (182 participant schools). The accreditation operation process included documentary reviews, national and international accredited commissioners conducted on-site visits. Descriptive analyses were used to indicate HPS award level distribution. The study established six key HPSAS standards. Each standard had at least two components; overall, there were 21 components and 47 scoring elements. Of the participating schools evaluated in 2012, four were at the gold, 14 silver, and 120 bronze levels, compared with five, 20, and 31, respectively, of schools evaluated in 2014. The study showed that schools at different award levels had different full-score rates in six standards. The schools at the gold level performed exceptionally well. The worst performance among the six standards at each award level was in the skill-based health curriculum. The HPSAS is an objective instrument used to evaluate the process and outcomes of the HPS program. In the future, combinations of different types of data (e.g. students' health behaviors, school climate, or teachers' health-teaching innovations) will enable further validation of the HPS effectiveness. © The Author

  19. Study of basic computer competence among public health nurses in Taiwan.

    PubMed

    Yang, Kuei-Feng; Yu, Shu; Lin, Ming-Sheng; Hsu, Chia-Ling

    2004-03-01

    Rapid advances in information technology and media have made distance learning on the Internet possible. This new model of learning allows greater efficiency and flexibility in knowledge acquisition. Since basic computer competence is a prerequisite for this new learning model, this study was conducted to examine the basic computer competence of public health nurses in Taiwan and explore factors influencing computer competence. A national cross-sectional randomized study was conducted with 329 public health nurses. A questionnaire was used to collect data and was delivered by mail. Results indicate that basic computer competence of public health nurses in Taiwan is still needs to be improved (mean = 57.57 +- 2.83, total score range from 26-130). Among the five most frequently used software programs, nurses were most knowledgeable about Word and least knowledgeable about PowerPoint. Stepwise multiple regression analysis revealed eight variables (weekly number of hours spent online at home, weekly amount of time spent online at work, weekly frequency of computer use at work, previous computer training, computer at workplace and Internet access, job position, education level, and age) that significantly influenced computer competence, which accounted for 39.0 % of the variance. In conclusion, greater computer competence, broader educational programs regarding computer technology, and a greater emphasis on computers at work are necessary to increase the usefulness of distance learning via the Internet in Taiwan. Building a user-friendly environment is important in developing this new media model of learning for the future.

  20. Examining the types and payments of the disabilities of the insurants in the National Farmers' Health Insurance program in Taiwan.

    PubMed

    Wang, Jiun-Hao; Chang, Hung-Hao

    2010-10-26

    In contrast to the considerable body of literature concerning the disabilities of the general population, little information exists pertaining to the disabilities of the farm population. Focusing on the disability issue to the insurants in the Farmers' Health Insurance (FHI) program in Taiwan, this paper examines the associations among socio-demographic characteristics, insured factors, and the introduction of the national health insurance program, as well as the types and payments of disabilities among the insurants. A unique dataset containing 1,594,439 insurants in 2008 was used in this research. A logistic regression model was estimated for the likelihood of received disability payments. By focusing on the recipients, a disability payment and a disability type equation were estimated using the ordinary least squares method and a multinomial logistic model, respectively, to investigate the effects of the exogenous factors on their received payments and the likelihood of having different types of disabilities. Age and different job categories are significantly associated with the likelihood of receiving disability payments. Compared to those under age 45, the likelihood is higher among recipients aged 85 and above (the odds ratio is 8.04). Compared to hired workers, the odds ratios for self-employed and spouses of farm operators who were not members of farmers' associations are 0.97 and 0.85, respectively. In addition, older insurants are more likely to have eye problems; few differences in disability types are related to insured job categories. Results indicate that older farmers are more likely to receive disability payments, but the likelihood is not much different among insurants of various job categories. Among all of the selected types of disability, a highest likelihood is found for eye disability. In addition, the introduction of the national health insurance program decreases the likelihood of receiving disability payments. The experience in Taiwan can

  1. Lifetime risks, loss of life expectancy, and health care expenditures for 19 types of cancer in Taiwan

    PubMed Central

    Wu, Tzu-Yi; Chung, Chia-Hua; Lin, Chia-Ni; Hwang, Jing-Shiang; Wang, Jung-Der

    2018-01-01

    Background The mortality rates for different cancers are no longer an efficient tool for making national policy. The purpose of this study were to quantify the lifetime risks, life expectancies (LEs) after diagnosis, expected years of life lost (EYLL), and lifetime health care expenditures for 19 major cancers in Taiwan. Methods A total of 831,314 patients with 19 pathologically proven cancers were abstracted from the Taiwan Cancer Registry from 1998 to 2012. They were linked to the National Mortality Registry (1998–2014) and National Health Insurance reimbursement database (1998–2013) for survival and health care costs. We estimated the cumulative incidence rate for ages 0–79 years and the lifetime survival function for patients with different cancer sites. The EYLL was calculated by subtracting the LE of each cancer cohort from that of the age- and sex-matched referents simulated from national life tables. The estimated lifetime cost was calculated by adding up the product of survival probability and mean cost at the corresponding duration-to-date after adjustment for the inflation to the year of 2013. Results There were 5 cancers with a lifetime risk exceeding 4%: colorectal, liver, lung, and prostate in males, and breast and colorectal in females. Cancers with EYLL of >10 years were: esophageal, intrahepatic bile ducts, liver, pancreas, oral, nasopharyngeal, leukemia, lung, and gallbladder, extrahepatic bile ducts and biliary tract in males, and intrahepatic bile ducts, pancreas, nasopharyngeal, lung, esophageal, leukemia, liver, gallbladder, extrahepatic bile ducts and biliary tract, ovary, and stomach in females. Cancers with lifetime health care expenditures exceeding US$50,000 to the National Health Insurance were as follows: leukemia, kidney, testis, renal pelvis and ureter in males, and renal pelvis and ureter, leukemia, breast, urinary bladder, kidney, ovary, and nasopharyngeal in females. All these impacts should be considered in health policy

  2. Does the Universal Health Insurance Program Affect Urban-Rural Differences in Health Service Utilization among the Elderly? Evidence from a Longitudinal Study in Taiwan

    ERIC Educational Resources Information Center

    Liao, Pei-An; Chang, Hung-Hao; Yang, Fang-An

    2012-01-01

    Purpose: To assess the impact of the introduction of Taiwan's National Health Insurance (NHI) on urban-rural inequality in health service utilization among the elderly. Methods: A longitudinal data set of 1,504 individuals aged 65 and older was constructed from the Survey of Health and Living Status of the Elderly. A difference-in-differences…

  3. Utilizing Health Information Technology to Support Universal Healthcare Delivery: Experience of a National Healthcare System.

    PubMed

    Syed-Abdul, Shabbir; Hsu, Min-Huei; Iqbal, Usman; Scholl, Jeremiah; Huang, Chih-Wei; Nguyen, Phung Anh; Lee, Peisan; García-Romero, Maria Teresa; Li, Yu-Chuan Jack; Jian, Wen-Shan

    2015-09-01

    Recent discussions have focused on using health information technology (HIT) to support goals related to universal healthcare delivery. These discussions have generally not reflected on the experience of countries with a large amount of experience using HIT to support universal healthcare on a national level. HIT was compared globally by using data from the Ministry of the Interior, Republic of China (Taiwan). Taiwan has been providing universal healthcare since 1995 and began to strategically implement HIT on a national level at that time. Today the national-level HIT system is more extensive in Taiwan than in many other countries and is used to aid administration, clinical care, and public health. The experience of Taiwan thus can provide an illustration of how HIT can be used to support universal healthcare delivery. In this article we present an overview of some key historical developments and successes in the adoption of HIT in Taiwan over a 17-year period, as well as some more recent developments. We use this experience to offer some strategic perspectives on how it can aid in the adoption of large-scale HIT systems and on how HIT can be used to support universal healthcare delivery.

  4. Prescriptions of traditional Chinese medicine, western medicine, and integrated Chinese-Western medicine for allergic rhinitis under the National Health Insurance in Taiwan.

    PubMed

    Huang, Sheng-Kang; Ho, Yu-Ling; Chang, Yuan-Shiun

    2015-09-15

    Allergic rhinitis has long been a worldwide health problem with a global growth trend. The use of traditional Chinese medicines alone or integrated Chinese-Western medicines for its treatment is quite common in Taiwan. Respiratory diseases account for the majority of outpatient traditional Chinese medicine treatment, while allergic rhinitis accounts for the majority of respiratory diseases. We hereby conduct a comparative analysis between traditional Chinese medicine treatments and western medicine treatments for allergic rhinitis in Taiwan. The results of the analysis on the prescription difference of traditional Chinese medicine and western medicine treatments would be helpful to clinical guide and health policy decision making of ethnopharmacological therapy. Patients diagnosed as allergic rhinitis with diagnostic code 470-478 (ICD-9-CM) were selected as subjects from 2009-2010 National Health Insurance Research Database based on the claim data from the nationwide National Health Insurance in Taiwan. This retrospective study used Chi-Square test to test the effects of gender and age on visit of traditional Chinese medicine, western medicine, and integrated Chinese-Western medicine treatments. A total of 45,804 patients diagnosed as allergic rhinitis with ICD-9-CM 470-478 were identified from 2009-2010 NHIRD. There were 36,874 subjects for western medicine treatment alone, 5829 subjects for traditional Chinese medicine treatment alone, and 3101 subjects for integrated Chinese-Western medicine treatment. Female patients were more than male in three treatments. 0-9 years children had the highest visit frequency in western medicine and integrated Chinese-Western medicine groups, while 10-19 years young-age rank the highest in traditional Chinese medicine group. The Chi-square test of independence showed that the effects of gender and age on visit of three treatments were significant. The prescription drugs of western medicine treatment alone were almost for

  5. The limits of global health diplomacy: Taiwan's observer status at the world health assembly.

    PubMed

    Herington, Jonathan; Lee, Kelley

    2014-10-01

    In 2009, health authorities from Taiwan (under the name "Chinese Taipei")a formally attended the 62nd World Health Assembly (WHA) of the World Health Organization as observers, marking the country's participation for the first time since 1972. The long process of negotiating this breakthrough has been cited as an example of successful global health diplomacy. This paper analyses this negotiation process, drawing on government documents, formal representations from both sides of the Taiwan Strait, and key informant interviews. The actors and their motivations, along with the forums, practices and outcomes of the negotiation process, are detailed. While it is argued that non-traditional diplomatic action was important in establishing the case for Taiwan's inclusion at the WHA, traditional concerns regarding Taiwanese sovereignty and diplomatic representation ultimately played a decisive role. The persistent influence of these traditional diplomatic questions illustrates the limits of global health diplomacy.

  6. The prescribing of Chinese herbal products in Taiwan: a cross-sectional analysis of the national health insurance reimbursement database.

    PubMed

    Hsieh, Shu-Ching; Lai, Jung-Nien; Lee, Chuan-Fang; Hu, Fu-Chang; Tseng, Wei-Lum; Wang, Jung-Der

    2008-06-01

    The consumption of Chinese herbal products (CHPs) is increasing exponentially. However, the scientific evidence is lacking and there is an urgent requirement for detailed pharmacoepidemiological information on CHP usage. This study was to investigate CHP prescription patterns in Taiwan. We carried out a cross-sectional analysis on a cohort of 200,000 patients based on 2004 data from the National Health Insurance (NHI) reimbursement database. Data mining techniques were applied to explore CHP co-prescription patterns. A total of 46,938 patients had been prescribed CHPs on at least one occasion in 2004. Patients using CHPs were generally female and middle-aged, made more outpatient visits, had fewer hospitalizations and consumed more medical resources than non-users of CHPs. A total of 1,073,030 CHPs were contained within 220,123 prescriptions, for which acute nasopharyngitis was the most common indication. Yan hu suo and Jia Wei Xiao Yao San were the most frequently prescribed single herb (SH) and herbal formula (HF), respectively. The results of the data mining showed that the best predictions were provided by co-prescriptions of 'Mo yao and Ru xiang', 'Ye jiao teng and Suan Zao Ren Tan' and 'Dang Gui Nian Tong Tang and Shu Jing Huo Xue Tang' in the groups of SH-SH, SH-HF and HF-HF, respectively. This study provides national-level CHP prescription profiles and utilization rates, and documents, for the first time, HF-HF prescription combinations in Chinese medicine (CM) practices in Taiwan. We conclude that more studies are needed to validate the safety and effectiveness of CHP prescriptions.

  7. The Mother Tongues as Second Languages: Nationalism, Democracy and Multilingual Education in Taiwan

    ERIC Educational Resources Information Center

    Dupré, Jean-François

    2014-01-01

    After nearly half a century of authoritarianism characterized by Chinese nationalism and Mandarin promotion, democratization in 1990s Taiwan was accompanied by a Taiwanization movement featuring calls for the revitalization of local languages and the promotion of linguistic equality. To that end, the government began planning for local language…

  8. Examining visitors' behavioral intentions and behaviors in a Taiwan National Park

    Treesearch

    Chieh-Lu Li; Garry E. Chick

    2011-01-01

    In 2007-2008, some visitors to Taroko National Park in Taiwan were surveyed to allow testing of a behavioral prediction model in the context of national park recreation. This model includes three constructs: values (a cultural anthropology factor), perceptions of service quality (service marketing factors), and perceptions of crowding (a national park recreation factor...

  9. Changes in hormone therapy prescriptions among middle-aged women in Taiwan: implications for health needs at menopause.

    PubMed

    Wu, Chao-Yuan; Wu, Shiow-Lan; Lin, Shio-Jean; Chu, Cordia Ming-Yeuk

    2011-01-01

    From the 1990s until 2002, hormone therapy (HT) was a popular treatment for menopausal syndrome in middle-aged women. Since the Women's Health Initiatives (WHI) studies in 2002 warned that the risk of HT might exceed its benefits, there has been a reduction in its use worldwide, including in Taiwan. Many studies reported this decline, but few discussed whether HT may or may not fulfill menopausal women's health needs. This study examines the changes in HT prescriptions and other measures by menopausal women in Taiwan and the implications of these changes in relation to their needs. This study analyzes annual and monthly rates of HT prescription and outpatient care utilization among Taiwanese women in the 45- to 64-year-old age group. It is based on medical claims data of the Taiwan National Health Insurance Programs from 2000 to 2004. The data showed that HT was the prevailing treatment for menopausal syndrome before the WHI publications. The rate of HT prescription increased annually, peaking in 2001 at 21.6%, but declined from 2002 to 9.7% in 2004. At the same time, the number of Taiwanese women seeking traditional Chinese medicine for the menopausal syndrome increased. HT prescriptions in Taiwan declined significantly after the WHI reports, demonstrating the elasticity of the need for HT. But utilization data in Taiwan showed that attendance at outpatient clinics at menopause remained constant and the use of traditional Chinese medicine increased. Further studies should investigate health needs from menopausal women's perspectives to develop appropriate measures to meet their needs. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  10. Medical education in Taiwan.

    PubMed

    Chou, Jen-Yu; Chiu, Chiung-Hsuan; Lai, Enoch; Tsai, Duujian; Tzeng, Chii-Ruey

    2012-01-01

    Taiwan's medical education system bears a close relationship with its colonial and post-colonial history. Since the late nineteenth century, Western medicine, Chinese medicine, and the practice of the other forms of traditional healing have encountered complex transactions with the state and one another, eventually evolving into the present medical system. Nowadays, the mainstream form of medical education in Taiwan is a 7-year Western program; other forms of medical education include a 5-year graduate program and traditional medicine programs. Challenged by the National Health Insurance that emphasizes cost management since 1995 and criticized by the US National Committee on Foreign Medical Education and Accreditation in 1998, medical education reform was implemented by the Taiwan Medical Accreditation Council established in 2000. The reform tries to bring humanities into various aspects of medical education, including student recruitment, curriculum, licensing, and continuing education. Similar to other modernization projects, the reform transplants the American and British standards to Taiwan. These changes hope to insure the reflective capabilities in physicians on the welfare of patients. However, frustration of current and future physicians may be deepened if the reform is insensitive to local issues or incapable of addressing new global tendencies.

  11. Has cost containment after the National Health Insurance system been successful? Determinants of Taiwan hospital costs.

    PubMed

    Hung, Jung-Hua; Chang, Li

    2008-03-01

    Taiwan implemented the National Health Insurance system (NHI) in 1995. After the NHI, the insurance coverage expanded and the quality of healthcare improved, however, the healthcare costs significantly escalated. The objective of this study is to determine what factors have direct impact on the increased costs after the NHI. Panel data analysis is used to investigate changes and factors affecting cost containment at Taipei municipal hospitals from 1990 to 2001. The results show that the expansion of insured healthcare coverage (especially to the elderly and the treatment of more complicated types of diseases), and the increased competition (requiring the growth of new technology and the longer average length of stay) are important driving forces behind the increase of hospital costs, directly influenced by the advent of the NHI. Therefore, policymakers should emphasize health prevention activities and disease management programs for the elderly to improve cost containment. In addition, hospital managers should find ways to improve the hospital efficiency (shorten the LOS) to reduce excess services and medical waste. They also need to better understand their market position and acquire suitable new-tech equipment earlier, to be a leader, not a follower. Finally, policymakers should establish related benchmark indices for what drivers up hospital costs (micro-aspect) and to control healthcare expenditures (macro-level).

  12. Pyogenic Liver Abscess as Endemic Disease, Taiwan

    PubMed Central

    Tsai, Feng-Chiao; Huang, Yu-Tsung; Chang, Luan-Yin

    2008-01-01

    Pyogenic liver abscess has become a health problem in Taiwanese society. However, the extent of this problem has remained unclear because of the lack of a population-based study. We therefore performed a nationwide analysis of pyogenic liver abscess in Taiwan from 1996 through 2004. We analyzed 29,703 cases from the Taiwan National Health Insurance database and 506 cases from National Taiwan University Hospital. Our analysis showed that the annual incidence of pyogenic liver abscess increased steadily from 11.15/100,000 population in 1996 to 17.59/100,000 in 2004. Diabetes, malignancy, renal disease, and pneumonia were associated with a higher risk for the disease. By contrast, death due to pyogenic liver abscess decreased over time, although population-based abscess-related death increased slightly. Renal disease, malignancy, pneumonia, and heart disease correlated with higher death rates; Klebsiella pneumoniae infection and therapeutic procedures were related to lower death rates. Diabetes did not significantly change death rates for the 506 patients from the hospital. PMID:18826824

  13. Variations in the persistence of health expenditures and the implications for the design of capitation payments in Taiwan.

    PubMed

    Ku, Li-Jung Elizabeth; Chiou, Meng-Jiun; Liu, Li-Fan

    2015-07-01

    The National Health Insurance (NHI) system in Taiwan launched a trial capitation provider payment programme in 2011, with the capitation formula based on patients' average NHI expenditure in the previous year. This study seeks to examine the concentration and persistence of health care expenditure among the elderly, and to assess the performance of the current capitation formula in predicting future high-cost users. This study analysed NHI expenditures for a nationally representative sample of people aged 65 years and over who took part in Taiwan's National Health Interview Survey, 2005. Expenditure concentration was assessed by the proportion of NHI expenditures attributable to four groups by expenditure percentile. Four transition probability matrixes examined changes in a person's position in the expenditure percentiles and generalized estimation equation models were estimated to identify significant predictors of a patient being in the top 10% of users. Between 2005 and 2009, the top 10% of users on average accounted for 55% of total NHI expenditures. Of the top 10% in 2005, 39% retained this position in 2006. However, expenditure persistence was the highest (77%) among the bottom 50% of users. NHI expenditure percentiles in both the baseline year and the prior year, and chronic conditions all significantly predicted future high expenditures. The model including chronic conditions performed better in predicting the top 10% of users (c-statistics increased from 0.772 to 0.904) than the model without. Given the increase in predictive ability, adding chronic conditions and baseline health care use data to Taiwan's capitation payment formula would correctly identify more high users. © The Author(s) 2015.

  14. Completeness and timeliness of tuberculosis notification in Taiwan

    PubMed Central

    2011-01-01

    Tuberculosis (TB) is a notifiable disease by the Communicable Disease Control Law in Taiwan. Several measures have been undertaken to improve reporting of TB but the completeness and timeliness of TB notification in Taiwan has not yet been systemically evaluated. Methods To assess completeness and timeliness of TB notification, potential TB cases diagnosed by health care facilities in the year 2005-2007 were identified using the reimbursement database of national health insurance (NHI), which has 99% population coverage in Taiwan. Potential TB patients required notification were defined as those who have TB-related ICD-9 codes (010-018) in the NHI reimbursement database in 2005-2007, who were not diagnosed with TB in previous year, and who have been prescribed with 2 or more types of anti-TB drugs. Each potential TB case was matched to the national TB registry maintained at Taiwan Centers for Disease Control (CDC) by using national identity number or, if non-citizen, passport number to determine whether the patients had been notified to local public health authorities and Taiwan CDC. The difference in the number of days between date of anti-tuberculosis treatment and date of notification was calculated to determine the timeliness of TB reporting. Results Of the 57,405 TB patients who were prescribed with 2 or more anti-tuberculosis drugs, 55,291 (96.3%) were notified to National TB Registry and 2,114 (3.7%) were not. Of the 55,291 notified cases, 45,250 (81.8%) were notified within 7 days of anti-tuberculosis treatment (timely reporting) and 10,041(18.2%) after 7 days (delayed reporting). Factors significantly associated with failure of notification are younger age, previously notified cases, foreigner, those who visited clinics and those who visited health care facilities only once or twice in 6 months. Conclusion A small proportion of TB cases were not notified and a substantial proportion of notified TB cases had delayed reporting, findings with implication for

  15. Disparity in Autism Spectrum Disorder Prevalence among Taiwan National Health Insurance Enrollees: Age, Gender and Urbanization Effects

    ERIC Educational Resources Information Center

    Hsu, Shang-Wei; Chiang, Po-Huang; Lin, Lam-Ping; Lin, Jin-Ding

    2012-01-01

    The present study aims to characterize the prevalence of autism spectrum disorders (ASDs) in Taiwan while examining the effects of age, gender, and urbanization on ASD occurrence. A cross-sectional study was conducted to analyze data from 895,639 random health insurance claimants who claimed medical services in the year 2007. Autism was defined…

  16. Social Capital and Health Inequality: Evidence from Taiwan

    ERIC Educational Resources Information Center

    Song, Lijun; Lin, Nan

    2009-01-01

    Does social capital, resources embedded in social relationships, influence health? This research examines whether social capital impacts depressive symptoms and overall perceived health status over and above the effects of social support. Our analyses use unique data from the Taiwan Social Change Survey collected in 1997, and measures social…

  17. Prescription profile of potentially aristolochic acid containing Chinese herbal products: an analysis of National Health Insurance data in Taiwan between 1997 and 2003.

    PubMed

    Hsieh, Shu-Ching; Lin, I-Hsin; Tseng, Wei-Lum; Lee, Chang-Hsing; Wang, Jung-Der

    2008-10-23

    Some Chinese herbal products (CHPs) may contain aristolochic acid (AA) or may be adulterated by the herbs suspected of containing AA which is nephrotoxic and carcinogenic. This study aims to identify the risk and the prescription profile of AA-containing CHPs (AA-CHPs) in Taiwan. A longitudinal analysis was conducted on a randomly sampled cohort of 200,000 patients using the data from the National Health Insurance (NHI) in Taiwan between 1997 and 2003. During the 7-year study period, 78,644 patients were prescribed with AA-CHPs; most patients were females, or middle-aged, or both. A total of 526,867 prescriptions were made to use 1,218 licensed AA-CHPs. Over 85% of the AA-exposed patients took less than 60 g of AA-herbs; however, about 7% were exposed to a cumulated dose of over 100 g of Radix et Rhizoma Asari (Xixin), Caulis Akebiae (Mutong) or Fructus Aristolochiae (Madouling). Patients of respiratory and musculoskeletal diseases received most of the AA-CHP prescriptions. The most frequently prescribed AA-CHPs Shujing Huoxie Tang, Chuanqiong Chadiao San and Longdan Xiegan Tang, containing Radix Stephaniae Tetrandrae, Radix et Rhizoma Asari and Caulis Akebiae, respectively. About one-third of people in Taiwan have been prescribed with AA-CHPs between 1997 and 2003. Although the cumulated doses were not large, further actions should be carried out to ensure the safe use of AA-CHPs.

  18. Prescription profile of potentially aristolochic acid containing Chinese herbal products: an analysis of National Health Insurance data in Taiwan between 1997 and 2003

    PubMed Central

    Hsieh, Shu-Ching; Lin, I-Hsin; Tseng, Wei-Lum; Lee, Chang-Hsing; Wang, Jung-Der

    2008-01-01

    Background Some Chinese herbal products (CHPs) may contain aristolochic acid (AA) or may be adulterated by the herbs suspected of containing AA which is nephrotoxic and carcinogenic. This study aims to identify the risk and the prescription profile of AA-containing CHPs (AA-CHPs) in Taiwan. Methods A longitudinal analysis was conducted on a randomly sampled cohort of 200,000 patients using the data from the National Health Insurance (NHI) in Taiwan between 1997 and 2003. Results During the 7-year study period, 78,644 patients were prescribed with AA-CHPs; most patients were females, or middle-aged, or both. A total of 526,867 prescriptions were made to use 1,218 licensed AA-CHPs. Over 85% of the AA-exposed patients took less than 60 g of AA-herbs; however, about 7% were exposed to a cumulated dose of over 100 g of Radix et Rhizoma Asari (Xixin), Caulis Akebiae (Mutong) or Fructus Aristolochiae (Madouling). Patients of respiratory and musculoskeletal diseases received most of the AA-CHP prescriptions. The most frequently prescribed AA-CHPs Shujing Huoxie Tang, Chuanqiong Chadiao San and Longdan Xiegan Tang, containing Radix Stephaniae Tetrandrae, Radix et Rhizoma Asari and Caulis Akebiae, respectively. Conclusion About one-third of people in Taiwan have been prescribed with AA-CHPs between 1997 and 2003. Although the cumulated doses were not large, further actions should be carried out to ensure the safe use of AA-CHPs. PMID:18945373

  19. Health risk perception and betel chewing behavior--the evidence from Taiwan.

    PubMed

    Chen, Chiang-Ming; Chang, Kuo-Liang; Lin, Lin; Lee, Jwo-Leun

    2013-11-01

    In this study, we provided an empirical examination of the interaction between people's health risk perception and betel chewing. We hypothesized that a better knowledge of possible health risks would reduce both the number of individuals who currently chew betel and the likelihood of those who do not yet chew betel to begin the habit. We constructed a simultaneous equation model with Bayesian two-stage approach to control the endogeneity between betel chewing and risk perception. Using a national survey of 26,684 observations in Taiwan, our study results indicated that better health knowledge reduced the possibility that people would become betel chewers. We also found that, in general, betel chewers have a poorer health risk perception than other population. Overall, the empirical evidence suggested that health authorities could reduce the odds of people becoming betel chewers by improving their knowledge of betel-chewing's harmful effects. © 2013 Elsevier Ltd. All rights reserved.

  20. A national survey of psychosocial job stressors and their implications for health among working people in Taiwan.

    PubMed

    Cheng, Y; Guo, Y L; Yeh, W Y

    2001-09-01

    The prevalence of job stress, distributions of major job stressors, and the associations of job stress with multiple self-reported health complaints were examined in a national survey conducted in 1994 in Taiwan. A total of 9,746 men and 5,599 women who were employed at the time of the survey and aged between 25 and 65-years were studied. Information on employment status, perceived level of job stress, major job stressors, and health complaints were obtained by a self-administered questionnaire. Overall, 7.6% of men and 6.5% of women reported often or always feeling very stressed at work. Higher levels of perceived job stress were found among subjects who were younger, with higher education level, working in a larger firm, working for longer hours per week, and who were administrators or managers. Problems with individual job content were ranked as the most important job stressor in men across all employment categories and in most women. Other major job stressors included problems with monetary rewards and lack of career prospects. The patterns of major job stressors appear to vary by employment grade and by gender. After adjustment for age and education, employees who perceived higher levels of job stress had significantly increased risks of multiple health problems, including strained eyes, ringing ears, chronic cough with phlegm, chest tightness. stomach problems, headache, and musculoskeletal discomfort. These results suggest that psychosocial stress in the workplace has profound impacts on health. This study identified high-risk groups and major types of job stressors for further investigation.

  1. The Effect of Free Adult Preventive Care Services on Subsequent Utilization of Inpatient Services in Taiwan.

    PubMed

    Tian, Wei-Hua

    2016-07-01

    The objective of this article is to investigate the relationship between the utilization of free adult preventive care services and subsequent utilization of inpatient services among elderly people under the National Health Insurance program in Taiwan. The study used secondary data from the 2005 Taiwan National Health Interview Survey and claim data from the 2006 Taiwan National Health Insurance Research Database for the elderly aged 65 or over. A bivariate probit model was used to avoid the possible endogeneity in individuals' utilization of free adult preventive care and inpatient services. This study finds that, when individuals had utilized the preventive care services in 2005, the probability that they utilized inpatient services in 2006 was significantly reduced by 13.89%. The findings of this study may provide a good reference for policy makers to guide the efficient allocation of medical resources through the continuous promotion of free adult preventive care services under the National Health Insurance program. © Australian Council for Educational Research 2016.

  2. Frequency and pattern of Chinese herbal medicine prescriptions for urticaria in Taiwan during 2009: analysis of the national health insurance database.

    PubMed

    Chien, Pei-Shan; Tseng, Yu-Fang; Hsu, Yao-Chin; Lai, Yu-Kai; Weng, Shih-Feng

    2013-08-15

    Large-scale pharmaco-epidemiological studies of Chinese herbal medicine (CHM) for treatment of urticaria are few, even though clinical trials showed some CHM are effective. The purpose of this study was to explore the frequencies and patterns of CHM prescriptions for urticaria by analysing the population-based CHM database in Taiwan. This study was linked to and processed through the complete traditional CHM database of the National Health Insurance Research Database in Taiwan during 2009. We calculated the frequencies and patterns of CHM prescriptions used for treatment of urticaria, of which the diagnosis was defined as the single ICD-9 Code of 708. Frequent itemset mining, as applied to data mining, was used to analyse co-prescription of CHM for patients with urticaria. There were 37,386 subjects who visited traditional Chinese Medicine clinics for urticaria in Taiwan during 2009 and received a total of 95,765 CHM prescriptions. Subjects between 18 and 35 years of age comprised the largest number of those treated (32.76%). In addition, women used CHM for urticaria more frequently than men (female:male = 1.94:1). There was an average of 5.54 items prescribed in the form of either individual Chinese herbs or a formula in a single CHM prescription for urticaria. Bai-Xian-Pi (Dictamnus dasycarpus Turcz) was the most commonly prescribed single Chinese herb while Xiao-Feng San was the most commonly prescribed Chinese herbal formula. The most commonly prescribed CHM drug combination was Xiao-Feng San plus Bai-Xian-Pi while the most commonly prescribed triple drug combination was Xiao-Feng San, Bai-Xian-Pi, and Di-Fu Zi (Kochia scoparia). In view of the popularity of CHM such as Xiao-Feng San prescribed for the wind-heat pattern of urticaria in this study, a large-scale, randomized clinical trial is warranted to research their efficacy and safety.

  3. Music Education Reform in Taiwan: Beginning Music Teachers' Perceptions of Their Teacher Preparation at National Taiwan Normal University

    ERIC Educational Resources Information Center

    Lo, Ling-I.

    2014-01-01

    The purpose of this study was to investigate beginning music teachers' perceptions of their music teacher preparation at National Taiwan Normal University (NTNU) regarding the Arts and Humanities field of the Grade 1-9 Curriculum. Research questions focused on discovering the most and least effective components of undergraduate training at NTNU,…

  4. Essential components in developing public policy to control viral hepatitis: lessons from Taiwan.

    PubMed

    Wallace, Jack; Pitts, Marian; Locarnini, Stephen; Ellard, Jeanne; Carman, Marina; Chen, Ding-Shinn

    2016-03-01

    Over 500 million people are estimated to be infected with chronic viral hepatitis with an increasing burden resulting from the infections. In 2010, the World Health Organization recommended national governments develop effective strategies to reduce the global impact of viral hepatitis. Taiwan, to support the implementation of the world's first national vaccination program, developed the first of a series of 5-year national strategies in 1982. Our study sought to identify the essential constituents of the strategic response to chronic viral hepatitis in Taiwan, which could then be used by other governments to inform best practice in strategy development. Semistructured qualitative interviews were conducted with key participants involved in the national response to viral hepatitis in Taiwan (n = 26) and a review of the literature. The development of a national strategic response is one of several factors in reducing the burden of viral hepatitis in Taiwan. Other critical factors are effective health services, a prioritization of disease prevention, government funding of science and technology, and sustained advocacy informed by a rigorous evidence base. While there has been significant policy, structural and financial commitment to reduce the burden of related to viral hepatitis, essential challenges remain. Taiwan's viral hepatitis policy response focuses on clinical interventions and would be strengthened by a broader involvement of interdisciplinary stakeholders, including people with viral hepatitis, and stronger coordination between the policy and government agencies responsible for their implementation.

  5. Vertical equity of healthcare in Taiwan: health services were distributed according to need

    PubMed Central

    2013-01-01

    Introduction To test the hypothesis that the distribution of healthcare services is according to health need can be achieved under a rather open access system. Methods The 2001 National Health Interview Survey of Taiwan and National Health Insurance claims data were linked in the study. Health need was defined by self-perceived health status. We used Concentration index to measure need-related inequality in healthcare utilization and expenditure. Results People with greater health need received more healthcare services, indicating a pro-need character of healthcare distribution, conforming to the meaning of vertical equity. For outpatient service, subjects with the highest health need had higher proportion of ever use in a year than those who had the least health need and consumed more outpatient visits and expenditures per person per year. Similar patterns were observed for emergency services and hospitalization. The concentration indices of utilization for outpatient, emergency services, and hospitalization suggest that the distribution of utilization was related to health need, whereas the preventive service was less related to need. Conclusions The universal coverage plus healthcare networking system makes it possible for healthcare to be utilized according to need. Taiwan’s experience can serve as a reference for health reform. PMID:23363855

  6. The Role of Language in National and Multinational Enterprises in Taiwan.

    ERIC Educational Resources Information Center

    Du-Babcock, Bertha; Babcock, Richard D.

    Communication patterns and language use in four national and multinational companies operating in Taiwan illustrate the potential for communication problems when more than one language is in use. The companies include Texas Instruments, Kaohsiung Monomer Company, Ltd., Bank of America, and Cheng-Yia International Corporation. In the four…

  7. Rethinking Taiwanese Nationality and Subjectivity: Implications from Language Issues in Colonial Taiwan in the 1920s

    ERIC Educational Resources Information Center

    Huang, Hsuan-Yi

    2017-01-01

    This historical study reflects on history curriculum debates over the last 20 years in Taiwan. To open up possibilities for contemporary Taiwanese to rethink themselves in terms of national culture and subjectivity, this paper explores the construction of Taiwanese subjectivity in the past. It focuses on the history of Taiwan under Japanese…

  8. Roles of General Practitioners in the Provision of Health Care Services for People with Intellectual Disabilities: A National Census in Taiwan

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Hsu, Shang-Wei; Yen, Chia-Feng; Chou, Ying-Ting; Wu, Chia-Ling; Chu, Cordia M.; Loh, Ching-Hui

    2009-01-01

    Aims: The aims of the present study were to explore the perceptions of general practitioners (GPs) in the provision of health care services for people with intellectual disabilities and to analyse GPs' priorities in the delivery of health care services to this group of people in Taiwan. Methods: The study employed a cross-sectional design and was…

  9. Accountability, utilization and providers for diabetes management in Taiwan, 2000-2009: an analysis of the National Health Insurance database.

    PubMed

    Chang, Tien-Jyun; Jiang, Yi-Der; Chang, Chia-Hsiun; Chung, Ching-Hu; Yu, Neng-Chun; Chuang, Lee-Ming

    2012-11-01

    The prevalence of diabetes has increased worldwide. To obtain nationwide data on accountability and utilization of health resources among diabetes patients in Taiwan, an analysis of the claims data for the National Health Insurance (NHI) from 2000 to 2009 was conducted. One-third of the NHI claims database was randomly sampled from 2000 to 2009. Diabetes was defined by three or more outpatient visits with diagnostic codes [International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM): 250 or A code: A181] within 1 year, or one inpatient discharge diagnosis. Accountability items and NHI codes of various metabolic parameters and examinations were identified. Medical utilization was measured by the frequency and cost of care associated with ambulatory visits, hospitalizations, and emergency care within each year. The annual check-up frequency for various examinations significantly increased from 2000 to 2009. Both the average outpatient department (OPD) cost per diabetes patient/year and the average inpatient department (IPD) cost per time increased 1.34-fold in the past decade. The average OPD cost per diabetes patient and average IPD cost of each admission for diabetes patients was four times and 1.4 times compare with the general population, respectively. The annual average medical cost of each diabetes patient affected with both micro- and macrovascular complications was four times compared with those without vascular complications. There was an increasing trend for diabetes patients to visit regional hospital for OPD and IPD, whereas visits to the local hospital decreased in the past decade. Due to the increased frequency of annual check-ups after various examinations, the quality of diabetes management has improved in the past decade in Taiwan. As diabetes patients affected with both micro- and macrovascular complications incurred costs four times compared with those without complications, it is worth screening high-risk individuals to

  10. Utilization of rehabilitation services for inpatient with cancer in Taiwan: a descriptive analysis from national health insurance database.

    PubMed

    Lin, Heui-Fen; Wu, Ying-Tai; Tsauo, Jau-Yih

    2012-08-16

    Cancer is a major cause of global morbidity and mortality. Since a high prevalence of functional impairments has been observed among cancer patients, rehabilitation has been proposed as a strategy to restore patients' functional independence. The increasing number of cancer patients combined with a growing need for rehabilitation may result in increased utilization of rehabilitation services. This study aimed to investigate the utilization of rehabilitation services among hospitalized cancer patients in Taiwan between 2004 and 2008. Annual admissions and total inpatient expenditures for admissions with a cancer diagnosis were calculated from the National Health Insurance Research Database (NHIRD). Rehabilitation services used by cancer and non-cancer patients, as well as the distributions of rehabilitation service type among the different hospital departments were also analyzed. The percentages of inpatient admissions with a cancer diagnosis increased from 14.01% to 17.1% between 2004 and 2008. During 2004, 5.25% of all inpatient admissions received rehabilitation services; this percentage increased to 5.62% by 2008. Among cancer admissions, 2.26% to 2.62% received rehabilitation services from 2004 to 2008. By comparison, 5.68% to 6.24% of non-cancer admissions received rehabilitation services during this period. Of the admissions who received rehabilitation services, only 6.44% and 7.96% had a cancer diagnosis in 2004 and 2008, respectively. Sixty-one percent of rehabilitation services were delivered in the departments of orthopedics (25.6%), neurology (14.4%), rehabilitation (11.9%), and neurosurgery (9.2%). In Taiwan, the utilization of rehabilitation services during hospitalization increased from 2004 to 2008. Although this trend was noted for cancer and non-cancer admissions, the utilization of rehabilitation services was generally greater by non-cancer admissions. Despite the benefits of rehabilitation, the actual rehabilitation needs of cancer patients

  11. Utilization of rehabilitation services for inpatient with cancer in Taiwan: a descriptive analysis from national health insurance database

    PubMed Central

    2012-01-01

    Background Cancer is a major cause of global morbidity and mortality. Since a high prevalence of functional impairments has been observed among cancer patients, rehabilitation has been proposed as a strategy to restore patients’ functional independence. The increasing number of cancer patients combined with a growing need for rehabilitation may result in increased utilization of rehabilitation services. This study aimed to investigate the utilization of rehabilitation services among hospitalized cancer patients in Taiwan between 2004 and 2008. Methods Annual admissions and total inpatient expenditures for admissions with a cancer diagnosis were calculated from the National Health Insurance Research Database (NHIRD). Rehabilitation services used by cancer and non-cancer patients, as well as the distributions of rehabilitation service type among the different hospital departments were also analyzed. Results The percentages of inpatient admissions with a cancer diagnosis increased from 14.01% to 17.1% between 2004 and 2008. During 2004, 5.25% of all inpatient admissions received rehabilitation services; this percentage increased to 5.62% by 2008. Among cancer admissions, 2.26% to 2.62% received rehabilitation services from 2004 to 2008. By comparison, 5.68% to 6.24% of non-cancer admissions received rehabilitation services during this period. Of the admissions who received rehabilitation services, only 6.44% and 7.96% had a cancer diagnosis in 2004 and 2008, respectively. Sixty-one percent of rehabilitation services were delivered in the departments of orthopedics (25.6%), neurology (14.4%), rehabilitation (11.9%), and neurosurgery (9.2%). Conclusions In Taiwan, the utilization of rehabilitation services during hospitalization increased from 2004 to 2008. Although this trend was noted for cancer and non-cancer admissions, the utilization of rehabilitation services was generally greater by non-cancer admissions. Despite the benefits of rehabilitation, the actual

  12. Evaluation of the Health-Promoting School Supporting Network in Taiwan

    ERIC Educational Resources Information Center

    Liao, Li-Ling; Liu, Chieh-Hsing; Chang, Fong-Ching; Cheng, Chi-Chia J.; Niu, Yu-Zhen; Chang, Tzu-Chau

    2015-01-01

    Background: Taiwan has advocated health-promoting schools (HPS) since 2001 and established the Health-Promoting School Supporting Network (HPSSN) in 2005 to offer administrative support and consultation. Respondents' opinions about HPSSN and the relationship between these perceptions and HPS implementation were examined. Methods: In 2011, 800…

  13. Growth References of Preschool Children Based on the Taiwan Birth Cohort Study and Compared to World Health Organization Growth Standards.

    PubMed

    Li, Yi-Fan; Lin, Shio-Jean; Lin, Kuan-Chia; Chiang, Tung-Liang

    2016-02-01

    To develop new growth references for height, weight, and body mass index (BMI) for children aged 0-5 years in the Taiwan Birth Cohort Study (TBCS) and to compare these references with both 1997 Taiwan references and World Health Organization (WHO) standards. Data were obtained from the TBCS of a nationally representative sample of 24,200 children. A total of 18,466 children completed the baseline survey at 6 months of age and three follow-up surveys at 18 months, 3 years, and 5.5 years of age. The modified LMS method was used to construct percentile curves by sex, including length/height for age, weight for age, and BMI for age. TBCS children of both sexes were shorter and lighter at birth compared with 1997 Taiwan references and WHO standards. The growth patterns of TBCS children were close to those of the 1997 Taiwan references after 6 months of age. Compared with WHO standards, however, TBCS children were heavier after 6 months of age. This study has developed TBCS references to monitor the growth of children in Taiwan, whose weight growth patterns differed from those "prescribed" by WHO standards. Copyright © 2016. Published by Elsevier B.V.

  14. The impact of occupational health service network and reporting system in Taiwan.

    PubMed

    Chu, Po-Ching; Fuh, Hwan-Ran; Luo, Jiin-Chyuan; Du, Chung-Li; Chuang, Hung-Yi; Guo, How-Ran; Liu, Chiu-Shong; Su, Chien-Tien; Tang, Feng-Cheng; Chen, Chun-Chieh; Yang, Hsiao-Yu; Guo, Yue Leon

    2013-01-01

    Underreporting occupational disease cases has been a long-standing problem in Taiwan, which hinders the progress in occupational health and safety. To address this problem, the government has founded the Network of Occupational Diseases and Injuries Service (NODIS) for occupational disease and injury services and established a new Internet-based reporting system. The aims of this study are to analyze the possible influence of the NODIS, comprised of Center for Occupational Disease and Injury Services and their local network hospitals, on compensable occupational diseases and describe the distribution of occupational diseases across occupations and industries from 2005 to 2010 in Taiwan. We conducted a secondary analysis of two datasets, including the NODIS reporting dataset and the National Labor Insurance scheme's dataset of compensated cases. For the NODIS dataset, demographics, disease distribution, and the time trends of occupational diseases were analyzed. The data of the Labor Insurance dataset was used to calculate the annual incidence of compensated cases. Furthermore, the annual incidence of reported occupational diseases from the NODIS was further compared with the annual incidence of compensable occupational diseases from the compensated dataset during the same period. After the establishment of the NODIS, the two annual incidence rates of reported and compensable occupational disease cases have increased by 1.2 and 2.0 folds from 2007 to 2010, respectively. The reason for this increased reporting may be the implementation of the new government-funded Internet-based system. The reason for the increased compensable cases may be the increasing availability of hospitals and clinics to provide occupational health services. During the 2008-2010 period, the most frequently reported occupational diseases were carpal tunnel syndrome, lumbar disc disorder, upper limb musculoskeletal disorders, and contact dermatitis. The new network and reporting system was

  15. A Scheme for "The Window of Taiwan National Park"

    NASA Astrophysics Data System (ADS)

    Tang, E. Y.-F.

    2015-08-01

    There are nine distinguished national parks in Taiwan. Each one has its own wild variety of natural inhabitants and cultural resources. However, due to the geographical inaccessibility, partially closed by natural disaster, or under the restrict protection by the authority, most of the places are difficult to reach for the public, not to mention for the disabled people. Therefore, a scheme, with the cutting edge technology, comprising the essences of all nine national parks in a space located in one of the national parks which is more convenient with public transportation system is presented. The idea is to open a window in the hope to offer a platform for better and easy understanding the features of all national parks, to increase the accessibility for disabled people, and to provide advanced services for the public. Recently, the progressing of digital image technology becomes more and more promising. Using mutual interactive ways and game-liked formation to promote the participation of visitors to gain learning experiences is now becoming a mainstream for exhibition in visitor centers and museums around the world. The method of the motion-sensing interactive exhibition has personalized feature which is programmed to store visitor's behaviors and become smarter in response with visitor in order to make each person feel that they are playing in a game. It involves scenarios, concepts and visitors' participation in the exhibition design to form an interactive flow among human, exhibits, and space. It is highly attractive and low barrier for young, senior and disabled people, and for the case of no physical objects to exhibit, visual technology is a way of solution. This paper presents the features and difficulties of national parks in Taiwan. Visitors' behavior and several cases have been investigated and analysed to find a suitable way for combining all the features of national parks in an exhibition. However, it should be noticed that this is not an alternative

  16. Governmental Disability Welfare Expenditure and National Economic Growth from 1991 to 2006 in Taiwan

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Lin, Lan-Ping

    2009-01-01

    The purposes of the present study were to describe the welfare expenditure for people with disabilities and examine its relation to national economic growth from 1991 to 2006 in Taiwan. We analyzed data mainly from the information of population with disabilities, disability welfare expenditure and national economic growth and gross national…

  17. The Impact of Graphic Cigarette Warning Labels and Smoke-Free Law on Health Awareness and Thoughts of Quitting in Taiwan

    ERIC Educational Resources Information Center

    Chang, Fong-Ching; Chung, Chi-Hui; Yu, Po-Tswen; Chao, Kun-yu

    2011-01-01

    The present study evaluated the impact of Taiwan's graphic cigarette warning labels and smoke-free law on awareness of the health hazards of smoking and thoughts of quitting smoking. National representative samples of 1074 and 1094 people, respectively, were conducted successfully by telephone in July 2008 (pre-law) and March 2009 (post-law).…

  18. Frequency and pattern of Chinese herbal medicine prescriptions for urticaria in Taiwan during 2009: analysis of the national health insurance database

    PubMed Central

    2013-01-01

    Background Large-scale pharmaco-epidemiological studies of Chinese herbal medicine (CHM) for treatment of urticaria are few, even though clinical trials showed some CHM are effective. The purpose of this study was to explore the frequencies and patterns of CHM prescriptions for urticaria by analysing the population-based CHM database in Taiwan. Methods This study was linked to and processed through the complete traditional CHM database of the National Health Insurance Research Database in Taiwan during 2009. We calculated the frequencies and patterns of CHM prescriptions used for treatment of urticaria, of which the diagnosis was defined as the single ICD-9 Code of 708. Frequent itemset mining, as applied to data mining, was used to analyse co-prescription of CHM for patients with urticaria. Results There were 37,386 subjects who visited traditional Chinese Medicine clinics for urticaria in Taiwan during 2009 and received a total of 95,765 CHM prescriptions. Subjects between 18 and 35 years of age comprised the largest number of those treated (32.76%). In addition, women used CHM for urticaria more frequently than men (female:male = 1.94:1). There was an average of 5.54 items prescribed in the form of either individual Chinese herbs or a formula in a single CHM prescription for urticaria. Bai-Xian-Pi (Dictamnus dasycarpus Turcz) was the most commonly prescribed single Chinese herb while Xiao-Feng San was the most commonly prescribed Chinese herbal formula. The most commonly prescribed CHM drug combination was Xiao-Feng San plus Bai-Xian-Pi while the most commonly prescribed triple drug combination was Xiao-Feng San, Bai-Xian-Pi, and Di-Fu Zi (Kochia scoparia). Conclusions In view of the popularity of CHM such as Xiao-Feng San prescribed for the wind-heat pattern of urticaria in this study, a large-scale, randomized clinical trial is warranted to research their efficacy and safety. PMID:23947955

  19. A Sketch of the Taiwan Zebrafish Core Facility.

    PubMed

    You, May-Su; Jiang, Yun-Jin; Yuh, Chiou-Hwa; Wang, Chien-Ming; Tang, Chih-Hao; Chuang, Yung-Jen; Lin, Bo-Hung; Wu, Jen-Leih; Hwang, Sheng-Ping L

    2016-07-01

    In the past three decades, the number of zebrafish laboratories has significantly increased in Taiwan. The Taiwan Zebrafish Core Facility (TZCF), a government-funded core facility, was launched to serve this growing community. The Core Facility was built on two sites, one located at the National Health Research Institutes (NHRI, called Taiwan Zebrafish Core Facility at NHRI or TZeNH) and the other is located at the Academia Sinica (Taiwan Zebrafish Core Facility at AS a.k.a. TZCAS). The total surface area of the TZCF is about 180 m(2) encompassing 2880 fish tanks. Each site has a separate quarantine room and centralized water recirculating systems, monitoring key water parameters. To prevent diseases, three main strategies have been implemented: (1) imported fish must be quarantined; (2) only bleached embryos are introduced into the main facilities; and (3) working practices were implemented to minimize pathogen transfer between stocks and facilities. Currently, there is no health program in place; however, a fourth measure for the health program, specific regular pathogen tests, is being planned. In March 2015, the TZCF at NHRI has been AAALAC accredited. It is our goal to ensure that we provide "disease-free" fish and embryos to the Taiwanese research community.

  20. Reported Numbers of Patients with Rare Diseases Based on Ten-Year Longitudinal National Disability Registries in Taiwan

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Lin, Lan-Ping; Hung, Wen-Jiu

    2013-01-01

    This paper aims to describe a general demographic picture of patients with rare diseases in Taiwan and particularly focuses on the prevalence of rare diseases over time, age and gender distributions. We analyzed data mainly from the national disability registry from 2002 to 2011 in Taiwan, Republic of China. The results showed that the number of…

  1. Extracorporeal membrane oxygenation use, expenditure, and outcomes in taiwan from 2000 to 2010.

    PubMed

    Hsu, Chiao-Po; Lee, Wui-Chiang; Wei, Hsiu-Mei; Sung, Shih-Hsien; Huang, Chun-Yang; Shih, Chun-Che; Lu, Tse-Min

    2015-01-01

    No study to date has systematically examined use, expenditure, and outcomes associated with extracorporeal membrane oxygenation (ECMO) use in Taiwan. The aim of this study was to examine ECMO use, expenditure, and outcomes during an 11-year period in Taiwan. Claims data were collected from the Taiwan National Health Insurance Research Database for patients who received ≥1 ECMO treatment between January 2000 and December 2010. Measurements included demographics, indications for ECMO use, length of hospital stay, outcome, and expenditure. A total of 3969 patients received ECMO during the study period (median age: 54.6 years). The number of patients receiving ECMO increased from 52 in 2000 to 1045 in 2010. The major indication for ECMO was cardiovascular disease (68.7%), followed by respiratory disease (17.9%). Median length of hospital stay was 13 days in 2000 and 17 days in 2010. Median expenditure (New Taiwan dollars) was $604 317 in 2000 and $673 888 in 2010. Some variables significantly differed by age, sex, hospital setting, calendar year, and indication for ECMO, and were associated with in-hospital and after-discharge mortality. ECMO use has increased dramatically in Taiwan over the last decade. The high mortality rate of ECMO users suggested that ECMO may be being used in Taiwan for situations in which it provides no added benefit. This situation may be a reflection of the current reimbursement criteria for National Health Insurance in Taiwan. Refinement of the indications for use of ECMO is suggested.

  2. Prescription profile of Chinese herbal products containing coumestrol, genestein, and/or daidzein among female users: an analysis of national health insurance data in Taiwan between 1997 and 2007.

    PubMed

    Wu, Chien-Tung; Tzeng, Jeng-Nan; Lai, Jung-Nien; Tsan, Shun-Hua; Wang, Jung-Der

    2012-10-16

    Some Chinese herbs contain several kinds of phytoestrogens, and these herbs are commonly prescribed in Taiwan. Phytoestrogens may influence the effects of estrogen in females, although their activities are weak. This study aims to identify the risk and analyze the prescription profile of commonly used phytoestrogenic herbs in Taiwan. The study analyzed women who had been prescribed phytoestrogenic herbs including coumestrol, genistein and/or daidzein between 1997 and 2007 in a fixed cohort taken from all female beneficiaries from the National Health Insurance Research Database of Taiwan. The prescription frequencies, cumulated dosages, and primary indications were listed. A total of 462,861 women were included in the study, of whom ~47.0% had used phytoestrogenic herbs at least once during the study period. A total of 6,270,813 prescriptions were recorded, and more than 20% of these contained phytoestrogens. The most commonly prescribed herb and formula were Puerariae Radix and Ge gen tang (Pueraria Decoction), respectively. Most of the prescriptions were issued for diseases of the respiratory system, followed by symptoms, signs, and ill-defined conditions and diseases of the musculoskeletal system and connective tissue. This study shows that women who sought medical treatment from Chinese medicine doctors for relief of respiratory discomfort had a high possibility of exposure to phytoestrogenic herbs. Safety issues related to the female endocrine system should be a priority for future research.

  3. Governmental disability welfare expenditure and national economic growth from 1991 to 2006 in Taiwan.

    PubMed

    Lin, Jin-Ding; Lin, Lan-Ping

    2009-01-01

    The purposes of the present study were to describe the welfare expenditure for people with disabilities and examine its relation to national economic growth from 1991 to 2006 in Taiwan. We analyzed data mainly from the information of population with disabilities, disability welfare expenditure and national economic growth and gross national product (GNP) per capita in Taiwan from 1991 to 2006. The percentage and overtime trend were used to examine the change in disability welfare expenditure, national economic growth and GNP per capita. Taiwan's economy continued its steady expansion on record an annual average growth of 5.4% and GNP per capita of 5.7% for the year 1991-2006. At the same period of time, the registered population with disabilities increased nearly five times (204,158 persons in 1991 to 981,015 persons in 2006), the government disability welfare expenditure was dramatically increasing to over 10 times from 1991 to 2006 (US$ 74 million to US$ 784 million). Although the total disability budget increased, the beneficiary of the individual with disability increased only 2.2 times. In the content of annual welfare budget for people with disabilities, it is difficult to figure out the increase pattern of the budget growth. However, the local government plays a vital role in disability welfare services gradually, it provides more than 85% welfare budget for people with disabilities. Finally, the author emphasizes that government should examine the long term effects of welfare budget allocation shifting from central government to local government to ensure the right of people with disabilities.

  4. Study on occupational safety and health strategy for Taiwan.

    PubMed

    Chuang, Kuen-Yuan; Su, Teh-Sheng; Kuo, Chao-Yin; Lin, Chien-Liang; Lin, Han-Yu; Yu, Yi-Chun

    2009-12-01

    The aim of this study was to establish a set of occupational safety and health (OSH) issues and development policies suitable for adoption in Taiwan. A survey was conducted on a sample of 102 experts and 235 industrial work safety personnel in Taiwan for statistical analysis of the general consensus, with the results showing such consensus in 104 individual policy indicators. Our results reveal that the most appropriate targets were considered to be annual 10% reductions in the 'occupational accident disability rate', 'occupational accident injury rate' and 'occupational diseases before 2010'. Responding to the specific question of the appropriate method of achieving a reduction in the number of accidents in Taiwan, the primary consideration for 13.4% of the experts and 10.6% of the industry personnel was 'promoting OSH awareness and enhancing the overall safety culture'. As regards the current OSH policy focus, 11.2% of the experts considered 'improving OSH legislation, standards and systems' to be the most important, whilst 8.9% of the industry personnel felt that 'recognizing work stress, overwork and emerging OSH issues' were the most important.

  5. Acculturation and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan.

    PubMed

    Yang, Yung-Mei; Wang, Hsiu-Hung

    2011-10-01

    To examine associations between demographic variables, acculturation, and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan. A cross-sectional survey of 203 participants in southern Taiwan. Instruments included a demographic inventory, the Suinn-Lew Asian Self-Identity Acculturation Scale, and the Short Form Health Survey-Version 2. Most participants had low acculturation levels. Length of residency, number of children, marital status, level of education, religion of spouse, and employment status of spouse significantly correlated with level of acculturation, as did mental health, bodily pain, vitality, and social functioning. Programs are needed to encourage social assimilation for Vietnamese immigrant women in Taiwan. Culturally sensitive medical evaluations will ensure early treatment of mental and physical health problems caused by the stress of acculturation. An increased understanding of variables affecting Southeast Asian immigrant women's acculturation process will improve health status.

  6. A retrospective cohort study on the risk of stroke in relation to a priori health knowledge level among people with type 2 diabetes mellitus in Taiwan.

    PubMed

    Lai, Yun-Ju; Hu, Hsiao-Yun; Lee, Ya-Ling; Ku, Po-Wen; Yen, Yung-Feng; Chu, Dachen

    2017-05-22

    Intervention of diabetes care education with regular laboratory check-up in outpatient visits showed long-term benefits to reduce the risk of macrovascular complications among people with type 2 diabetes. However, research on the level of a priori health knowledge to the prevention of diabetic complications in community settings has been scarce. We therefore aimed to investigate the association of health knowledge and stroke incidence in patients with type 2 diabetes in Taiwan. A nationally representative sample of general Taiwanese population was selected using a multistage systematic sampling process from Taiwan National Health Interview Survey (NHIS) in 2005. Subjects were interviewed by a standardized face-to-face questionnaire in the survey, obtaining information of demographics, socioeconomic status, family medical history, obesity, health behaviors, and 15-item health knowledge assessment. The NHIS dataset was linked to Taiwan National Health Insurance claims data to retrieve the diagnosis of type 2 diabetes in NHIS participants at baseline and identify follow-up incidence of stroke from 2005 to 2013. Univariate and multivariate Cox regressions were used to estimate the effect of baseline health knowledge level to the risk of stroke incidence among this group of people with type 2 diabetes. A total of 597 diabetic patients with a mean age of 51.28 years old and nearly half of males were analyzed. During the 9-year follow-up period, 65 new stroke cases were identified among them. Kaplan-Meier curves comparing the three groups of low/moderate/high knowledge levels revealed a statistical significance (p-value of log-rank test <0.01). After controlling for potential confounders, comparing to the group of low health knowledge level, the relative risk of stroke was significantly lower for those with moderate (adjusted hazard ratio [AHR] = 0.63; 95% CI, 0.33-1.19; p-value = 0.15) and high level of health knowledge (AHR = 0.43; 95% CI, 0.22-0.86; p

  7. Cost evaluation of clinical laboratory in Taiwan's National Health System by using activity-based costing.

    PubMed

    Su, Bin-Guang; Chen, Shao-Fen; Yeh, Shu-Hsing; Shih, Po-Wen; Lin, Ching-Chiang

    2016-11-01

    To cope with the government's policies to reduce medical costs, Taiwan's healthcare service providers are striving to survive by pursuing profit maximization through cost control. This article aimed to present the results of cost evaluation using activity-based costing performed in the laboratory in order to throw light on the differences between costs and the payment system of National Health Insurance (NHI). This study analyzed the data of costs and income of the clinical laboratory. Direct costs belong to their respective sections of the department. The department's shared costs, including public expenses and administrative assigned costs, were allocated to the department's respective sections. A simple regression equation was created to predict profit and loss, and evaluate the department's break-even point, fixed cost, and contribution margin ratio. In clinical chemistry and seroimmunology sections, the cost per test was lower than the NHI payment and their major laboratory tests had revenues with the profitability ratio of 8.7%, while the other sections had a higher cost per test than the NHI payment and their major tests were in deficit. The study found a simple linear regression model as follows: "Balance=-84,995+0.543×income (R2=0.544)". In order to avoid deficit, laboratories are suggested to increase test volumes, enhance laboratory test specialization, and become marginal scale. A hospital could integrate with regional medical institutions through alliances or OEM methods to increase volumes to reach marginal scale and reduce laboratory costs, enhancing the level and quality of laboratory medicine.

  8. New Drug Reimbursement and Pricing Policy in Taiwan.

    PubMed

    Chen, Gau-Tzu; Chang, Shu-Chen; Chang, Chee-Jen

    2018-05-01

    Taiwan has implemented a national health insurance system for more than 20 years now. The benefits of pharmaceutical products and new drug reimbursement scheme are determined by the Expert Advisory Meeting and the Pharmaceutical Benefit and Reimbursement Scheme (PBRS) Joint Committee in Taiwan. To depict the pharmaceutical benefits and reimbursement scheme for new drugs and the role of health technology assessment (HTA) in drug policy in Taiwan. All data were collected from the Expert Advisory Meeting and the PBRS meeting minutes; new drug applications with HTA reports were derived from the National Health Insurance Administration Web site. Descriptive statistics were used to analyze the timeline of a new drug from application submission to reimbursement effective, the distribution of approved price, and the approval rate for a new drug with/without local pharmacoeconomic study. After the second-generation national health insurance system, the timeline for a new drug from submission to reimbursement effective averages at 436 days, and that for an oncology drug reaches an average of 742 days. New drug approval rate is 67% and the effective rate (through the approval of the PBRS Joint Committee and the acceptance of the manufacturer) is 53%. The final approved price is 53.6% of the international median price and 70% of the proposed price by the manufacturer. Out of 95 HTA reports released during the period January 2011 to February 2017, 28 applications (30%) conducted an HTA with a local pharmacoeconomic study, and all (100%) received reimbursement approval. For the remaining 67 applications (70%) for which HTA was conducted without a local pharmacoeconomic analysis, 54 cases (81%) were reimbursed. New drug applications with local pharmacoeconomic studies are more likely to get reimbursement. Copyright © 2018. Published by Elsevier Inc.

  9. Extracorporeal Membrane Oxygenation Use, Expenditure, and Outcomes in Taiwan From 2000 to 2010

    PubMed Central

    Hsu, Chiao-Po; Lee, Wui-Chiang; Wei, Hsiu-Mei; Sung, Shih-Hsien; Huang, Chun-Yang; Shih, Chun-Che; Lu, Tse-Min

    2015-01-01

    Background No study to date has systematically examined use, expenditure, and outcomes associated with extracorporeal membrane oxygenation (ECMO) use in Taiwan. The aim of this study was to examine ECMO use, expenditure, and outcomes during an 11-year period in Taiwan. Methods Claims data were collected from the Taiwan National Health Insurance Research Database for patients who received ≥1 ECMO treatment between January 2000 and December 2010. Measurements included demographics, indications for ECMO use, length of hospital stay, outcome, and expenditure. Results A total of 3969 patients received ECMO during the study period (median age: 54.6 years). The number of patients receiving ECMO increased from 52 in 2000 to 1045 in 2010. The major indication for ECMO was cardiovascular disease (68.7%), followed by respiratory disease (17.9%). Median length of hospital stay was 13 days in 2000 and 17 days in 2010. Median expenditure (New Taiwan dollars) was $604 317 in 2000 and $673 888 in 2010. Some variables significantly differed by age, sex, hospital setting, calendar year, and indication for ECMO, and were associated with in-hospital and after-discharge mortality. Conclusions ECMO use has increased dramatically in Taiwan over the last decade. The high mortality rate of ECMO users suggested that ECMO may be being used in Taiwan for situations in which it provides no added benefit. This situation may be a reflection of the current reimbursement criteria for National Health Insurance in Taiwan. Refinement of the indications for use of ECMO is suggested. PMID:25797598

  10. Health literacy in familial hypercholesterolemia: A cross-national study.

    PubMed

    Hagger, Martin S; Hardcastle, Sarah J; Hu, Miao; Kwok, See; Lin, Jie; Nawawi, Hapizah M; Pang, Jing; Santos, Raul D; Soran, Handrean; Su, Ta-Chen; Tomlinson, Brian; Watts, Gerald F

    2018-06-01

    Background High rates of inadequate health literacy are associated with maladaptive health outcomes in chronic disease including increased mortality and morbidity rates, poor treatment adherence and poor health. Adequate health literacy may be an important factor in the effective treatment and management of familial hypercholesterolemia, and may also be implicated in genetic screening for familial hypercholesterolemia among index cases. The present study examined the prevalence and predictors of health literacy in familial hypercholesterolemia patients attending clinics in seven countries. Design Cross-sectional survey. Methods Consecutive FH patients attending clinics in Australia, Brazil, China, Hong Kong, Malaysia, Taiwan and the UK completed measures of demographic variables (age, gender, household income and highest education level) and a brief three-item health literacy scale. Results Rates of inadequate health literacy were lowest in the UK (7.0%), Australia (10.0%), Hong Kong (15.7%) and Taiwan (18.0%) samples, with higher rates in the Brazil (22.0%), Malaysia (25.0%) and China (37.0%) samples. Income was an independent predictor of health literacy levels, accounting for effects of age. Health literacy was also independently related to China national group membership. Conclusions Findings indicate non-trivial levels of inadequate health literacy in samples of familial hypercholesterolemia patients. Consistent with previous research in chronic illness, inadequate health literacy is related to income as an index of health disparities. Chinese familial hypercholesterolemia patients are more likely to have high rates of inadequate health literacy independent of income. Current findings highlight the imperative of education interventions targeting familial hypercholesterolemia patients with inadequate health literacy.

  11. Epidemiological features and costs of herpes zoster in Taiwan: a national study 2000 to 2006.

    PubMed

    Jih, Jaw-Shyang; Chen, Yi-Ju; Lin, Ming-Wei; Chen, Yu-Chun; Chen, Tzeng-Ji; Huang, Yu-Lin; Chen, Chih-Chiang; Lee, Ding-Dar; Chang, Yun-Ting; Wang, Wen-Jen; Liu, Han-Nan

    2009-11-01

    To analyse the epidemiological characteristics and related costs of herpes zoster in Taiwan, a nationally representative cohort of 1,000,000 individuals from the National Health Insurance register was followed up from 2000 to 2006 and their claims data analysed. Overall, 34,280 patients were diagnosed with zoster (incidence 4.89/1000 person-years) and 2944 patients (8.6%) developed post-herpetic neuralgia 3 months after the start of the zoster rash (incidence 0.42/1000 person-years). People with older age, diabetes, and immunocompromising conditions were at higher risk of developing zoster and post-herpetic neuralgia. The overall hospitalization rate for zoster was 16.1 cases per 100,000 person-years. The cost for each home care case and per hospitalized case were approximately 53.30 euro and 1224.70 euro, respectively. Further research into the cost-effectiveness of zoster vaccine is needed.

  12. Prescription profile of Chinese herbal products containing coumestrol, genestein, and/or daidzein among female users: an analysis of national health insurance data in Taiwan between 1997 and 2007

    PubMed Central

    2012-01-01

    Background Some Chinese herbs contain several kinds of phytoestrogens, and these herbs are commonly prescribed in Taiwan. Phytoestrogens may influence the effects of estrogen in females, although their activities are weak. This study aims to identify the risk and analyze the prescription profile of commonly used phytoestrogenic herbs in Taiwan. Methods The study analyzed women who had been prescribed phytoestrogenic herbs including coumestrol, genistein and/or daidzein between 1997 and 2007 in a fixed cohort taken from all female beneficiaries from the National Health Insurance Research Database of Taiwan. The prescription frequencies, cumulated dosages, and primary indications were listed. Results A total of 462,861 women were included in the study, of whom ~47.0% had used phytoestrogenic herbs at least once during the study period. A total of 6,270,813 prescriptions were recorded, and more than 20% of these contained phytoestrogens. The most commonly prescribed herb and formula were Puerariae Radix and Ge gen tang (Pueraria Decoction), respectively. Most of the prescriptions were issued for diseases of the respiratory system, followed by symptoms, signs, and ill-defined conditions and diseases of the musculoskeletal system and connective tissue. Conclusion This study shows that women who sought medical treatment from Chinese medicine doctors for relief of respiratory discomfort had a high possibility of exposure to phytoestrogenic herbs. Safety issues related to the female endocrine system should be a priority for future research. PMID:23072740

  13. An in-depth assessment of a diagnosis-based risk adjustment model based on national health insurance claims: the application of the Johns Hopkins Adjusted Clinical Group case-mix system in Taiwan.

    PubMed

    Chang, Hsien-Yen; Weiner, Jonathan P

    2010-01-18

    Diagnosis-based risk adjustment is becoming an important issue globally as a result of its implications for payment, high-risk predictive modelling and provider performance assessment. The Taiwanese National Health Insurance (NHI) programme provides universal coverage and maintains a single national computerized claims database, which enables the application of diagnosis-based risk adjustment. However, research regarding risk adjustment is limited. This study aims to examine the performance of the Adjusted Clinical Group (ACG) case-mix system using claims-based diagnosis information from the Taiwanese NHI programme. A random sample of NHI enrollees was selected. Those continuously enrolled in 2002 were included for concurrent analyses (n = 173,234), while those in both 2002 and 2003 were included for prospective analyses (n = 164,562). Health status measures derived from 2002 diagnoses were used to explain the 2002 and 2003 health expenditure. A multivariate linear regression model was adopted after comparing the performance of seven different statistical models. Split-validation was performed in order to avoid overfitting. The performance measures were adjusted R2 and mean absolute prediction error of five types of expenditure at individual level, and predictive ratio of total expenditure at group level. The more comprehensive models performed better when used for explaining resource utilization. Adjusted R2 of total expenditure in concurrent/prospective analyses were 4.2%/4.4% in the demographic model, 15%/10% in the ACGs or ADGs (Aggregated Diagnosis Group) model, and 40%/22% in the models containing EDCs (Expanded Diagnosis Cluster). When predicting expenditure for groups based on expenditure quintiles, all models underpredicted the highest expenditure group and overpredicted the four other groups. For groups based on morbidity burden, the ACGs model had the best performance overall. Given the widespread availability of claims data and the superior explanatory

  14. Challenges and Strategies of Laboratory Diagnosis for Newly Emerging Influenza Viruses in Taiwan: A Decade after SARS

    PubMed Central

    Wu, Ho-Sheng

    2015-01-01

    Since the first case of severe acute respiratory syndrome (SARS) in Taiwan was identified in March 2003, viral respiratory infections, in particular the influenza virus, have become a national public health concern. Taiwan would face a serious threat of public health problems if another SARS epidemic overlapped with a flu outbreak. After SARS, the Taiwan Centers for Disease Control accelerated and strengthened domestic research on influenza and expanded the exchange of information with international counterparts. The capacity of influenza A to cross species barriers presents a potential threat to human health. Given the mutations of avian flu viruses such as H7N9, H6N1, and H10N8, all countries, including Taiwan, must equip themselves to face a possible epidemic or pandemic. Such preparedness requires global collaboration. PMID:26290876

  15. Taiwan Regulation of Biobanks.

    PubMed

    Fan, Chien-Te; Hung, Tzu-Hsun; Yeh, Chan-Kun

    2015-01-01

    This paper introduces legal framework and governance structure in relation to the management and development of biobanks in Taiwan. At first, we briefly describe Taiwan's population, political system and health care system. Secondly, this research introduces biobanking framework of Taiwan including 25 biobanks established with the approval of the Ministry of Health and Welfare. In those biobanks, "Taiwan Biobank" is the first and the largest government-supported biobank which comprises population-based cohort study and disease- oriented study. Since the collection of information, data, and biological specimen of biobanks often involve highly sensitive personal information, in the legal framework of Taiwan, there is a specific regulation, "Human Biobank Management Act" (HBMA), which plays an important role in regulating biobanks in Taiwan. HBMA, the Personal Information Act and other regulations constitute a comprehensive legal and regulatory privacy framework of biobanks. Through the introduction and analysis of the current legal framework applicable to biobanks, we found that there are several challenges that need to be solved appropriately that involve duplicate review systems, the obstacles in the international collaboration, and data sharing between biobanks in Taiwan. © 2015 American Society of Law, Medicine & Ethics, Inc.

  16. Utilization of nuclear medicine scintigraphy in Taiwan, 1997-2009.

    PubMed

    Hung, Mao-Chin; Hsieh, Wanhua Annie; Chang, Peter Wushou; Hwang, Jeng-Jong

    2011-12-01

    To analyze the utilization of nuclear medicine scintigraphy in the Taiwanese population within the national health-care system between 1997 and 2009. Based on the Taiwan's National Health Insurance Research Database of 1997-2009, a retrospective population-based analysis was conducted. Descriptive statistics and regression analysis were employed to analyze the frequencies and longitudinal trends in the utilization of diagnostic nuclear medicine procedures during the period. In addition, correlation analysis was applied to determine the correlated factors in the utility of nuclear medicine scintigraphy. The annual total nuclear medicine scintigraphy was estimated to be 256,389 on average in 1997-2009 and 11.7 per 1,000 population over the period. The frequency had increased by 67% over the years, from 8.2 per 1,000 population in 1997 to 13.7 per 1,000 population in 2009. The most frequently performed procedures were whole-body bone scans (33.4% of total) and myocardial perfusion scans (29.4% of total), with 4,615 and 5,620 increments per year, respectively. Most patients were in the age group of 41-65 years old when taking examinations. In addition, male subjects were slightly more than female patients (51.5 vs. 48.5%). Furthermore, the frequencies of whole-body bone scans and PET scans were proportional to the incidences of cancers (correlation coefficients were 0.96 and 0.94, respectively). The utilization of nuclear medicine scintigraphy with the National Health Insurance system in Taiwan has been changed considerably in the past 13 years. Both whole-body bone scan and myocardial perfusion scan were performed most often with significantly increases. The trend of nuclear medicine scintigraphy may have potential impact on making health-care policy in Taiwan.

  17. Predictors of Burnout Among Nurses in Taiwan.

    PubMed

    Lee, Huan-Fang; Yen, Miaofen; Fetzer, Susan; Chien, Tsair Wei

    2015-08-01

    Nurse burnout is a crucial issue for health care professionals and impacts nurse turnover and nursing shortages. Individual and situational factors are related to nurse burnout with predictors of burnout differing among cultures and health care systems. The predictors of nurse burnout in Asia, particularly Taiwan, are unknown. The purpose of this study was to investigate the predictors of burnout among a national sample of nurses in Taiwan. A secondary data analysis of a nationwide database investigated the predictors of burnout among 1,846 nurses in Taiwan. Hierarchical regression analysis determined the relationship between predictors and burnout. Predictors of Taiwanese nurse burnout were age, physical/psychological symptoms, job satisfaction, work engagement, and work environment. The most significant predictors were physical/psychological symptoms and work engagement. The variables explained 35, 39, and 18 % of the emotional exhaustion, personal accomplishment, and depersonalization variance for 54 % of the total variance of burnout. Individual characteristics and nurse self-awareness, especially work, engagement can impact Taiwanese nurses' burnout. Nurse burnout predictors provide administrators with information to develop strategies including education programs and support services to reduce nurse burnout.

  18. An investigation of the use of acupuncture in stroke patients in Taiwan: a national cohort study.

    PubMed

    Weng, Shu-Wen; Chen, Ta-Liang; Yeh, Chun-Chieh; Liao, Chien-Chang; Lane, Hsin-Long; Lin, Jaung-Geng; Shih, Chun-Chuan

    2016-08-26

    Acupuncture is considered a complementary and alternative medicine in many countries. The purpose of this study was to report the pattern of acupuncture use and associated factors in patients with stroke. We used claims data from Taiwan's National Health Insurance Research Database and identified 285001 new-onset stroke patients in 2000-2008 from 23 million people allover Taiwan. The use of acupuncture treatment after stroke within one year was identified. We compared sociodemographics, coexisting medical conditions, and stroke characteristics between stroke patients who did and did not receive acupuncture treatment. The use of acupuncture in stroke patients increased from 2000 to 2008. Female gender, younger age, white-collar employee status, higher income, and residence in areas with more traditional Chinese medicine (TCM) physicians were factors associated with acupuncture use in stroke patients. Ischemic stroke (odds ratio [OR] 1.21, 95 % confidence interval [CI] 1.15-1.28), having no renal dialysis (OR 2.76, 95 % CI 2.45-3.13), receiving rehabilitation (OR 3.20, 95 % CI 3.13-3.27) and longer hospitalization (OR 1.23, 95 % CI 1.19-1.27) were also associated with acupuncture use. Stroke patients using rehabilitation services were more likely to have more acupuncture visits and a higher expenditure on acupuncture compared with stroke patients who did not receive rehabilitation services. The application of acupuncture in stroke patients is well accepted and increasing in Taiwan. The use of acupuncture in stroke patients is associated with sociodemographic factors and clinical characteristics.

  19. Education Reform in Taiwan: A Search for a "National" Identity through Democratisation and Taiwanisation.

    ERIC Educational Resources Information Center

    Law, Wing-Wah

    2002-01-01

    Argues that democratisation, localization, and national identity are indivisible in Taiwan. Explains that social pressure groups, teachers, and parents are empowered in policy making processes, while the power of school officials to respond to these groups is limited. Discusses the role of school curriculum in promoting ethnic cultures and…

  20. Tablet splitting of narrow therapeutic index drugs: a nationwide survey in Taiwan.

    PubMed

    Chou, Chia-Lin; Hsu, Chia-Chen; Chou, Chia-Yu; Chen, Tzeng-Ji; Chou, Li-Fang; Chou, Yueh-Ching

    2015-12-01

    Tablet splitting or pill splitting frequently occurs in daily medical practice. For drugs with special pharmacokinetic characters, such as drugs with narrow therapeutic index (NTI), unequal split tablets might lead to erroneous dose titration and it even cause toxicity. The aim of this study was to investigate the frequency of prescribing split NTI drugs at ambulatory setting in Taiwan. A population-based retrospective study was conducted using the National Health Insurance Research Database in Taiwan. All ambulatory visits were analyzed from the longitudinal cohort datasets of the National Health Insurance Research Database. The details of ambulatory prescriptions containing NTI drugs were extracted by using the claims datasets of one million beneficiaries from National Healthcare Insurance Research Database in 2010 in Taiwan. The analyses were stratified by dosage form, patient age and the number of prescribed tablets in a single dose for each NTI drugs. Main outcome measures Number and distinct dosage forms of available NTI drug items in Taiwan, number of prescriptions involved split NTI drugs, and number of patients received split NTI drugs. A total of 148,548 patients had received 512,398 prescriptions of NTI drugs and 41.8 % (n = 62,121) of patients had received 36.3 % (n = 185,936) of NTI drug prescriptions in form of split tablets. The percentage of splitting was highest in digoxin prescriptions (81.0 %), followed by warfarin (72.0 %). In the elderly patients, split tablets were very prevalent with digoxin (82.4 %) and warfarin (84.5 %). NTI drugs were frequently prescribed to be taken in split forms in Taiwan. Interventions may be needed to provide effective and convenient NTI drug use. Further studies are needed to evaluate the clinical outcome of inappropriate split NTI drugs.

  1. Disease burden and related medical costs of rotavirus infections in Taiwan

    PubMed Central

    Lu, Chun-Yi; Lauderdale, Tsai-Ling; Fang, Yin-Hua; Wang, Chung-Yi; Ho, Yu-Huai; Hung, Che-Lun; Chang, Luan-Yin; Lee, Chin-Yun; Huang, Li-Min

    2006-01-01

    Background The disease burden and associated medical costs of rotavirus infections in inpatient and outpatient sectors in Taiwan were examined in anticipation of the availability of new rotavirus vaccines. Methods The yearly national case number and medical costs for all for inpatients and outpatients with acute gastroenteritis (AGE) were extracted from the Bureau of National Health Insurance database in Taiwan according to ICD-9-CM codes. A retrospective study was also performed using records of children with AGE seen at three hospitals in Taiwan in 2001 to identify laboratory confirmed rotavirus infection cases. The annual incidence and related medical costs of AGE due to rotavirus infection were then estimated. Results Children <5 years old comprised 83.6% of inpatient and 62.0% of outpatient pediatric AGE cases in Taiwan in 2001. Rotavirus was the most common agent detected among AGE patients in this age group in the three hospitals, and was detected in 32.9% (221/672) of inpatient and 24% (23/96) of outpatient stool specimens tested for microbial etiologies. An estimated 277,400 to 624,892 cases of rotavirus infections sought medical care in Taiwan in 2001, equaling one in 2 to 5 children <5 years old required medical care due to rotavirus infection. The incidence of hospitalization due to rotavirus infections was 1,528–1,997/100,000 for children <5 years old. The total associated medical costs due to rotavirus infection were estimated at US $10–16 millions in Taiwan in 2001. Although the per-capita medical cost of rotavirus infection was lower in Taiwan than in the United States or Hong Kong, the personal economic burden was similar among the three places when normalized for gross national incomes per capita. Conclusion Infections caused by rotavirus constitute an important human and economic burden among young children in Taiwan. A safe and effective vaccine is urgently needed. PMID:17173677

  2. [A comparative study on Koii (public doctor) system and its effect on public health in colonial Taiwan and Korea].

    PubMed

    Moon, Myungki

    2014-08-01

    Koii(Public Doctor) System introduced into Taiwan in 1896 for the purpose of filling up medical vacuum of rural area and therefore spreading modern medical system all over Taiwan, was transplanted in 1913 into Colonial Korea for the same purpose. In terms of system itself Koii system in both areas were almost the same, but quite different in practices. First, Koiis in Taiwan was forced to write concrete medical report every month on the medical situation in the area under jurisdiction, whereas to those in Korea writing monthly report was not so compulsory. This difference resulted in some gaps in the quality of medical statistics of the two areas. Second, Unlike their counterparts in Korea, Koiis in Taiwan organized their own associations both locally and nationally and it helped to build up their own networks and share informations on medical situation including informations on infectious diseases. Third, Koiis in Taiwan formed more harmonious relationship between Taiwanese Police than their counterparts in Korea, which helped them to execute various medical activities in more comfortable environment. Taiwanese People went to medical institutions a lot more frequently than Korean People, and this difference was basically derived from the quite different density of Koii assignment in both areas. Korean People had to spend more time and money to utilize modern medical institutions than Taiwanese People did. The different density of Koii assignment also affected the results of prevention and eradication of infectious diseases; in Taiwan plague and small-pox has been successfully controled, whereas Chosun Government general was not so successful in controling infectious diseases including small-pox. Small-pox infected in Korea was about 6 times to Taiwan, and the number of death by small-pox was 9 times to Taiwan. One of the keys to this difference is the different role of Koiis. In Korea, Koiis could do little thing about infectious diseases mainly because of

  3. Disease burden and epidemiology of herpes zoster in pre-vaccine Taiwan.

    PubMed

    Lin, Yung-Hsiu; Huang, Li-Min; Chang, I-Shou; Tsai, Fang-Yu; Lu, Chun-Yi; Shao, Pei-Lan; Chang, Luan-Yin

    2010-02-03

    Herpes zoster, a common disease, has an important impact on the health of adults, particularly the elderly, and the health system. This study evaluated the disease burden and epidemiological characteristics of herpes zoster in Taiwan. Using herpes zoster-related ICD-9-CM codes used on Taiwan's National Health Insurance claims, we analyzed overall and age group differences in incidence, complications, utilization of healthcare facilities, lengths of stay, and cost of their medical care in Taiwan's population from 2000 to 2005. The overall annual incidence of zoster was 4.97 cases per 1000 people, with women having a significantly higher incidence than men (5.20 per 1000 vs. 4.72 per 1000, p<0.001). The incidence increased stepwise with age, with 5.18 cases per 1000 in people 40-50 years old, 8.36 in those 50-60, 11.09 in those 60-70, and 11.77 in those above 70 years old. The estimated lifetime risk of developing herpes zoster was 32.2%. Zoster-related hospitalizations and medical cost per patient increased with age. In conclusion, about two-thirds of Taiwan's zoster cases occur in adults older than 40 years old and about one-third of the population would develop zoster within their lifetime. (c) 2009 Elsevier Ltd. All rights reserved.

  4. Surveys of medical seeking preference, mental health literacy, and attitudes toward mental illness in Taiwan, 1990-2000.

    PubMed

    Wu, Chia-Yi; Liu, Shen-Ing; Chang, Shu-Sen; Sun, Fang-Ju

    2014-01-01

    Mental health promotion campaigns require a good understanding of public attitudes and mental health literacy. Few studies have investigated changes in these two aspects over time. We aimed to examine such changes and their associations with help-seeking preference in Taiwan. Data were extracted from the Taiwan Social Change Survey (1990, 1995, and 2000) based on national representative samples. Each wave of the surveys included four questions about attitudes toward severe mental illness, a case vignette describing depressive and anxiety symptoms to evaluate respondents' mental health literacy, and their preference of medical and/or informal help-seeking if they develop such symptoms. Mental and physical health statuses measured using the Chinese Health Questionnaire and self-reported chronic physical illnesses were included as covariates. There were 2531, 2075, and 1892 respondents in the three waves of the surveys, respectively. During the 1990 s, approximately one in four to five Taiwanese held some misconceptions toward mental illness. The attitudes toward mental illness were generally not associated with medical or informal help-seeking preference after statistical adjustment. However, respondents viewing symptoms in the vignette as physical or mental in origin were more willing to seek help than those who saw these symptoms as not being an illness. Attribution of depressive and anxiety symptoms appeared to be more likely to influence help-seeking behaviors than attitudes toward mental illness. Enhancing public mental health literacy toward depression may help facilitate help-seeking in response to potential mental illness. Copyright © 2013. Published by Elsevier B.V.

  5. "Foreign brides" meet ethnic politics in Taiwan.

    PubMed

    Tsai, Ming-Chang

    2011-01-01

    A great number of women from China, Vietnam, and Indonesia recently arrived in Taiwan to marry men of lower social strata. Such an unusual pattern of migration has stimulated debates about the status and the citizenship of the new arrivals. This study analyzes Taiwanese responses toward these marriage migrants by using a national survey conducted in 2004. Three aspects of restrictive attitudes were tapped concerning these newcomers: (1) rights to work; (2) access to public health insurance; and (3) full citizenship. Immigrants from China were most opposed, compared to women with other origins (Southeast Asia, Japan, Europe, and the US). The seemingly unrelated regression estimation regression results do not support the split labor market hypotheses, as marriage migrants do not appear to be economic threats toward members of the lower classes. In contrast, ethnic nationalism plays a key role in determining the natives’ restrictive attitudes. The case of Taiwan represents a special genre, where ethnic politics selectively arouses the social rejection of women immigrants of certain origins.

  6. Classification management plan of groundwater quality in Taiwan

    NASA Astrophysics Data System (ADS)

    Chen, Chun Ming; Chen, Yu Ying; Pan, Shih Cheng; Li, Hui Jun; Hsiao, Fang Ke

    2017-04-01

    Taiwan Environmental Protection Administration has been monitoring regional water quality for 14 years. Since the beginning of 2002 till now, there are 453 regional groundwater monitoring wells in ten groundwater subregions in Taiwan, and the monitoring of groundwater quality has been carried out for a long time. Currently, water quality monitoring project has reached 50 items, while the number of water quality monitoring data has reached more than 20,000. In order to use the monitoring data efficiently, this study constructed the localized groundwater quality indicators of Taiwan. This indicator takes into account the different users' point of view, incorporating the Taiwan groundwater pollution monitoring standards (Category II), irrigation water quality standard and drinking water source water quality standard. 50 items of water quality monitoring projects were simplified and classified. The groundwater quality parameters were divided into five items, such as potability for drinking water, salting, external influence, health influences and toxicity hazard. The weight of the five items of groundwater was calculated comprehensively, and the groundwater quality of each monitoring well was evaluated with three grades of good, ordinary, and poor. According to the monitoring results of the groundwater monitoring wells in October to December of 2016, about 70% of groundwater quality in Taiwan is in good to ordinary grades. The areas with poor groundwater quality were mostly distributed in coastal, agriculture and part of the urban areas. The conductivity or ammonia nitrogen concentration was higher in those regions, showing that groundwater may be salinized or affected by external influences. Groundwater quality indicators can clearly show the current comprehensive situation of the groundwater environment in Taiwan and can be used as a tool for groundwater quality classification management. The indicators can coordinate with the Taiwan land planning policy in the

  7. Temporal trend and nationwide utility for hysterectomies in Taiwan, 1997-2010.

    PubMed

    Huang, Wei-Yi; Huang, Kuo-How; Chang, Wen-Chun; Wu, Shiao-Chi

    2016-10-01

    This study investigates the nationwide utilization and temporal trend of hysterectomies in Taiwan. The present study used the National Health Insurance Research Database that included claims of nearly the entire population in Taiwan since the inception of the National Health Insurance program in 1995. We analyzed age-adjusted rates of hysterectomies in Taiwan from 1997 through to 2010 and compared with the rates in 16 countries of the Organization for Economic Co-operation and Development. We also examined the utilization of various types of hysterectomies in Taiwan during this period. There was a cross-country variation in the age-standardized rate of hysterectomy: 105 per 100,000 females in Spain, 156 per 100,000 females in Taiwan, 179 per 100,000 females in 16 Organization for Economic Co-operation and Development countries, and 325 per 100,000 females in the United States in 2008. The trend of the age-standardized rate of hysterectomy in Taiwan declined from 222.3 per 100,000 women in 1998 to 145.2 per 100,000 women in 2010. The most common type of hysterectomy during this period was total abdominal hysterectomy (51.2%). Subtotal hysterectomies increased by 117% (r 2 =0.89; p<0.01), from 672 in 1997 to 1458 in 2010; however, total hysterectomies decreased by 3.5% (r 2 =0.43; p=0.01), from 20,966 in 1997 to 20,230 in 2010. Laparoscopically assisted procedures (laparoscopic supracervical hysterectomy and laparoscopic hysterectomy) increased 4.98-fold (r 2 =0.23; p=0.09), from 1453 in 1997 to 8684 in 2010. By contrast, the proportion of conventional open hysterectomies (total abdominal hysterectomy, and subtotal or supracervical abdominal hysterectomy) decreased by 36.5% (r 2 =0.59; p<0.01), from 17,327 in 1997 to 10,994 in 2010. The proportion of vaginal hysterectomies decreased by 29.7% (r 2 =0.72; p<0.01), from 2858 in 1997 to 2010 in 2010. As in most Western countries, hysterectomy rates in Taiwan declined by year. There was a marked shift in the types of

  8. User inspection of National Taiwan University Hospital's telehealth care information system.

    PubMed

    Wu, Pei Hsuan; Chen, Chi-Huang; Chen, Hui-Te; Shu, Che-Hsuan; Lin, Feng-Sheng; Wang, Yi-Van; Li, Hao-Jhun; Wu, Yuan-Ting; Lai, Feipei

    2010-01-01

    The telehealth care system has been important in the healthcare world for several decades; however, Taiwan only began work on telehealth care this past year. This paper outlines the effectiveness of the telehealth care system developed by the National Taiwan University Hospital (NTUH). The usability of the integrated telehealth care system was analyzed through of heuristic evaluation and its usefulness. By using the heuristic evaluation form as developed by Nielsen, it is possible to examine the telehealth care system from the user's perspective. In addition, in assessing the usefulness through lists of criteria, system developers can determine the pros and the cons of the database. Ultimately, the heuristic evaluation revealed several violations on the system, but are not prohibitive to the development of such as system. Similarly, evaluation of the usefulness comes out positive; despite the fact that the suggested changes proposed by the users can be said are the main weaknesses of the system. With some improvements, the telehealth care system can be used efficiently in NTUH's healthcare system.

  9. Maternity Leave in Taiwan

    ERIC Educational Resources Information Center

    Feng, Joyce Yen; Han, Wen-Jui

    2010-01-01

    Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk…

  10. Taiwan Biobank: a project aiming to aid Taiwan's transition into a biomedical island.

    PubMed

    Fan, Chien-Te; Lin, Jui-Chu; Lee, Chung-His

    2008-02-01

    Essentially, the term 'biobank' can be defined in different ways. Taking the UK Biobank's experience as the main example, the Taiwan Biobank aims to collect the DNA of a large group of people on the population base and track their health and lifestyle for at least 10 years. It is hoped that the information collected, regarding the mechanisms underlying how genes and environmental factors interact with each other to make us ill, will benefit the society in various ways, including the exploration of a new generation of treatments, support to preventive medicine discovery and also the possible benefits for the promotion of evolving public health-related industries in Taiwan. However, the involvement of large-scale population base gene data collection also triggered serious ethical, legal and social issues. In Taiwan, the challenge is even more serious than for any other biobanking experiences that have occurred previously. Among all the ethical, legal and social issues, the convergence of aboriginal people protection provided under Taiwan's Constitution imposes on the research team an obligation to create an innovative Ethical & Legal Governance Framework adaptable to the unique social background of Taiwan, including a workable public consultation/communication mechanism. In early 2005, the creation of the 'Taiwan Biobank' has been included as a part of Taiwan's strategic development in promoting the country as an island of biomedicine. In this report, the ideology, the goals and special features, government strategy, visions and, in particular, the ethical, legal and social issue planning of the Taiwan Biobank will be briefly introduced and reviewed.

  11. Trends in health care resource utilization and pharmacological management of COPD in Taiwan from 2004 to 2010.

    PubMed

    Tsai, Ying-Huang; Yang, Tsung-Ming; Lin, Chieh-Mo; Huang, Shu-Yi; Wen, Yu-Wen

    2017-01-01

    COPD has attracted widespread attention worldwide. The prevalence of COPD in Taiwan has been reported, but little is known about trends in health care resource utilization and pharmacologic management in COPD treatment. The objective of this article was to study trends in health care resource utilization, pharmacologic management, and medical costs of COPD treatment in Taiwan. Reimbursement claims in the Taiwan National Health Insurance System from 2004 to 2010 were collected. The disease burden of COPD, including health care resource utilization and medical costs, was evaluated. The pharmacy cost of COPD increased from 2004 to 2010 due to the increased utilization of long-acting muscarinic antagonist (LAMA) and fixed-dose combination of long-acting β2-agonist and inhaled corticosteroid (LABA/ICS), whereas the cost of all other COPD-related medications decreased. The average outpatient department (OPD) cost per patient increased 29.3% from 1,070 USD in 2004 to 1,383 USD in 2010. The highest average total medical cost per patient was 3,434 USD in 2005, and it decreased 12.4% to 3,008 USD in 2010. There was no significant difference in the average number of OPD visits and emergency department visits per patient. The highest average number of hospital admissions was 0.81 in 2005, and it decreased to 0.65 in 2010. The average number of intensive care unit (ICU) admissions decreased from 0.52 in 2005 to 0.31 in 2010. From 2004 to 2010, the average total medical cost per patient of COPD was slightly decreased because of the decreased average number of hospital admissions and ICU admissions. The costs of both LAMA and LABA/ICS increased, while the cost for all other COPD-related medications decreased. These findings suggest that the increased utilization of LAMA and LABA/ICS may have contributed to the decreased average number of hospital admissions and ICU admissions in COPD patients from 2004 to 2010.

  12. Real-Time Surveillance of Infectious Diseases: Taiwan's Experience.

    PubMed

    Jian, Shu-Wan; Chen, Chiu-Mei; Lee, Cheng-Yi; Liu, Ding-Ping

    Integration of multiple surveillance systems advances early warning and supports better decision making during infectious disease events. Taiwan has a comprehensive network of laboratory, epidemiologic, and early warning surveillance systems with nationwide representation. Hospitals and clinical laboratories have deployed automatic reporting mechanisms since 2014 and have effectively improved timeliness of infectious disease and laboratory data reporting. In June 2016, the capacity of real-time surveillance in Taiwan was externally assessed and was found to have a demonstrated and sustainable capability. We describe Taiwan's disease surveillance system and use surveillance efforts for influenza and Zika virus as examples of surveillance capability. Timely and integrated influenza information showed a higher level and extended pattern of influenza activity during the 2015-16 season, which ensured prompt information dissemination and the coordination of response operations. Taiwan also has well-developed disease detection systems and was the first country to report imported cases of Zika virus from Miami Beach and Singapore. This illustrates a high level of awareness and willingness among health workers to report emerging infectious diseases, and highlights the robust and sensitive nature of Taiwan's surveillance system. These 2 examples demonstrate the flexibility of the surveillance systems in Taiwan to adapt to emerging infectious diseases and major communicable diseases. Through participation in the GHSA, Taiwan can more actively collaborate with national counterparts and use its expertise to strengthen global and regional surveillance capacity in the Asia Pacific and in Southeast Asia, in order to advance a world safe and secure from infectious disease.

  13. Real-Time Surveillance of Infectious Diseases: Taiwan's Experience

    PubMed Central

    Jian, Shu-Wan; Chen, Chiu-Mei; Lee, Cheng-Yi

    2017-01-01

    Integration of multiple surveillance systems advances early warning and supports better decision making during infectious disease events. Taiwan has a comprehensive network of laboratory, epidemiologic, and early warning surveillance systems with nationwide representation. Hospitals and clinical laboratories have deployed automatic reporting mechanisms since 2014 and have effectively improved timeliness of infectious disease and laboratory data reporting. In June 2016, the capacity of real-time surveillance in Taiwan was externally assessed and was found to have a demonstrated and sustainable capability. We describe Taiwan's disease surveillance system and use surveillance efforts for influenza and Zika virus as examples of surveillance capability. Timely and integrated influenza information showed a higher level and extended pattern of influenza activity during the 2015-16 season, which ensured prompt information dissemination and the coordination of response operations. Taiwan also has well-developed disease detection systems and was the first country to report imported cases of Zika virus from Miami Beach and Singapore. This illustrates a high level of awareness and willingness among health workers to report emerging infectious diseases, and highlights the robust and sensitive nature of Taiwan's surveillance system. These 2 examples demonstrate the flexibility of the surveillance systems in Taiwan to adapt to emerging infectious diseases and major communicable diseases. Through participation in the GHSA, Taiwan can more actively collaborate with national counterparts and use its expertise to strengthen global and regional surveillance capacity in the Asia Pacific and in Southeast Asia, in order to advance a world safe and secure from infectious disease. PMID:28418738

  14. Physicians as well as nonphysician health care professionals in Taiwan have higher risk for lumbar herniated intervertebral disc than general population.

    PubMed

    Chan, Feng-Kai; Hsu, Chien-Chin; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Weng, Shih-Feng

    2018-01-01

    Physicians in Taiwan have long working hours and are at risk for inappropriate posture when handling patients, which may contribute to lumbar herniated intervertebral disc (L-HIVD). This study was conducted to delineate this issue, which is still unknown. This nationwide population-based cohort study was based on Taiwan National Health Insurance Research Database. We identified 25,428 physicians, 32,316 nonphysician health care professionals (HCPs), and an identical number of age- and sex-matched individuals from the general population. All individuals who had L-HIVD before 2007 were excluded. We compared the L-HIVD risk between physicians and general population, nonphysician HCPs and general population, and physicians and nonphysician HCPs by tracing their medical histories between 2007 and 2011. A comparison among physician specialties was also performed. Physicians and nonphysician HCPs had higher L-HIVD risk than the general population [odds ratio (OR): 1.149; 95% confidence interval (CI): 1.011-1.307 and OR: 1.220; 95% CI: 1.080-1.378, respectively]. Physicians did not have higher L-HIVD risk than nonphysician HCPs [adjusted OR (AOR): 0.912; 95% CI: 0.795-1.046]. Physician specialties of orthopedics and obstetrics and gynecology had a trend of higher L-HIVD risk than other specialties (AOR: 1.538; 95% CI: 0.805-2.939, and AOR: 1.306; 95% CI: 0.967-1.764, respectively). Physicians as well as nonphysician health care professionals in Taiwan have higher L-HIVD risk than the general population, which could be attributed to a probable role of long working hours. This result provides an important reference for the government to promote occupational health in health care professionals; however, further studies are warranted for the underlying mechanisms. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  15. Factors associated with utilization of traditional Chinese medicine by white collar foreign workers living in Taiwan.

    PubMed

    Daly, Maria; Tai, Chen-Jei; Deng, Chung-Yeh; Chien, Li-Yin

    2009-01-14

    Traditional Chinese medicine (TCM) has remained an integral part of Chinese culture and society for thousands of years. In Taiwan TCM is a recognized element of its National Health Insurance Scheme. However, there is no knowledge about how TCM is accessed by foreign workers from a non-Asian cultural background. The objectives of this study were to investigate the prevalence and patterns of TCM use among non-Asian white-collar workers living in Taiwan, and examine factors likely to influence their use of TCM. This study applied a cross-sectional survey design. A total of 207 white-collar foreign workers of a non-Asian background currently holding National Health Insurance cards who had lived in Taiwan for 4 months or more participated in this study. The prevalence of TCM use was 45%. The most frequently used therapies were traditional Chinese herbs/medicine and acupuncture. Factors indicating the likelihood of TCM usage were age 31-40 years, visit to an allopathic medical doctor in the last year, ability to read Chinese, having a friend or family member available to assist in the use of TCM, and access to information about TCM services available in Taiwan. Utilization of TCM by people of a non-Asian background living in Taiwan appears to be most influenced by enabling factors including language ability, access to information, and informal reference persons.

  16. Determining Factors for Utilization of Preventive Health Services among Adults with Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin

    2012-01-01

    Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled…

  17. Rural and urban married Asian immigrants in Taiwan: determinants of their physical and mental health.

    PubMed

    Chen, Walter; Shiao, Wen-Been; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh

    2013-12-01

    Different geographical areas with unique social cultures or societies might influence immigrant health. This study examines whether health inequities and different social factors exist regarding the health of rural and urban married Asian immigrants. A survey was conducted on 419 rural and 582 urban married Asian immigrants in Taiwan in 2009. Whereas the descriptive results indicate a worse mental health status between rural and urban married Asian immigrants, rural married immigrants were as mentally healthy as urban ones when considering different social variables. An analysis of regional stratification found different social-determinant patterns on rural and urban married immigrants. Whereas social support is key for rural immigrant physical and mental health, acculturation (i.e., language proficiency), socioeconomics (i.e., working status), and family structure (the number of family members and children living in the family) are key to the mental health of urban married immigrants in addition to social support. This study verifies the key roles of social determinants on the subjective health of married Asian immigrants. Area-differential patterns on immigrant health might act as a reference for national authorities to (re)focus their attention toward more area-specific approaches for married Asian immigrants.

  18. Program Changes in Technology Teacher Education in Taiwan.

    ERIC Educational Resources Information Center

    Lai, Chih-Chien Steven

    Taiwan has two technology teacher departments: one at the National Taiwan Normal University (NTNU) and the other at National Kaohsiung Normal University (NKNU). In recent years, both universities' technology teacher education programs have simultaneously followed two lines of development: the transition from an industrial arts education program to…

  19. Disparities in the use of preventive health care among children with disabilities in Taiwan.

    PubMed

    Tsai, Wen-Chen; Kung, Pei-Tseng; Wang, Jong-Yi

    2012-01-01

    Children with disabilities face more barriers accessing preventive health services. Prior research has documented disparities in the receipt of these services. However, most are limited to specific types of disability or care. This study investigates disparities in the use of preventive health care among children with disabilities in Taiwan. Three nationwide databases from the Ministry of the Interior, Bureau of Health Promotion, and National Health Research Institutes were linked to gather related information between 2006 and 2008. A total of 8572 children with disabilities aged 1-7 years were included in this study. Multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 37.58% of children with disabilities received preventive health care in 2008. Children with severe and very severe disabilities were less likely to use preventive care than those with mild severity. Children with disabilities from the lowest income family were less likely to have preventive care than other income groups. Urbanization was strongly associated with the receipt of preventive health care. However, surprisingly, urban children with disabilities were less likely to receive preventive care than all others. Under universal health insurance coverage, the overall usage of preventive health care is still low among children with disabilities. The study also identified several disparities in their usage. Potential factors affecting the lack of use deserve additional research. Policymakers should target low socioeconomic brackets and foster education about the importance of preventive care. Mobile health services should be continually provided in those areas in need. Capitation reimbursement and other incentives should be considered in improving the utilization among children with disabilities. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Volunteer transitions and physical and psychological health among older adults in Taiwan.

    PubMed

    Li, Yueh-Ping; Chen, Yuh-Min; Chen, Ching-Huey

    2013-11-01

    This study examines the relationship between transitions in volunteering activity and physical and psychological health outcomes among older adults in Taiwan. We used 3 waves of a longitudinal survey from Taiwan (1999, 2003, and 2007) including 1,847 older adults aged 58-74. We categorized volunteer activity over time into 5 categories and used generalized estimating equations to examine the relationship between volunteer transition group membership and health outcomes. Approximately, 3% of older volunteers kept volunteering and 7% stopped or started their volunteering over time. Engaging in any volunteering, including continuous volunteering, discrete volunteering, active-to-inactive volunteering, and inactive-to-active volunteering, was significantly associated with better self-rated health and higher life satisfaction when compared with the nonvolunteering group. Only those in the continuous volunteer group and those who shifted from inactive-to-active volunteering showed a positive association with better physical function and less depression, compared with the nonvolunteering group. The results suggest that the positive relationship between volunteering and health may decline when older adults discontinue or withdraw from volunteering. More research is needed to explore the mechanism behind older people's desistance from, persistence in, and resumption of volunteer engagement.

  1. Physician specialty and the quality of medical care experiences in the context of the Taiwan national health insurance system.

    PubMed

    Tsai, Jenna; Shi, Leiyu; Yu, Wei-Lung; Hung, Li-Mei; Lebrun, Lydie A

    2010-01-01

    Based on a recent patient survey from Taiwan, where there is universal health insurance coverage and unrestricted physician choice, this study examined the relationship between physician specialty and the quality of primary medical care experiences. We assessed ambulatory patients' experiences with medical care using the Primary Care Assessment Tool, representing 7 primary care domains: first contact (ie, accessibility and utilization); longitudinality (ie, ongoing care); coordination (ie, referrals and information systems); comprehensiveness (ie, services available and provided); family centeredness; community orientation; and cultural competence. Having a primary care physician was significantly associated with patients reporting higher quality of primary care experiences. Specifically, relative to specialty care physicians, primary care physicians enhanced accessibility, achieved better community orientation and cultural competence, and provided more comprehensive services. In an area with universal health insurance and unrestricted physician choice, ambulatory patients of primary care physicians rated their medical care experiences as superior to those of patients of specialists. In addition to providing health insurance coverage, promoting primary care should be included as a health policy to improve patients' quality of ambulatory medical care experiences.

  2. Factors influencing consumer adoption of USB-based Personal Health Records in Taiwan

    PubMed Central

    2012-01-01

    Background Usually patients receive healthcare services from multiple hospitals, and consequently their healthcare data are dispersed over many facilities’ paper and electronic-based record systems. Therefore, many countries have encouraged the research on data interoperability, access, and patient authorization. This study is an important part of a national project to build an information exchange environment for cross-hospital digital medical records carried out by the Department of Health (DOH) of Taiwan in May 2008. The key objective of the core project is to set up a portable data exchange environment in order to enable people to maintain and own their essential health information. This study is aimed at exploring the factors influencing behavior and adoption of USB-based Personal Health Records (PHR) in Taiwan. Methods Quota sampling was used, and structured questionnaires were distributed to the outpatient department at ten medical centers which participated in the DOH project to establish the information exchange environment across hospitals. A total of 3000 questionnaires were distributed and 1549 responses were collected, out of those 1465 were valid, accumulating the response rate to 48.83%. Results 1025 out of 1465 respondents had expressed their willingness to apply for the USB-PHR. Detailed analysis of the data reflected that there was a remarkable difference in the “usage intention” between the PHR adopters and non-adopters (χ2 =182.4, p < 0.001). From the result of multivariate logistic regression analyses, we found the key factors affecting patients’ adoption pattern were Usage Intention (OR, 9.43, 95%C.I., 5.87-15.16), Perceived Usefulness (OR, 1.60; 95%C.I., 1.11-2.29) and Subjective Norm (OR, 1.47; 95%C.I., 1.21-1.78). Conclusions Higher Usage Intentions, Perceived Usefulness and Subjective Norm of patients were found to be the key factors influencing PHR adoption. Thus, we suggest that government and hospitals should promote the

  3. Physicians as well as nonphysician health care professionals in Taiwan have higher risk for lumbar herniated intervertebral disc than general population

    PubMed Central

    Chan, Feng-Kai; Hsu, Chien-Chin; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Weng, Shih-Feng

    2018-01-01

    Abstract Physicians in Taiwan have long working hours and are at risk for inappropriate posture when handling patients, which may contribute to lumbar herniated intervertebral disc (L-HIVD). This study was conducted to delineate this issue, which is still unknown. This nationwide population-based cohort study was based on Taiwan National Health Insurance Research Database. We identified 25,428 physicians, 32,316 nonphysician health care professionals (HCPs), and an identical number of age- and sex-matched individuals from the general population. All individuals who had L-HIVD before 2007 were excluded. We compared the L-HIVD risk between physicians and general population, nonphysician HCPs and general population, and physicians and nonphysician HCPs by tracing their medical histories between 2007 and 2011. A comparison among physician specialties was also performed. Physicians and nonphysician HCPs had higher L-HIVD risk than the general population [odds ratio (OR): 1.149; 95% confidence interval (CI): 1.011–1.307 and OR: 1.220; 95% CI: 1.080–1.378, respectively]. Physicians did not have higher L-HIVD risk than nonphysician HCPs [adjusted OR (AOR): 0.912; 95% CI: 0.795–1.046]. Physician specialties of orthopedics and obstetrics and gynecology had a trend of higher L-HIVD risk than other specialties (AOR: 1.538; 95% CI: 0.805–2.939, and AOR: 1.306; 95% CI: 0.967–1.764, respectively). Physicians as well as nonphysician health care professionals in Taiwan have higher L-HIVD risk than the general population, which could be attributed to a probable role of long working hours. This result provides an important reference for the government to promote occupational health in health care professionals; however, further studies are warranted for the underlying mechanisms. PMID:29505537

  4. Achieving organizational change: findings from a case study of health promoting hospitals in Taiwan.

    PubMed

    Lee, Chiachi Bonnie; Chen, Michael S; Powell, Michael; Chu, Cordia Ming-Yeuk

    2014-06-01

    The Taiwanese Network of Health Promoting Hospitals (HPH) has been in place since 2006 and developing rapidly. The criticism of inadequate evaluation of the HPH approach taken elsewhere also holds true for the Taiwan HPH Network. Organizational change is a key to sustainable and effective health promotion, and it is also an important aspect in the European HPH movement. Therefore, this study aims to evaluate changes in organizational capacity for the implementation of HPH in Taiwan. All 55 HPH coordinators were invited to participate in the study, and 52 of them completed the questionnaires. The survey covered seven dimensions of HPH organizational capacity, and a total score of each dimension was calculated and converted to a figure on a scale of 10. This study has shown that HPH made a positive impact on HP hospitals in Taiwan regarding organizational change in capacity building for HPH. Leadership, organization culture and mission and strategy received the top three highest mean scores (8.19 ± 1.25, 8.08 ± 1.39, 7.99 ± 1.42), while staff participation received the lowest score (7.62 ± 1.26). The high level of organizational change was associated with the high satisfaction levels of organizational support from the viewpoint of the HPH coordinators. Based on a cluster analysis, a majority of the HP hospitals in Taiwan seemed to have adopted the addition model in putting the HPH initiative into practice; a few hospitals appeared to have accepted HPH initiative well through the integration model. These results presented evidence that HPH contributed to organizational capacity building of hospitals for health promotion.

  5. National Identity and Its Relationship with Teachers' Historical Knowledge and Pedagogy: The Case of Taiwan

    ERIC Educational Resources Information Center

    Sung, Pei-Fen; Yang, Meng-Li

    2009-01-01

    National identity is one of the most important forms of ideology that affects human behaviours. Yet, the issue of whether it influences history teachers' subject matter knowledge or teaching practice is overlooked most of the time. With regime change in Taiwan, history curriculum and textbooks are no longer dominated by a China-centred narrative;…

  6. Leisure Experiences and Depressive Symptoms among Chinese Older People: A National Survey in Taiwan

    ERIC Educational Resources Information Center

    Lu, Luo

    2011-01-01

    We aimed to explore older people's subjective leisure experiences and to further examine associations of such experiences with their depressive symptoms in Taiwan. Known correlates of depression, such as demographics, physical health, and social support, were taken into account. Face-to-face interviews were conducted to collect data using…

  7. [Comparing the Health Needs of Older Aboriginal and Older Ethnic Chinese Individuals in Taiwan].

    PubMed

    Lee, Ling-Ling; Lin, Shu-Shuan; Yen, Chia-Feng; Chuang, Jui-Ling

    2016-04-01

    Providing healthcare to older people is an essential policy in Taiwan. Previous studies have assessed the health needs of older people residing in urban areas. Evidence related to the differences in healthcare needs between older aboriginal and older ethnic Chinese people in Taiwan is insufficient. As both groups exhibit mutually distinct physical and socio-cultural attributes, understanding their different health needs is necessary to provide tailored and effective healthcare. To investigate the distinct health needs of older aboriginal and older ethnic Chinese using a comprehensive health-needs assessment tool. A cross-sectional study design was used. Older people aged 65 or over were proportionally sampled from communities. The Elderly Assessment System Care Standard instrument was used to collect data through interviews held in participant homes or in community activity centers between October 20th and December 20th, 2011. A total of 180 older people were recruited. A majority of participants had at least one chronic disease, disability, or frailty. Across a range of dimensions and categories of health needs, older aboriginal people had statistically significant higher health needs than non-aboriginal ones. However, older ethnic Chinese participants had higher levels of need in the domains of housing/financing and social participation/isolation. Regression analysis found that independence, risk of frailty, and risk of falls explained the majority of health needs, with R2 values of 64% and 69.6% for older aboriginal and older ethnic Chinese participants, respectively. However, the respective impact of these three categories on overall health needs varied between the two groups. Based on our findings, healthcare providers should focus on improving the self-care capabilities of older aboriginal people and on reducing the risk of breakdowns in care for older ethnic Chinese people in order to enhance the quality of elderly care in Taiwan.

  8. The impact of global budgeting on health service utilization, health care expenditures, and quality of care among patients with pneumonia in Taiwan.

    PubMed

    Lin, C-Y; Ma, T; Lin, C-C; Kao, C-H

    2016-02-01

    This study evaluated the effect of global budgeting on health service utilization, health care expenditures, and the quality of care among patients with pneumonia in Taiwan. The National Health Insurance Research Database (NHIRD) was used for analysis. Data on patients diagnosed with pneumonia during 2000-2001 (the prebudget group) were used as the baseline data, and data on patients diagnosed with pneumonia during 2004-2005 (the postbudget group) were used as the postintervention data. The length of stay (LOS), diagnostic costs, drug costs, therapy costs, total costs, risk of readmission within 14 days, and risk of revisiting the Emergency Department (ED) within 3 days of discharge before and after implementing the global budget system were analyzed and compared. Data on 32,535 patients with pneumonia were analyzed. The mean LOS increased from 6.36 ± 0.07 to 10.78 ± 0.09 days after implementing the global budget system. The mean total costs in the prebudget and postbudget groups were 22,697.82 ± 542.40 and 62,016.7 ± 793.19 New Taiwan dollars (NT$), respectively. The mean rate of revisiting the ED within 3 days decreased from 5.5 ± 0.2 % to 4.6 ± 0.1 % in the prebudget and postbudget groups, respectively. The mean rates of readmission within 14 days before were 6.1 ± 0.2 % and 8.2 ± 0.2 % in the prebudget and postbudget groups, respectively. Global budgeting is associated with a significantly longer LOS, higher health care costs, and poorer quality of care among patients with pneumonia.

  9. A National Investigation of Teachers' Environmental Literacy as a Reference for Promoting Environmental Education in Taiwan

    ERIC Educational Resources Information Center

    Liu, Shiang-Yao; Yeh, Shin-Cheng; Liang, Shi-Wu; Fang, Wei-Ta; Tsai, Huei-Min

    2015-01-01

    Taiwan's government enacted the Environmental Education Act in June 2011. In the beginning of the implementation of the Act, a national assessment of schoolteachers' environmental literacy was performed in order to establish the baseline for evaluating the effectiveness of environmental education policy. This large-scale assessment involved a…

  10. Taiwan: improving radiography through application of Six Sigma techniques.

    PubMed

    Chen, Yan-Kwang; Lin, Jerry; Chang, Cheng-Chang

    2005-01-01

    The healthcare industry has shown significant recent growth potential in Taiwan. Associated financial problems have grown considerably since 1995, when national health insurance was implemented. Taiwan's healthcare bureau began to change the primary quantity-based healthcare expense payment method to a case-based payment model. Hospitals are now challenged to minimize healthcare waste. This article examines the application of manufacturing-based Six Sigma methods to an X-ray radiography improvement project to reduce the defect ratio of films for a teaching hospital in Taiwan. It was determined that (1) analysis of customer satisfaction data helped the Six Sigma improvement team identify critical quality elements; (2) the Six Sigma Level in this healthcare project is Lower than that in the manufacturing industry; (3) the improvement opportunity and the time required for the project had a direct correlation to the importance ascribed to the project and the cooperation received; and (4) process change can be made more quickly in the healthcare industry than in the manufacturing industry.

  11. Factors associated with utilization of traditional Chinese medicine by white collar foreign workers living in Taiwan

    PubMed Central

    Daly, Maria; Tai, Chen-Jei; Deng, Chung-Yeh; Chien, Li-Yin

    2009-01-01

    Background Traditional Chinese medicine (TCM) has remained an integral part of Chinese culture and society for thousands of years. In Taiwan TCM is a recognized element of its National Health Insurance Scheme. However, there is no knowledge about how TCM is accessed by foreign workers from a non-Asian cultural background. The objectives of this study were to investigate the prevalence and patterns of TCM use among non-Asian white-collar workers living in Taiwan, and examine factors likely to influence their use of TCM. Methods This study applied a cross-sectional survey design. A total of 207 white-collar foreign workers of a non-Asian background currently holding National Health Insurance cards who had lived in Taiwan for 4 months or more participated in this study. Results The prevalence of TCM use was 45%. The most frequently used therapies were traditional Chinese herbs/medicine and acupuncture. Factors indicating the likelihood of TCM usage were age 31–40 years, visit to an allopathic medical doctor in the last year, ability to read Chinese, having a friend or family member available to assist in the use of TCM, and access to information about TCM services available in Taiwan. Conclusion Utilization of TCM by people of a non-Asian background living in Taiwan appears to be most influenced by enabling factors including language ability, access to information, and informal reference persons. PMID:19144152

  12. [Reflection on the Differences and Similarities of Mental Health Care in Virginia and Taiwan: Geography, History, Culture, and Nurse Practitioners].

    PubMed

    Lu, Chueh-Fen; Tung, Ching-Chuan; Ely, Linda

    2016-12-01

    Sponsored by the pilot overseas internships project of the Ministry of Education, Taiwan, the authors and ten undergraduate students from Taiwan visited several mental health facilities in Virginia for one month. These facilities included the Catawba State Hospital, Salem Veteran Affairs Medical Center, Carilion Saint Albans Behavioral Health (New River Valley Medical Center), Warm Hearth Village, Adult & Child Family Counseling private outpatient clinic, the Free Clinic of the New River Valley, New Life Clubhouse, and Self-Government Program for Assertive Community Treatment. In-depth dialogue and participation in nursing care under the supervision of registered nurses facilitated the authors' reflection on mental health care and the roles and functions of Taiwanese nurse practitioners. The present article adopts a macro view in order to compare the related issues between Taiwan and Virginia, including: geographic features, history, culture of health-seeking behavior, healthcare insurance, and the relationships among various professionals. How these issues relate to social-cultural background and how the overall healthcare environment impacts upon the roles of nurse practitioners in Taiwan are rarely discussed in literature. We expect that this cross-cultural contrast and reflection will elicit a better understanding of how these factors have shaped and affected the roles of Taiwanese nurse practitioners. Further, suggestions about how to improve the nursing profession in Taiwan are presented.

  13. An investigation of snakebite antivenom usage in Taiwan.

    PubMed

    Lin, Chih-Chuan; Chaou, Chung-Hsien; Tseng, Chiung-Yao

    2016-08-01

    Four types of antivenom are used to treat snakebites by the six species of venomous snakes native to Taiwan. Research into antivenom use in Taiwan and its outcomes, as well as the utility of current Taiwan Poison Control Center guidelines for antivenom use, has been limited. We aimed to provide increased understanding by investigating the treatment and outcomes of patients treated for snakebite in Taiwan. On the basis of data collected from the 2009 Taiwan National Health Insurance database, patients with snakebites were identified and categorized into two sets of groups according to types of antivenom administered. The relationships between antivenom types, dosage and the variables of antibiotic use, surgical intervention, acute respiratory failure acute, renal failure, antivenom-related allergic reaction, mortality, need for hospital admission, and length of hospitalization were analyzed by multivariate logistic regression and the Kruskal-Wallis test. The majority of patients were successfully treated by administration of 1 vial of antivenom and discharged without complications. However, patients treated for neurotoxic-type venom snakebite required administration of larger doses of antivenom and > 30% required surgical intervention, particularly those treated for Chinese cobra snakebite. Approximately 10% of patients were administered two types of antivenom. The results partially support Taiwan Poison Control Center guidelines for treating the hemorrhagic-type venom snakebite. However, deficit in the guidelines for treatment of neurotoxic-type venom snakebite is obvious and new guidelines for treatment of neurotoxic-type venom snakebite and diagnosis should be developed. Copyright © 2015. Published by Elsevier B.V.

  14. Medical Resource Utilization by Taiwanese Psychiatric Inpatients under the National Health Insurance System.

    PubMed

    Lee, Chiachi Bonnie; Li, Chung-Yi; Lin, Chih-Ming

    2016-12-01

    The length of stay in Taiwan's psychiatric facilities is unusually long compared with that of other countries. To identify factors associated with the high length of stay in the acute and chronic psychiatric wards of a public psychiatric hospital. The present study consisted of 912 inpatients discharged from a public psychiatric hospital in Northern Taiwan in 2005. Demographic characteristics, discharge diagnoses, and medical resource utilization were retrieved from the inpatient claim data of the National Health Insurance Database. Multivariate logistic regression models were performed to identify significant predictors for a long length of stay (LOS). Covariate adjusted odds ratios and a 95% confidence interval (CI) were applied to explore the effects of financial barriers, demographic, and diagnostic characteristics, and readmission for medical care. A median LOS of 35.0 days and median medical charge of USD 3,271.50 were reported. A greater likelihood of a high degree of medical care was found among patients who were exempt from copayments, were diagnosed with schizophrenia, had a co-morbidity factor, and were admitted from emergency visits. The results showed that patients in the 45--60 year age group had a higher risk of long LOS than those in the 18--30 year age group. A longer LOS in Taiwan might reflect more free access to hospitals and further extensive utilization of medical facilities under the National Health Insurance system. It was noted that age, sex, disease characteristics, and insurance policies were associated with a high medical utilization. However, the lack of a copayment may partially explain the long LOS in our study. Other causes, such as inadequate supplies of resources for psychiatric services, may also deserve closer study. A failure to adjust for potentially confounding factors might limit interpretation of the observed relationship between such potential factors and medical resource utilization. These findings support the future

  15. Disparities in the Use of Preventive Health Care among Children with Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Tsai, Wen-Chen; Kung, Pei-Tseng; Wang, Jong-Yi

    2012-01-01

    Children with disabilities face more barriers accessing preventive health services. Prior research has documented disparities in the receipt of these services. However, most are limited to specific types of disability or care. This study investigates disparities in the use of preventive health care among children with disabilities in Taiwan. Three…

  16. Comparison of electrocardiographic findings and associated risk factors between Taiwan Chinese and US White adults.

    PubMed

    Wu, Chih-Cheng; Yeh, Wen-Ting; Crow, Richard S; Bai, Chyi-Huey; Pan, Wen-Harn

    2008-08-18

    Electrocardiographic (ECG) findings are known to differ by race, however, systematic comparisons of findings between eastern and western countries are rare. To compare the ECG findings and associated coronary heart disease (CHD) risk factors between Taiwan Chinese and US White adults aged >or=40 years. We compared the prevalence rate of Minnesota Code criteria based ECG findings and associated CHD risk factors by using data from the third National Health and Nutrition Examination Survey (NHANES III) and the Nutrition and Health Survey in Taiwan (NAHSIT, 1993-1996). Examining all the ECG findings collectively, we observed a higher prevalence of major Minnesota Code findings in Taiwan Chinese women than in US White women (15.0% vs. 10.5%), particularly ST segment depression (5.4% vs. 2.4%) and T wave abnormalities (10.8% vs. 4.8%). The prevalence of major Minnesota Code findings was similar in both Taiwan Chinese and US White men (22.7% vs. 19.6%). Taiwan Chinese men had a higher prevalence of ST segment elevation (13.7% vs. 0.9%). Taiwan Chinese also had a higher prevalence of left ventricular hypertrophy with repolarization change than US Whites in both sexes (2.7% vs. 1.4% for men, 4.3% vs. 1.3% for women). Taiwan Chinese had more favorable CHD risk factor profiles than US Whites, including lipid profile, obesity, central obesity, and smoking status. The prevalence of hypertension was similar between the two groups, however, a lower percentage of Taiwan Chinese received treatment. Taiwan Chinese men had a lower prevalence of diabetes mellitus than US White men, whereas Taiwan Chinese women had a higher prevalence than US White women. These results suggest that substantial differences in ECG findings exist between Taiwan Chinese and US Whites which cannot be entirely explained by CHD risk factors alone.

  17. Cost-effectiveness of granulocyte colony-stimulating factor prophylaxis in chemotherapy-induced febrile neutropenia among breast cancer and Non-Hodgkin's lymphoma patients under Taiwan's national health insurance system.

    PubMed

    Wen, Tsun-Jen; Wen, Yu-Wen; Chien, Chun-Ru; Chiang, Shao-Chin; Hsu, William Wei-Yuan; Shen, Li-Jiuan; Hsiao, Fei-Yuan

    2017-04-01

    The beneficial effects of granulocyte colony-stimulating factor (G-CSF) prophylaxis on reducing the risk of chemotherapy-induced febrile neutropenia (CIFN) were well documented throughout the literature. However, existing data regarding its cost-effectiveness were conflicting. We estimated the cost-effectiveness of G-CSF prophylaxis in CIFN under Taiwan's National Health Insurance (NHI) system. Data on clinical outcomes and direct medical costs were derived for 5179 newly diagnosed breast cancer and 629 non-Hodgkin's lymphoma (NHL) patients from the NHI claims database. Patients were further categorized into three subgroups as "primary-", "secondary-" and "no -" prophylaxis based on their patterns of G-CSF use. Generalized estimating equations were applied to estimate the impact of G-CSF use on the incidence of CIFN. The incremental cost-effectiveness ratios of primary and secondary prophylactic G-CSF use were calculated and sensitivity analyses were performed. Primary prophylaxis of G-CSF decreased the incidence of CIFN by 27% and 83%, while secondary prophylaxis by 34% and 22% in breast cancer and NHL patients, respectively. Compared with those with no prophylaxis, the incremental cost per CIFN reduced in primary prophylaxis is $931 and $52 among patients with breast cancer and NHL, respectively. In contrast, secondary prophylaxis is dominated by no prophylaxis and primary prophylaxis in both cancer patients. Primary but not secondary prophylactic use of G-CSF was cost-effective in CIFN in breast cancer and NHL patients under Taiwan's NHI system. © 2016 John Wiley & Sons, Ltd.

  18. Influence of Latitude on the Prevalence of Kawasaki Disease: A Retrospective Cohort Study from the Taiwan National Health Insurance Database and Review of the Literature.

    PubMed

    Chang, Chaw-Liang; Wong, Chih-Shung; Yang, Yi-Chen; Chiu, Nan-Chang

    2018-04-25

    Background: Countries at higher latitudes have higher incidence rates of Kawasaki disease (KD) than do countries at lower latitudes in the Asian and West Pacific area. However, the precise influence of latitude on KD incidence rates requires further clarification. Methods: We searched the Longitudinal Health Insurance Database 2005 to retrieve patients’ medical records from 1996 to 2009. The patients with KD were categorized as living in northern, middle, and southern Taiwan; the period prevalence of KD for each area was determined. Climate variables, including temperature, sunshine duration, precipitation, and relative humidity, were collected from the Taiwan Central Weather Bureau. The effect of latitude on the period KD prevalence and the correlation between climate variables and KD prevalence were calculated. Results: After patients without complete data excluded, a total of 61,830 children up to 10 years old were retrieved, from which 404 patients with KD were recognized. The period prevalence of KD increased significantly with latitude ( p = 0.0004). Climate variables associated with high temperature demonstrated a connection with KD prevalence; however, this correlation was not statistically significant. Conclusions: Our study demonstrated that higher latitude is associated with a higher KD prevalence in Taiwan.

  19. Pregnancy-associated mortality in Taiwan, 2004-2011.

    PubMed

    Sha, Li; Wu, Tung-Pi; Liang, Fu-Wen; Chen, Lea-Hua; Lu, Tsung-Hsueh; Huang, Ya-Li

    2016-06-01

    Pregnancy-associated death is defined by the American College of Obstetricians and Gynecologists as "a death of a woman while pregnant or within 1 year of termination of pregnancy, irrespective of the cause of death." We sought to determine pregnancy-associated mortality ratio (PAMR) in Taiwan and to compare the cause of death pattern with other countries to assess the national health status of Taiwanese women. We linked four nationwide population-based data sets (birth registration, birth notification, National Health Insurance claims, and cause of death mortality) from 2004 to 2011 to identify women aged 15-49 years that died from pregnancy-associated deaths. We then calculated the PAMR and cause of death distribution by maternal age. A total of 559 pregnancy-associated deaths were identified with an overall PAMR of 36 (deaths per 100,000 live births). The J-shaped age-specific PAMR mortality pattern was noted, in which the PAMR was 32, 25, 24, 36, 71, 143, and 369 for women aged 15-19 years, 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, and 45-49 years, respectively. The age-standardized PAMR decreased drastically from 45 in 2004-2005 to 36 in 2006-2007 and 30 in 2008-2009, but leveled off to 33 in 2010-2011. The proportion of indirect causes increased from 2004-2007 to 2008-2011 among women aged 15-29 years and 35-49 years. Compared with previous studies, the PAMR of Taiwan is moderate. However, the proportion of external causes of pregnancy-associated deaths in Taiwan is the lowest compared with other regions. Further studies (such as death review) are needed to explore possible preventable factors. Copyright © 2016. Published by Elsevier B.V.

  20. The Geothermal Potential, Current and Opportunity in Taiwan

    NASA Astrophysics Data System (ADS)

    Song, Sheng-Rong

    2016-04-01

    Located in the west Pacific Rim of Fire, Taiwan possesses rich geothermal resources due to volcanic activities and rapid uplifting of plate collision. Based on available data prior to 1980, Taiwan may have about 1 GWe of potential shallow geothermal energy, which is less than 3% of the national gross power generation. A 3-Mw pilot power plant, therefore, was constructed in 1981 and terminated in 1993 in the Chingshui geothermal field of Ilan, northeastern Taiwan. Recently, one of the National Science & Technology Program (NSTP) projects has been conducting research and reevaluating the island-wide deep geothermal energy. Four hot potential sites have been recognized. They are: (1) Tatun Volcano Group of northern Taiwan; (2) I-Lan Plain of NE Taiwan; (3) Lu-Shan area of Central Taiwan; and (4) Hua-Tung area of eastern Taiwan. We found that the geothermal resource in Taiwan may be as high as 160 GWe, with 33.6 GWe of exploitable geothermal energy. There are no any commercial geothermal power plants until now in Taiwan, although the potential is great. However, geothermal energy has been listed as one of major tasks of National Energy Program, Phase II (NEP-II) in Taiwan. We will conduct more detailed geothermal energy surveys on some proposed hot sites and to construct an EGS pilot geothermal plant with 1 MWe capability in a few years. Currently, there are three nuclear power plants, named No. 1, 2 & 3, in operations, which produce 16.5% gross generation of electricity and one (No. 4) is under construction, but is stopped and sealed now in Taiwan. Furthermore, the life-span of 40-year operation for those three power plants will be close-at hand and retire in 2018-2019, 2021-2023 and 2024-2025, respectively. Therefore, to find alternative energy sources, especially on the clean, renewable and sustainable ones for generating electricity are emergent and important for Taiwan's government in next few years. Among various energy sources, geothermal energy can be as base

  1. An Integrated Syndromic Surveillance System for Monitoring Scarlet Fever in Taiwan

    PubMed Central

    Wu, Wan-Jen; Liu, Yu-Lun; Kuo, Hung-Wei; Huang, Wan-Ting; Yang, Shiang-Lin; Chuang, Jen-Hsiang

    2013-01-01

    Objective To develop an integrated syndromic surveillance system for timely monitoring and early detection of unusual situations of scarlet fever in Taiwan, since Hong Kong, being so close geographically to Taiwan, had an outbreak of scarlet fever in June 2011. Introduction Scarlet fever is a bacterial infection caused by group A streptococcus (GAS). The clinical symptoms are usually mild. Before October, 2007, case-based surveillance of scarlet fever was conducted through notifiable infectious diseases in Taiwan, but was removed later from the list of notifiable disease because of improved medical care capacities. In 2011, Hong Kong had encountered an outbreak of scarlet fever (1,2). In response, Taiwan developed an integrated syndromic surveillance system using multiple data sources since July 2011. Methods More than 99% of the Taiwan population is covered by National Health Insurance. We first retrospectively evaluated claims data from the Bureau of National Health Insurance (BNHI) by comparing with notifiable diseases reporting data from Taiwan Centers for Disease Control (TCDC). The claims data included information on scarlet fever diagnosis (ICD-9-CM code 034.1), date of visits, location of hospitals and age of patients from outpatient (OPD), emergency room (ER) and hospital admissions. Daily aggregate data of scarlet fever visits or hospitalizations were prospectively collected from BNHI since July 2011. Over 70% of the deaths in Taiwan are reported to the Office of Statistics of Department of Health electronically. We obtained daily data on electronic death certification data and used SAS Enterprise Guide 4.3 (SAS Institute Inc., Cary, NC, USA) for data management and analysis. Deaths associated with scarlet fever or other GAS infections were identified by text mining from causes of death with keywords of traditional Chinese ‘scarlet fever’, ‘group A streptococcus’ or ‘toxic shock syndrome’ (3). Results From January 2006 to September 2007, the

  2. The Taiwan Birth Panel Study: a prospective cohort study for environmentally- related child health

    PubMed Central

    2011-01-01

    Background The Taiwan Birth Panel Study (TBPS) is a prospective follow-up study to investigate the development of child health and disease in relation to in-utero and/or early childhood environmental exposures. The rationale behind the establishment of such a cohort includes the magnitude of potential environmental exposures, the timing of exposure window, fatal and children's susceptibility to toxicants, early exposure delayed effects, and low-level or unknown neurodevelopmental toxicants. Methods A total of 486 mother-infant paired was enrolled from April 2004 to January 2005 in this study. Maternal blood before delivery, placenta and umbilical cord blood at birth, and mothers' urine after delivery were collected. The follow-up was scheduled at birth, 4, 6 months, and 1, 2, 3 and 5 years. The children's blood, urine, hair, and saliva were collected at 2 years of age and children's urine was collected at 5 years of age as well. The study has been approved by the ethical committee of National Taiwan University Hospital. All the subjects signed the inform consent on entering the study and each of the follow up. Results Through this prospective birth cohort, the main health outcomes were focused on child growth, neurodevelopment, behaviour problem and atopic diseases. We investigated the main prenatal and postnatal factors including smoking, heavy metals, perfluorinated chemicals, and non-persistent pesticides under the consideration of interaction of the environment and genes. Conclusions This cohort study bridges knowledge gaps and answers unsolved issues in the low-level, prenatal or postnatal, and multiple exposures, genetic effect modification, and the initiation and progression of "environmentally-related childhood diseases." PMID:21838884

  3. Relationship Between Parental and Adolescent eHealth Literacy and Online Health Information Seeking in Taiwan.

    PubMed

    Chang, Fong-Ching; Chiu, Chiung-Hui; Chen, Ping-Hung; Miao, Nae-Fang; Lee, Ching-Mei; Chiang, Jeng-Tung; Pan, Ying-Chun

    2015-10-01

    This study examined the relationship between parental and adolescent eHealth literacy and its impact on online health information seeking. Data were obtained from 1,869 junior high school students and 1,365 parents in Taiwan in 2013. Multivariate analysis results showed that higher levels of parental Internet skill and eHealth literacy were associated with an increase in parental online health information seeking. Parental eHealth literacy, parental active use Internet mediation, adolescent Internet literacy, and health information literacy were all related to adolescent eHealth literacy. Similarly, adolescent Internet/health information literacy, eHealth literacy, and parental active use Internet mediation, and parental online health information seeking were associated with an increase in adolescent online health information seeking. The incorporation of eHealth literacy courses into parenting programs and school education curricula is crucial to promote the eHealth literacy of parents and adolescents.

  4. Social cohesion and health in old age: a study in southern Taiwan.

    PubMed

    Chen, Wenling; Okumiya, Kiyohito; Wada, Taizo; Sakamoto, Ryota; Imai, Hissei; Ishimoto, Yasuko; Kimura, Yumi; Fukutomi, Eriko; Fujisawa, Michiko; Shih, Hsin-I; Chang, Chia-Ming; Matsubayashi, Kozo

    2015-11-01

    Previous studies have found that social cohesion and trust (SCT) were associated with psychological well-being and physical health. In this study, we investigated the associations between SCT and mental and physical health among community-dwelling elderly in a town in southern Taiwan. The study population consisted of 149 community-dwelling elderly aged 65 years and older (68 men, 81 women; mean age, 75.4 ± 6.1 years) residing in the town of Dashe in southern Taiwan. Activities of daily living (ADL), SCT, depression, subjective quality of life (QOL), current medical status, past medical history, and health behaviors were assessed in face-to-face interviews. Objective neurobehavioral functions were assessed using the timed up & go (TUG) test, functional reach test, and handgrip test. Scores for ADL and Geriatric Depression Scale (GDS) were significantly correlated with SCT, and SCT was significantly correlated with all subjective QOL items. In addition, a strong correlation was observed between SCT and relationship with friends. Values for SCT (median ≥ 20) were significantly associated with both subjective sense of health (median ≥ 68) and subjective happiness (median ≥ 73) after adjusting for age, sex, and ADL. SCT is an important variable that influences self-rated health and happiness, independently of ADL, age, and sex. When assessing geriatric psychological function, SCT should be examined more carefully, given its association with subjective sense of health and happiness, depression, and physical function.

  5. Temporal trend analysis of avoidable mortality in Taiwan, 1971-2008: overall progress, with areas for further medical or public health investment.

    PubMed

    Chen, Brian K; Yang, Chun-Yuh

    2013-06-06

    Avoidable mortality (AM), or "unnecessary untimely death," is considered an indicator of health care quality. We investigated trends in the age-standardized mortality rates (ASMRs) and associated standard expected years of life lost (SEYLL) for deaths amenable to medical care or public health measures in Taiwan from 1971-2008, with an emphasis on identifying areas where additional medical or public health investment may help reduce the burden of AM. Taiwan's ASMRs per 100,000 for AM and other causes of death were calculated using data from the National Death Certificate Registry in five-year bins from 1971 to 2008. SEYLL rates per 100,000 were calculated annually from 1971 to 2008 using the same data source. ASMR for almost all AM and other causes of death declined dramatically from 1971 to 2008 except for lung cancer (16.6% and 7.4% increase among men and women, respectively) and breast cancer (109.8% increase among women). In the same period, SEYLL due to lung cancer increased from 269.2 to 555.7 for men and 249.7 to 342.5 for women. For women, SEYLL due to breast cancer increased from 263.5 in 1971 to 659.3 in 2008. There were gender-specific differences in the reduction (or increase) in AM rates, with women showing larger rates of reduction or smaller rates of increase. Among men, AM fell by 65.9% from 1971-1975 to 2006-2008, and deaths from other causes increased by 15.6%. Among women, AM and deaths from other causes fell by 80.8% and 59.8% respectively. SEYLL decreased, respectively among males and females, from 23,147.3 and 24,081.1 in 1971 to 11,261.8 and 5,929.6 in 2008. From 1971 to 2008, Taiwan experienced a dramatic reduction in most AM and corresponding SEYLL except for lung cancer (for both males and females) and breast cancer (for females). Additional effort should be devoted to public health measures to combat the rising prevalence of smoking in Taiwan, which may be responsible for the increasing AM from lung cancer. If AM in breast cancer continues

  6. Prescription frequency and patterns of Chinese herbal medicine for liver cancer patients in Taiwan: a cross-sectional analysis of the National Health Insurance Research Database.

    PubMed

    Ting, Chin-Tsung; Kuo, Chian-Jue; Hu, Hsiao-Yun; Lee, Ya-Ling; Tsai, Tung-Hu

    2017-02-20

    Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. Chinese herbal medicine (CHM) is frequently provided to HCC patients. The aim of this study was to understand the prescription frequency and patterns of CHM for HCC patients by analyzing the claims data from the National Health Insurance (NHI) in Taiwan. We identified 73918 newly diagnosed HCC subjects from the database of Registry for Catastrophic Illness during 2002 to 2009 and to analyze the frequency and pattern of corresponding CHM prescriptions for HCC patients. There were a total of 685,079 single Chinese herbal prescriptions and 553,952 Chinese herbal formula prescriptions used for 17,373 HCC subjects before 2 years of HCC diagnosis. Among the 13,093 HCC subjects who used CHMs after HCC diagnosis, there were 462,786 single Chinese herbal prescriptions and 300,153 Chinese herbal formula prescriptions were counted. By adjusting with person-year and ratio of standardized incidence rate, the top ten prescribed single herbal drugs and Chinese herbal formulas for HCC patients were described in our study. Among them, we concluded that, Oldenlandia diffusa (Chinese herbal name: Bai-Hua-She-She-Cao), Radix et Rhizoma Rhei (Da Huang) and the herbal preparation of Xiao-Chai-Hu-Tang and Gan-Lu-Yin, were the most obviously increased and important CHMs been used for HCC patients. We established an accurate and validated method for the actual frequency and patterns of CHM use in treating HCC in Taiwan. We propose that these breakthrough findings may have important implications for HCC therapy, clinical trials and modernization of CHM.

  7. Assessing the Use of the Family Affluence Scale as Socioeconomic Indicators for Researching Health Inequalities in Taiwan Adolescents

    ERIC Educational Resources Information Center

    Lin, Yu-Chen

    2011-01-01

    This study examined the reliability and validity of the Family Affluence Scale (FAS) and explored the relationship between FAS and health in a general adolescent population of Taiwan. Our data was obtained from a 2009 school-based survey. In total, 3,368 students (1,741 boys, 1,627 girls) in grades 6-10 in Kinmen County, Taiwan completed a…

  8. Identity Exploration, Commitment, and Distress: A Cross National Investigation in China, Taiwan, Japan, and the United States

    ERIC Educational Resources Information Center

    Berman, Steven L.; You, Yu-Fang; Schwartz, Seth; Teo, Grace; Mochizuki, Kohei

    2011-01-01

    This study tested cross cultural measurement equivalence of three identity constructs by testing the factor invariance among participants from four nations. Data from measures of identity exploration, commitment, and distress were collected from university students in Mainland China (n = 85), Taiwan (n = 117), Japan (n = 117), and the United…

  9. Understanding the productive author who published papers in medicine using National Health Insurance Database: A systematic review and meta-analysis.

    PubMed

    Chien, Tsair-Wei; Chang, Yu; Wang, Hsien-Yi

    2018-02-01

    Many researchers used National Health Insurance database to publish medical papers which are often retrospective, population-based, and cohort studies. However, the author's research domain and academic characteristics are still unclear.By searching the PubMed database (Pubmed.com), we used the keyword of [Taiwan] and [National Health Insurance Research Database], then downloaded 2913 articles published from 1995 to 2017. Social network analysis (SNA), Gini coefficient, and Google Maps were applied to gather these data for visualizing: the most productive author; the pattern of coauthor collaboration teams; and the author's research domain denoted by abstract keywords and Pubmed MESH (medical subject heading) terms.Utilizing the 2913 papers from Taiwan's National Health Insurance database, we chose the top 10 research teams shown on Google Maps and analyzed one author (Dr. Kao) who published 149 papers in the database in 2015. In the past 15 years, we found Dr. Kao had 2987 connections with other coauthors from 13 research teams. The cooccurrence abstract keywords with the highest frequency are cohort study and National Health Insurance Research Database. The most coexistent MESH terms are tomography, X-ray computed, and positron-emission tomography. The strength of the author research distinct domain is very low (Gini < 0.40).SNA incorporated with Google Maps and Gini coefficient provides insight into the relationships between entities. The results obtained in this study can be applied for a comprehensive understanding of other productive authors in the field of academics.

  10. The feasibility of QR-code prescription in Taiwan.

    PubMed

    Lin, C-H; Tsai, F-Y; Tsai, W-L; Wen, H-W; Hu, M-L

    2012-12-01

    An ideal Health Care Service is a service system that focuses on patients. Patients in Taiwan have the freedom to fill their prescriptions at any pharmacies contracted with National Health Insurance. Each of these pharmacies uses its own computer system. So far, there are at least ten different systems on the market in Taiwan. To transmit the prescription information from the hospital to the pharmacy accurately and efficiently presents a great issue. This study consisted of two-dimensional applications using a QR-code to capture Patient's identification and prescription information from the hospitals as well as using a webcam to read the QR-code and transfer all data to the pharmacy computer system. Two hospitals and 85 community pharmacies participated in the study. During the trial, all participant pharmacies appraised highly of the accurate transmission of the prescription information. The contents in QR-code prescriptions from Taipei area were picked up efficiently and accurately in pharmacies at Taichung area (middle Taiwan) without software system limit and area limitation. The QR-code device received a patent (No. M376844, March 2010) from Intellectual Property Office Ministry of Economic Affair, China. Our trial has proven that QR-code prescription can provide community pharmacists an efficient, accurate and inexpensive device to digitalize the prescription contents. Consequently, pharmacists can offer better quality of pharmacy service to patients. © 2012 Blackwell Publishing Ltd.

  11. Health-care data collecting, sharing, and using in Thailand, China mainland, South Korea, Taiwan, Japan, and Malaysia.

    PubMed

    Aljunid, Syed Mohamed; Srithamrongsawat, Samrit; Chen, Wen; Bae, Seung Jin; Pwu, Raoh-Fang; Ikeda, Shunya; Xu, Ling

    2012-01-01

    This article sought to describe the health-care data situation in six selected economies in the Asia-Pacific region. Authors from Thailand, China mainland, South Korea, Taiwan, Japan, and Malaysia present their analyses in three parts. The first part of the article describes the data-collection process and the sources of data. The second part of the article presents issues around policies of data sharing with the stakeholders. The third and final part of the article focuses on the extent of health-care data use for policy reform in these different economies. Even though these economies differ in their economic structure and population size, they share some similarities on issues related to health-care data. There are two main institutions that collect and manage the health-care data in these economies. In Thailand, China mainland, Taiwan, and Malaysia, the Ministry of Health is responsible through its various agencies for collecting and managing the health-care data. On the other hand, health insurance is the main institution that collects and stores health-care data in South Korea and Japan. In all economies, sharing of and access to data is an issue. The reasons for limited access to some data are privacy protection, fragmented health-care system, poor quality of routinely collected data, unclear policies and procedures to access the data, and control on the freedom on publication. The primary objective of collecting health-care data in these economies is to aid the policymakers and researchers in policy decision making as well as create an awareness on health-care issues for the general public. The usage of data in monitoring the performance of the heath system is still in the process of development. In conclusion, for the region under discussion, health-care data collection is under the responsibility of the Ministry of Health and health insurance agencies. Data are collected from health-care providers mainly from the public sector. Routinely collected data are

  12. Asian Dust Storm Elevates Children’s Respiratory Health Risks: A Spatiotemporal Analysis of Children’s Clinic Visits across Taipei (Taiwan)

    PubMed Central

    Yu, Hwa-Lung; Chien, Lung-Chang; Yang, Chiang-Hsing

    2012-01-01

    Concerns have been raised about the adverse impact of Asian dust storms (ADS) on human health; however, few studies have examined the effect of these events on children’s health. Using databases from the Taiwan National Health Insurance and Taiwan Environmental Protection Agency, this study investigates the documented daily visits of children to respiratory clinics during and after ADS that occurred from 1997 to 2007 among 12 districts across Taipei City by applying a Bayesian structural additive regressive model controlled for spatial and temporal patterns. This study finds that the significantly impact of elevated children’s respiratory clinic visits happened after ADS. Five of the seven lagged days had increasing percentages of relative rate, which was consecutively elevated from a 2-day to a 5-day lag by 0.63%∼2.19% for preschool children (i.e., 0∼6 years of age) and 0.72%∼3.17% for school children (i.e., 7∼14 years of age). The spatial pattern of clinic visits indicated that geographical heterogeneity was possibly associated with the clinic’s location and accessibility. Moreover, day-of-week effects were elevated on Monday, Friday, and Saturday. We concluded that ADS may significantly increase the risks of respiratory diseases consecutively in the week after exposure, especially in school children. PMID:22848461

  13. Does Eating Out Make Elderly People Depressed? Empirical Evidence from National Health and Nutrition Survey in Taiwan.

    PubMed

    Chang, Hung-Hao; Saeliw, Kannika

    2017-06-01

    This study investigates the association between eating out and depressive symptoms among elderly people. Potential mediators that may link to elderly eating out and depressive symptoms are also discussed. A unique dataset of 1,184 individuals aged 65 and older was drawn from the National Health and Nutrition Survey in 2008 in Taiwan. A bivariate probit model and an instrumental variable probit model were estimated to account for correlated, unmeasured factors that may be associated with both the decision and frequency of eating out and depressive symptoms in the elderly. An additional analysis is conducted to check whether the nutrient intakes and body weights can been seen as mediators that link the association between eating out and depressive symptoms of the elderly. Elderly people who eat out are 38 percent points more likely to have depressive symptoms than their counterparts who do not eat out, after controlling for socio-demographic characteristics and other factors. A positive association between the frequency of eating out and the likelihood of having depressive symptoms of the elderly is also found. It is evident that one addition meal away from home is associated with an increase of the likelihood of being depressed by 3.8 percentage points. With respect to the mediations, we find that nutrient intakes and body weight are likely to serve as mediators for the positive relationship between eating out and depressive symptoms in the elderly. Our results show that elderly who eat out have a higher chance of having depressive symptoms. To prevent depressive symptoms in the elderly, policy makers should be aware of the relationship among psychological status, physical health and nutritional health when assisting the elderly to better manage their food consumption away from home. Our study have some caveats. First, the interpretation of our results on the causality issue calls for caution in that our analysis relies on a cross-sectional survey. Second, other

  14. Web-Based and Telephone Surveys to Assess Public Perception Toward the National Health Insurance in Taiwan: A Comparison of Cost and Results

    PubMed Central

    Tan, Elise Chia-Hui

    2015-01-01

    Background Numerous studies have examined the impact of global budget payment systems of health insurance on patient access to medical care. In order to monitor the population’s accessibility to health services, a series of survey are often used to understand public perceptions of the health care provider. Taiwan implemented the single-payer National Health Insurance in 1995 and has been conducting a series of surveys to monitor public perception of the NHI after adopting a global budget payment system in 2002. Although telephone surveys are commonly used in obtaining public opinions on various public health issues, limitations such as higher cost and influence of interviewers do raise some concerns. Web-based surveys, one of the alternative methods, may be free from these problems. Objective Our aim was to examine the difference of sociodemographic characteristics, satisfaction of NHI and NHI-contracted health care providers, attitude toward NHI-related issues, behavior in seeking medical advice and self-reported health status between those who completed Web-based surveys and those reached by telephone. Methods This study compared the demographic factors of participants who took either a Web-based survey (1313 participants) or random digit dialing telephone survey (2411 participants) that contained identical questions. Results Compared to telephone survey respondents, Web-based respondents tended to be younger (P<.001), unmarried (P<.001), non-smokers (P<.001), with a higher education (P<.001), and a higher monthly household income (P<.001) and worse self-reported health status (P=.008); however, they were less likely to report suffering from a chronic disease (P<.001). Despite these differences in background characteristics, no significant differences were observed in their answers related to the seeking of medical care or NHI-related issues. Telephone survey respondents reported greater satisfaction with NHI services. Web-based surveys were also shown to

  15. Motivations for Older Adults' Participation in Distance Education: A Study at the National Open University of Taiwan

    ERIC Educational Resources Information Center

    Mulenga, Derek; Liang, Jr-Shiuan

    2008-01-01

    This study investigated the factor structure of motivational constructs as expressed by older adult learners and examined how these constructs correlated with selected socio-demographic characteristics at the National Open University of Taiwan (NOUT). Results were based on the responses of 371 elders to the 32-item Reasons for Participation Scale…

  16. Online detection of potential duplicate medications and changes of physician behavior for outpatients visiting multiple hospitals using national health insurance smart cards in Taiwan.

    PubMed

    Hsu, Min-Huei; Yeh, Yu-Ting; Chen, Chien-Yuan; Liu, Chien-Hsiang; Liu, Chien-Tsai

    2011-03-01

    Doctor shopping (or hospital shopping), which means changing doctors (or hospitals) without professional referral for the same or similar illness conditions, is common in Hong Kong, Taiwan and Japan. Due to the lack of infrastructure for sharing health information and medication history among hospitals, doctor-shopping patients are more likely to receive duplicate medications and suffer adverse drug reactions. The Bureau of National Health Insurance (BNHI) adopted smart cards (or NHI-IC cards) as health cards in Taiwan. With their NHI-IC cards, patients can freely access different medical institutions. Because an NHI-IC card carries information about a patient's prescribed medications received from different hospitals nationwide, we used this system to address the problem of duplicate medications for outpatients visiting multiple hospitals. A computerized physician order entry (CPOE) system was enhanced with the capability of accessing NHI-IC cards and providing alerts to physicians when the system detects potential duplicate medications at the time of prescribing. Physician responses to the alerts were also collected to analyze changes in physicians' behavior. Chi-square tests and two-sided z-tests with Bonferroni adjustments for multiple comparisons were used to assess statistical significance of differences in actions taken by physicians over the three months. The enhanced CPOE system for outpatient services was implemented and installed at the Pediatric and Urology Departments of Taipei Medical University Wan-Fang Hospital in March 2007. The "Change Log" that recorded physician behavior was activated during a 3-month study period from April to June 2007. In 67.93% of patient visits, the physicians read patient NHI-IC cards, and in 16.76% of the reads, the NHI-IC card contained at least one prescribed medication that was taken by the patient. Among the prescriptions issued by physicians, on average, there were 2.36% prescriptions containing at least one

  17. Cost-effectiveness analysis of endoscopic tympanoplasty versus microscopic tympanoplasty for chronic otitis media in Taiwan.

    PubMed

    Tseng, Chih-Chieh; Lai, Ming-Tang; Wu, Chia-Che; Yuan, Sheng-Po; Ding, Yi-Fang

    2018-03-01

    Health care systems and physicians need to conform to budgets and streamline resources to provide cost-effective quality care. Although endoscopic tympanoplasty (ET) has been performed for decades, no studies on the cost-effectiveness of ET and microscopic tympanoplasty (MT) for treating chronic otitis media have been published. The present study aimed to compare the cost-effectiveness of ET and MT for treating chronic otitis media. This study was performed using a Cohort-style Markov decision-tree economic model with a 30-year time horizon. The economic perspective was that of a third-party payer (Taiwan National Health Insurance System). Two treatment strategies were compared, namely ET and MT. The primary outcome was the incremental cost per quality-adjusted life year (QALY). Probabilities were obtained from meta-analyses. Costs were obtained from the published literature and Taiwan National Health Insurance System database. Multiple sensitivity analyses were performed to account for data uncertainty. The reference case revealed that the total cost of ET was $NT 20,901 for 17.08 QALY per patient. By contrast, the total cost of MT was $NT 21,171 for 17.15 QALY per patient. The incremental cost effectiveness ratio for ET versus that of MT was $NT 3703 per QALY. The cost-effectiveness acceptability curve indicated that ET was comparable to MT at a willingness-to-pay threshold of larger than $NT 35,000 per QALY. This cost-effectiveness analysis indicates that ET is comparable to MT for treating chronic otitis media in Taiwan. This result provides the latest information for physicians, the government, and third-party payers to select proper clinical practice. Copyright © 2017. Published by Elsevier Taiwan LLC.

  18. Industrial workers' health and environmental pollution under the new international division of labor: the Taiwan experience.

    PubMed Central

    Chen, M S; Huang, C L

    1997-01-01

    Using Taiwan as an example, this paper conducts a historical analysis of the relationship between economic development in the new international division of labor and environmental pollution and industrial workers' health. Three industries-asbestos, plastic, and dye-were chosen for case studies. We trace the emergence of each industry in Taiwan and study each industry's protection of workers' health and environmental quality. Under the new international division of labor, the state's prioritization of economic development leads to lenient regulation. Under such state policies, employers have few incentives to invest in the protection of their workers' health and in the control of environmental pollution. Workers and the public are constrained in their efforts to protect their own health and prevent environmental pollution. This situation is exemplified by the deplorable working conditions and inadequate environmental pollution controls in the asbestos, plastic, and dye industries. Workers' health and the public's health are greatly compromised by economic development in the new international division of labor. Images p1228-a p1228-b PMID:9240119

  19. Epidemiological Features of Japanese Encephalitis in Taiwan from 2000 to 2014

    PubMed Central

    Chang, Yu-Kang; Chang, Hsiao-Ling; Wu, Ho-Sheng; Chen, Kow-Tong

    2017-01-01

    The incidence of Japanese encephalitis (JE) decreased sharply after the national vaccination program was implemented in Taiwan in 1968. However, cases of JE still occur. The purpose of this study was to assess the epidemiology and vaccination policy for JE in Taiwan. We analyzed the data on JE cases reported to the Taiwan Centers for Disease Control (Taiwan CDC) between 2000 and 2014. During the 15-year study period, a total of 4,474 cases were reported to the Taiwan CDC. Of these, 379 (8.5%) were classified as confirmed cases, and 4,095 (91.5%) were classified as suspected cases. The incidence of JE ranged from 0.59 to 1.61 per 1,000,000 people and peaked in 2007. Men had a higher incidence of JE than women (1.37 versus 0.84 per 1,000,000; P = 0.03). Patients who were 40–59 years of age had a higher incidence than did patients younger than 20 years (1.82 versus 0.23; P < 0.001). Patients who lived in the eastern region of Taiwan had the highest incidence rate of JE (P < 0.001). Compared with those who were not vaccinated with the JE vaccine, patients who received four doses of JE vaccine had a lower risk of suffering from death and/or hospitalization (adjusted odds ratio: 0.26; 95% confidence interval: 0.08–0.90; P = 0.04). JE is still a public health problem in Taiwan, and monitoring JE via diagnostic testing to determine the best vaccination program along with enforcing JE vaccine boosters for adults is necessary to eliminate JE in Taiwan. PMID:27821699

  20. Epidemiological Features of Japanese Encephalitis in Taiwan from 2000 to 2014.

    PubMed

    Chang, Yu-Kang; Chang, Hsiao-Ling; Wu, Ho-Sheng; Chen, Kow-Tong

    2017-02-08

    The incidence of Japanese encephalitis (JE) decreased sharply after the national vaccination program was implemented in Taiwan in 1968. However, cases of JE still occur. The purpose of this study was to assess the epidemiology and vaccination policy for JE in Taiwan. We analyzed the data on JE cases reported to the Taiwan Centers for Disease Control (Taiwan CDC) between 2000 and 2014. During the 15-year study period, a total of 4,474 cases were reported to the Taiwan CDC. Of these, 379 (8.5%) were classified as confirmed cases, and 4,095 (91.5%) were classified as suspected cases. The incidence of JE ranged from 0.59 to 1.61 per 1,000,000 people and peaked in 2007. Men had a higher incidence of JE than women (1.37 versus 0.84 per 1,000,000; P = 0.03). Patients who were 40-59 years of age had a higher incidence than did patients younger than 20 years (1.82 versus 0.23; P < 0.001). Patients who lived in the eastern region of Taiwan had the highest incidence rate of JE ( P < 0.001). Compared with those who were not vaccinated with the JE vaccine, patients who received four doses of JE vaccine had a lower risk of suffering from death and/or hospitalization (adjusted odds ratio: 0.26; 95% confidence interval: 0.08-0.90; P = 0.04). JE is still a public health problem in Taiwan, and monitoring JE via diagnostic testing to determine the best vaccination program along with enforcing JE vaccine boosters for adults is necessary to eliminate JE in Taiwan. © The American Society of Tropical Medicine and Hygiene.

  1. Taiwan's second remote sensing satellite

    NASA Astrophysics Data System (ADS)

    Chern, Jeng-Shing; Ling, Jer; Weng, Shui-Lin

    2008-12-01

    FORMOSAT-2 is Taiwan's first remote sensing satellite (RSS). It was launched on 20 May 2004 with five-year mission life and a very unique mission orbit at 891 km altitude. This orbit gives FORMOSAT-2 the daily revisit feature and the capability of imaging the Arctic and Antarctic regions due to the high enough altitude. For more than three years, FORMOSAT-2 has performed outstanding jobs and its global effectiveness is evidenced in many fields such as public education in Taiwan, Earth science and ecological niche research, preservation of the world heritages, contribution to the International Charter: space and major disasters, observation of suspected North Korea and Iranian nuclear facilities, and scientific observation of the atmospheric transient luminous events (TLEs). In order to continue the provision of earth observation images from space, the National Space Organization (NSPO) of Taiwan started to work on the second RSS from 2005. This second RSS will also be Taiwan's first indigenous satellite. Both the bus platform and remote sensing instrument (RSI) shall be designed and manufactured by NSPO and the Instrument Technology Research Center (ITRC) under the supervision of the National Applied Research Laboratories (NARL). Its onboard computer (OBC) shall use Taiwan's indigenous LEON-3 central processing unit (CPU). In order to achieve cost effective design, the commercial off the shelf (COTS) components shall be widely used. NSPO shall impose the up-screening/qualification and validation/verification processes to ensure their normal functions for proper operations in the severe space environments.

  2. Body Mass Index, Nutrient Intakes, Health Behaviours and Nutrition Knowledge: A Quantile Regression Application in Taiwan

    ERIC Educational Resources Information Center

    Chen, Shih-Neng; Tseng, Jauling

    2010-01-01

    Objective: To assess various marginal effects of nutrient intakes, health behaviours and nutrition knowledge on the entire distribution of body mass index (BMI) across individuals. Design: Quantitative and distributional study. Setting: Taiwan. Methods: This study applies Becker's (1965) model of health production to construct an individual's BMI…

  3. Availability, health-care costs, and utilization patterns of biologics in Taiwan.

    PubMed

    Hsieh, Chee-Ruey; Liu, Ya-Ming

    2012-01-01

    To provide an overview of the use of biologics in Taiwan, including the access to new biologics, the impact of this access on the growth of health-care expenditure, and the utilization patterns. We first conducted a market-level analysis to investigate the availability of global biologics in Taiwan as well as the growth and concentration of aggregate spending on biologics. We then conducted a patient-level analysis to investigate the costs and utilization patterns for selected new biologics. We found that the concentration index is such that the 20 leading biologics in Taiwan account for more than 90% of the total spending on biologics. In our patient-level study on four biologics, the annual cost of treatment per patient ranged from NT$100,000 to NT$400,000. The prevalence rate of the user was between 6.5 and 37.2 per 100,000 of population. The treatment costs were inversely related to the prevalence rate of users. We also found that physicians in larger and public hospitals were more likely to prescribe new biologics to their patients compared with their counterparts practicing in smaller and private hospitals. In addition, we found that physicians were more likely to prescribe biologics to patients with more severe diseases and higher comorbidities. We conclude that public spending on biologics in Taiwan is highly targeted toward about 20 products with higher annual expenditures and growth rates and that the utilization of these biologics is targeted at a small number of patients. In addition, the access to these costly biologics is not uniform among patients in a country with universal coverage for prescription drugs. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  4. Spatial autocorrelation analysis of health care hotspots in Taiwan in 2006

    PubMed Central

    2009-01-01

    Background Spatial analytical techniques and models are often used in epidemiology to identify spatial anomalies (hotspots) in disease regions. These analytical approaches can be used to not only identify the location of such hotspots, but also their spatial patterns. Methods In this study, we utilize spatial autocorrelation methodologies, including Global Moran's I and Local Getis-Ord statistics, to describe and map spatial clusters, and areas in which these are situated, for the 20 leading causes of death in Taiwan. In addition, we use the fit to a logistic regression model to test the characteristics of similarity and dissimilarity by gender. Results Gender is compared in efforts to formulate the common spatial risk. The mean found by local spatial autocorrelation analysis is utilized to identify spatial cluster patterns. There is naturally great interest in discovering the relationship between the leading causes of death and well-documented spatial risk factors. For example, in Taiwan, we found the geographical distribution of clusters where there is a prevalence of tuberculosis to closely correspond to the location of aboriginal townships. Conclusions Cluster mapping helps to clarify issues such as the spatial aspects of both internal and external correlations for leading health care events. This is of great aid in assessing spatial risk factors, which in turn facilitates the planning of the most advantageous types of health care policies and implementation of effective health care services. PMID:20003460

  5. [An outline medical history of Taiwan (I): the period of folklore medicine and witch doctor].

    PubMed

    Li, C

    1997-01-01

    The paper makes a correlated analysis on the origin of health folklore between Chinese in mainland and Taiwan island. After quoting literatures written by authors living in the Qing dynasty in Taiwan, this paper analyses health condition among aboriginals of Taiwan during the witchcraft age. Along with the increasing immigration from China mainland to Taiwan island, health of folklore and gods from China mainland were introduced into Taiwan, hence the period of witch doctor in Taiwan, featuring the correlation of both. Though modern medicine in Taiwan is so advanced, yet there are still witch doctors elsewhere.

  6. Intimate partner violence-related experiences and mental health among college students in Japan, Singapore, South Korea and Taiwan.

    PubMed

    Kamimura, Akiko; Nourian, Maziar M; Assasnik, Nushean; Franchek-Roa, Kathy

    2016-05-01

    Intimate partner violence (IPV) is a significant public health threat that contributes to a wide range of mental and physical health problems for victims. The purpose of this study was to examine IPV-related experiences and mental health outcomes among college students in Japan, Singapore, South Korea and Taiwan. The data were obtained from the Inter-University Consortium for Political and Social Research (ICPSR), the International Dating Violence Study (IDVS) 2001-2006 (ICPSR 29583; N = 981; Japan n = 207; Singapore n = 260; South Korea n = 256; Taiwan n = 258). Co-experience of physical IPV victimization and perpetration was associated with borderline personality traits and posttraumatic stress disorder (PTSD), but not with depression. Childhood sexual abuse, gender hostility and violence socialization were significant predictors of borderline personality traits, depression and PTSD. While country and gender variations in mental health are noted, there are two specific populations that may need special attention for mental health interventions: Taiwanese women especially for borderline personality traits and PTSD, and Japanese men especially for depression. IPV victimization and perpetration, childhood sexual abuse, gender hostility and violence socialization have a significant impact on the mental health of college students in Japan, Singapore, South Korea and Taiwan. Since IPV and mental health are significant public health issues, research on IPV and mental health consequences of IPV victimization and perpetration in these countries should be further expanded in order to better understand the interventions that will be effective in treating victims, perpetrators and victim/perpetrators of IPV. © The Author(s) 2016.

  7. Threat-responsiveness and the decision to obtain free influenza vaccinations among the older adults in Taiwan.

    PubMed

    Li, Ying-Chun; Liu, Chi-Mei

    2009-07-31

    Although older adults are encouraged by government agencies to receive influenza vaccinations, many do not obtain them. In Taiwan, where universal health care coverage has significantly reduced the barriers of access to care, the health care system has provided free influenza vaccinations for people 65 years or older since 2001. Nevertheless, the numbers of people who use this service are much fewer than expected. The aim of this study was to explore major factors that might affect the decision to receive influenza vaccinations among older adults in Taiwan. Using national representative health insurance medical claims from the National Health Insurance Research Database between 2002 and 2004, we investigated the role of threat-responsiveness, represented by prior vaccinations and prior physician visits for flu-like respiratory conditions, in the decisions of older adults to obtain vaccinations in Taiwan. Among the sample of 23,023 older adults, the overall yearly vaccination rates in this study were 38.6%, 44.3% and 39.3% for 2002, 2003, and 2004, respectively. Adjusting for covariates of individual and health care facility characteristics, the multivariate logistic regression revealed that older adults who had had prior vaccinations were ten times more likely to be vaccinated during the following influenza season than those who had not (OR=10.22, 95%CI: 9.82-10.64). The greater the frequency of prior physician visits for flu-like respiratory conditions, the greater the likelihood that one would decide to be vaccinated. Visits during prior interim (non-epidemic) season exerted a stronger positive influence than prior influenza season on this likelihood (OR=1.59, 95% CI: 1.46-1.73 vs. OR=1.11 95% CI: 1.01-1.22, respectively). Threat-responsiveness, or perceived risk, greatly influences influenza vaccination rates among the older adults in Taiwan. These findings can be used to help design public health campaigns to increase the influenza vaccination rate in this

  8. Impact of work-related cancers in Taiwan-Estimation with QALY (quality-adjusted life year) and healthcare costs.

    PubMed

    Lee, Lukas Jyuhn-Hsiarn; Lin, Cheng-Kuan; Hung, Mei-Chuan; Wang, Jung-Der

    2016-12-01

    This study estimates the annual numbers of eight work-related cancers, total losses of quality-adjusted life years (QALYs), and lifetime healthcare expenditures that possibly could be saved by improving occupational health in Taiwan. Three databases were interlinked: the Taiwan Cancer Registry, the National Mortality Registry, and the National Health Insurance Research Database. Annual numbers of work-related cancers were estimated based on attributable fractions (AFs) abstracted from a literature review. The survival functions for eight cancers were estimated and extrapolated to lifetime using a semi-parametric method. A convenience sample of 8846 measurements of patients' quality of life with EQ-5D was collected for utility values and multiplied by survival functions to estimate quality-adjusted life expectancies (QALEs). The loss-of-QALE was obtained by subtracting the QALE of cancer from age- and sex-matched referents simulated from national vital statistics. The lifetime healthcare expenditures were estimated by multiplying the survival probability with mean monthly costs paid by the National Health Insurance for cancer diagnosis and treatment and summing this for the expected lifetime. A total of 3010 males and 726 females with eight work-related cancers were estimated in 2010. Among them, lung cancer ranked first in terms of QALY loss, with an annual total loss-of-QALE of 28,463 QALYs and total lifetime healthcare expenditures of US$36.6 million. Successful prevention of eight work-related cancers would not only avoid the occurrence of 3736 cases of cancer, but would also save more than US$70 million in healthcare costs and 46,750 QALYs for the Taiwan society in 2010.

  9. The determinants of health care expenditure toward the end of life: evidence from Taiwan.

    PubMed

    Chang, Simon; He, Yang; Hsieh, Chee-Ruey

    2014-08-01

    This paper empirically investigates the relationship between the health care expenditure of end-of-life patients and hospital characteristics in Taiwan where (i) hospitals of different ownership differ in their financial incentives; (ii) patients are free to choose their providers; and (iii) health care services are paid for by a single public payer on a fee-for-services basis with a global budget cap. Utilizing insurance claims for 11 863 individuals who died during 2005-2007, we trace their hospital expenditures over the last 24 months of their lives. We find that end-of-life patients who are treated by private hospitals in general are associated with higher inpatient expenditures than those treated by public hospitals, while there is no significant difference in days of hospital stay. This finding is consistent with the difference in financial incentives between public and private hospitals in Taiwan. Nevertheless, we also find that the public-private differences vary across accreditation levels. Copyright © 2013 John Wiley & Sons, Ltd.

  10. Team care of type 2 diabetes mellitus in Taiwan.

    PubMed

    Wang, Chih-Yuan; Yu, Neng-Chun; Sheu, Wayne Huey-Herng; Tsai, Shih-Tzer; Tai, Tong-Yuan

    2014-12-01

    Type 2 diabetes mellitus (T2DM) is a global health-care and national policy issue. As fluctuating glycemic control in diabetes often results in serious complications, we must encourage the diabetes educators' efforts at long-term follow-up among patients with T2DM. Therefore, certified diabetes educators (CDEs) play the most pivotal roles as life-long protectors for patients with T2DM. In the past 15 years, more than 4,000 CDEs have been trained and qualified, including health professionals such as physicians, nurses, dieticians, and pharmacists. The most important initiation of diabetes share care in Taiwan was originated in I-Lan County. Initiated to provide regional diabetes care, the name of this program is the Lan-Yang Diabetes Shared Care System. In 2006, the Taiwanese Association of Diabetes Educators (TADE) carried out a nationwide survey to evaluate the status of diabetes control in Taiwan, focusing on the "ABC" goal (A: HbA1c <7.0%, B: blood pressure <130/80 mmHg, C: LDL-cholesterol <100 mg/dl/total cholesterol <160 mg/dl). The results revealed that the percentage of patients with diabetes who fulfilled all ABC goals was only 4.1%. Five years later, in 2011, TADE compared two nationwide surveys and found total ABC attainment rates of 4.1% and 8.6%, respectively. The team-care approach to T2DM has been underway for over 20 years in Taiwan. Future interventions and treatment algorithms with team-based education should aim at preventing acute and chronic complications, which remains a long-term challenge in Taiwan. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. HIV/HCV Coinfection in Taiwan.

    PubMed

    Hsu, Ching-Sheng; Kao, Jia-Horng

    2016-01-01

    Both human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection are important global public health problems with shared transmission routes. Although HIV/HCV coinfection is not uncommon, the prevalence rates vary significantly across different studies and regions. In Taiwan, injection drug users have become the major contributors to the HIV/AIDS epidemic since 2005. Because the prevalence of HCV infection is high in injection drug users, this HIV epidemic is also associated with a significant increase of HIV/HCV coinfection in Taiwan. To control Taiwan's HIV epidemic, Taiwan Centers for Disease Control (CDC) launched a harm-reduction program in 2006. The HIV epidemic, the percentage attributed to injection drug users, and the prevalence of HIV/HCV coinfection gradually declined thereafter. In this article, we aimed to thoroughly examine the current literatures of HIV/HCV coinfection in Taiwan and hope to provide a better understanding of the needs for the management of this coinfection. We conducted a narrative review and searched for literature from PubMed, Ovid MEDLINE, and the Cochrane Library database untill August 2015. Studies relevant to the epidemiology and associated risk factors of HIV/HCV coinfection in Taiwan were examined and discussed.

  12. [Centennial retrospective on the evolution and development of nursing education in Taiwan].

    PubMed

    Yeh, Mei Chang

    2014-08-01

    Nursing education in Taiwan has developed significantly over the past one hundred years. Throughout the first half of the 20th century, nursing education in Taiwan ended at the high school level. However, over the most recent 50 years, this level has been gradually raised, and nursing doctoral programs are now offered today. Changes in the nursing profession over the past century have been influenced by social and political factors, war, the health care policies, and national education policies. Areas of nursing education that have presented key challenges to change and innovation include the nursing faculty, curriculum, teaching materials, and quality of teaching. Today, key future goals for nursing education in Taiwan are: Raising the entry level of generic nursing education from junior high to the high-school level, improving the curricula for master's and doctoral students, cultivating advanced practice nurses, improving the quality of nursing faculties, and establishing a mechanism to ensure the consistent quality of nursing education.

  13. Taiwan Teacher Preparation Program Evaluation: Some Critical Perspectives

    ERIC Educational Resources Information Center

    Liu, Tze-Chang

    2015-01-01

    This paper focuses on the influences and changes of recent Taiwan teacher preparation program evaluation (TTPPE) as one of the national evaluation projects conducted by the Higher Education Evaluation and Accreditation Council of Taiwan. The main concerns are what kind of ideology is transformed through the policy by means of evaluation, and what…

  14. Health empowerment among immigrant women in transnational marriages in Taiwan.

    PubMed

    Yang, Yung-Mei; Wang, Hsiu-Hung; Lee, Fang-Hsin; Lin, Miao-Ling; Lin, Pei-Chao

    2015-03-01

    The aim of this study was to develop, implement, and evaluate a theory-based intervention designed to promote increased health empowerment for marriage migrant women in Taiwan. The rapid increase of international marriage immigration through matchmaking agencies has received great attention recently because of its impact on social and public health issues in the receiving countries. A participatory action research (PAR) and in-depth interviews were adopted. Sixty-eight women participated in this study. Eight workshops of the health empowerment project were completed. Through a PAR-based project, participants received positive outcomes. Four outcome themes were identified: (a) increasing health literacy, (b) facilitating capacity to build social networks, (c) enhancing sense of self-worth, and (d) building psychological resilience. PAR was a helpful strategy that enabled disadvantaged migrant women to increase their health literacy, psychological and social health, and well-being. The findings can be referenced by the government in making health-promoting policies for Southeast Asian immigrant women to increase their well-being. Community health nurses can apply PAR strategies to plan and design health promotion intervention for disadvantaged migrant women. © 2014 Sigma Theta Tau International.

  15. Stock or stroke? Stock market movement and stroke incidence in Taiwan.

    PubMed

    Chen, Chun-Chih; Chen, Chin-Shyan; Liu, Tsai-Ching; Lin, Ying-Tzu

    2012-12-01

    This paper investigates the impact of stock market movement on incidences of stroke utilizing population-based aggregate data in Taiwan. Using the daily data from the Taiwan Stock Exchange Capitalization Weighted Stock Index and from the National Health Insurance Research Database during 2001/1/1-2007/12/31, which consist of 2556 observations, we examine the effects of stock market on stroke incidence - the level effect and the daily change effects. In general, we find that both a low stock index level and a daily fall in the stock index are associated with greater incidences of stroke. We further partition the data on sex and age. The level effect is found to be significant for either gender, in the 45-64 and 65 ≥ age groups. In addition, two daily change effects are found to be significant for males and the elderly. Although stockholdings can increase wealth, they can also increase stroke incidence, thereby representing a cost to health. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Hospital ownership and performance: evidence from stroke and cardiac treatment in Taiwan.

    PubMed

    Lien, Hsien-Ming; Chou, Shin-Yi; Liu, Jin-Tan

    2008-09-01

    This paper compares program expenditure and treatment quality of stroke and cardiac patients between 1997 and 2000 across hospitals of various ownership types in Taiwan. Because Taiwan implemented national health insurance in 1995, the analysis is immune from problems arising from the complex setting of the U.S. health care market, such as segmentation of insurance status or multiple payers. Because patients may select admitted hospitals based on their observed and unobserved characteristics, we employ instrument variable (IV) estimation to account for the endogeneity of ownership status. Results of IV estimation find that patients admitted to non-profit hospitals receive better quality care, either measured by 1- or 12-month mortality rates. In terms of treatment expenditure, our results indicate no difference between non-profits and for-profits index admission expenditures, and at most 10% higher long-term expenditure for patients admitted to non-profits than to for-profits.

  17. [A Long Stream: The Historical Influence of Peking Union Medical College on the Development of Modern Nursing Education in Taiwan].

    PubMed

    Tsai, Duu-Jian; Lee, Meng-Chih

    2017-10-01

    The faculty of Peiping Union Medical College (PUMC) formatively influenced the development of modern nursing in Taiwan. PUMC, which retreated with the national government to Taiwan from Mainland China in 1949, was initially established earlier in that century by enthusiastic medical missionaries and later reformed by the Rockefeller Foundation. After relocating to Taiwan, PUMC teachers and graduates have provided critical leadership in disseminating modern nursing education in Taiwan and in integrating public health and clinical services to establish a solid foundation for Taiwanese nursing education. To highlight the significant contributions of PUMC alumni in Taiwan, this article explores three dimensions as follows: 1) Establishing the foundation of modern nursing education in Taiwan; 2) Channeling aids from the United States and the international communities to improve nursing education; and 3) Raising the international profile and influence of the Taiwan nursing society. In celebration of the centennial anniversary of PUMC, we encourage in the spirit of PUMC congeniality greater Cross-Strait collaboration among elite professionals in order to further advance PUMC leadership in Asian medical education and cultural enlightenment.

  18. Weekly lottery sales volume and suicide numbers: a time series analysis on national data from Taiwan.

    PubMed

    Chen, Vincent Chin-Hung; Stewart, Robert; Lee, Charles Tzu-Chi

    2012-07-01

    To investigate the association between weekly lottery sales and number of suicide deaths in Taiwan. All suicides aged 15+ years during 2004-2006 in Taiwan were included. Poisson autoregression time series models investigated associations of weekly numbers with contemporaneous and recent sales from two national lotteries in operation. Adjustments were made for seasonal fluctuation, temperature, monthly unemployment and autocorrelation. In fully adjusted models, suicide deaths were negatively correlated with sales of tickets for a low-prize, low-cost lottery system. However, they were correlated positively with recent sales for a higher-cost, larger-prize system. Both correlations were stronger for male than female suicide numbers but differed in terms of age groups most strongly implicated. Associations between lottery sales and suicide numbers differed according to the nature of the lottery. A low-prize, low-publicity system appeared to be more benign than a high-prize, high-publicity one.

  19. Health examination utilization in the visually disabled population in Taiwan: a nationwide population-based study

    PubMed Central

    2013-01-01

    Background People with visual disabilities have increased health needs but face worse inequity to preventive health examinations. To date, only a few nationwide studies have analyzed the utilization of preventive adult health examinations by the visually disabled population. The aim of this study was to investigate the utilization of health examinations by the visually disabled population, and analyze the factors associated with the utilization. Methods Visual disability was certified by ophthalmologists and authenticated by the Ministry of the Interior (MOI), Taiwan. We linked data from three different nationwide datasets (from the MOI, Bureau of Health Promotion, and National Health Research Institutes) between 2006 and 2008 as the data sources. Independent variables included demographic characteristics, income status, health status, and severity of disability; health examination utilization status was the dependent variable. The chi-square test was used to check statistical differences between variables, and a multivariate logistic regression model was used to examine the associated factors with health examination utilization. Results In total, 47,812 visually disabled subjects aged 40 years and over were included in this study, only 16.6% of whom received a health examination. Lower utilization was more likely in male subjects, in those aged 65 years and above, insured dependents and those with a top-ranked premium-based salary, catastrophic illness/injury, chronic diseases of the genitourinary system, and severe or very severe disabilities. Conclusion The overall health examination utilization in the visually disabled population was very low. Lower utilization occurred mainly in males, the elderly, and those with severe disabilities. PMID:24313981

  20. The effects of group health education on childbearing knowledge, attitude, and behaviour among Southeast Asian immigrant women in Taiwan.

    PubMed

    Wang, Hsiu-Hung; Lin, Miao-Ling; Yang, Yung-Mei; Tsai, Hsiu-Min; Huang, Joh-Jong

    2012-12-01

    to explore the effects of a group health education programme on the childbearing knowledge, attitude, and behaviours among Southeast Asian immigrant women in Taiwan. a quasi-experimental design with convenience sampling was used. participants living in Kaohsiung County, Taiwan, were randomly divided by districts into either the experimental group or the control group. one hundred Southeast Asian immigrant women were recruited as research participants. Among the 100 participants, 50 were in the experimental group and 50 were in the control group. A total of 99 participants completed the entire research procedure. a structured interview was used to evaluate the effects of a group health education programme. the interview consisted of four measurements: the Demographic Inventory Scale, the Childbearing Knowledge Scale, the Childbearing Attitude Scale, and the Childbearing Planning Scale. after employing the group health education intervention, statistically significant changes from the pre-test to the post-test were found in the experimental group's scores for the Childbearing Knowledge Scale (P<0.0001), the Childbearing Attitude Scale (P<0.01), and the Childbearing Planning Scale (P<0.0001). The study's results indicated that providing education through group learning with guidance and support in childbearing health significantly improved Southeast Asian immigrant women's childbearing health knowledge, attitudes, and behaviours. an appropriate, community-based group health education programme can create awareness for childbearing health among Southeast Asian immigrant women in Taiwan and improve their childbearing attitudes and behaviours. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Counseling Psychology Licensure in Taiwan: Development, Challenges, and Opportunities

    ERIC Educational Resources Information Center

    Wang, Li-fei; Kwan, Kwong-Liem K.; Huang, Su-Fei

    2011-01-01

    The development and consequences of licensure for counseling psychologists in Taiwan are presented to promote cross-cultural awareness surrounding issues in the counseling psychology profession. The national licensure statute for counseling psychologists in Taiwan was established by the Taiwanese Legislature in 2001. While the licensing system…

  2. Glaucoma correlates with increased risk of Parkinson's disease in the elderly: a national-based cohort study in Taiwan.

    PubMed

    Lai, Shih-Wei; Lin, Cheng-Li; Liao, Kuan-Fu

    2017-08-01

    Very little is known about the association between glaucoma and Parkinson's disease in the elderly. The objective of this study was to determine whether glaucoma is associated with Parkinson's disease in older people in Taiwan. A retrospective cohort study was conducted to analyze the Taiwan National Health Insurance Program database from 2000 to 2010. We included 4330 subjects aged 65 years or older with newly diagnosed glaucoma as the glaucoma group, and 17,000 randomly selected subjects without a glaucoma diagnosis as the non-glaucoma group. Both groups were matched for sex, age, other comorbidities, and index year of glaucoma diagnosis. The incidence of Parkinson's disease at the end of 2011 was measured. A multivariable Cox proportional hazard regression model was used to measure the hazard ratio and 95% confidence intervals for Parkinson's disease associated with glaucoma. The overall incidence of Parkinson's disease was 1.28-fold higher in the glaucoma group than that in the non-glaucoma group (7.73 vs. 6.02 per 1000 person-years; 95% confidence interval 1.18, 1.40). After controlling for potential confounding factors, the adjusted hazard ratio of Parkinson's disease was 1.23 for the glaucoma group (95% confidence interval 1.05, 1.46), compared with the non-glaucoma group. Older people with glaucoma correlate with a small but statistically significant increase in the risk for Parkinson's disease. Whether glaucoma may be a non-motor feature of Parkinson's disease in older people requires further research to confirm.

  3. History and development of ophthalmology in Taiwan.

    PubMed

    Hou, Yu-Chih; Oren, Gale A; Chen, Muh-Shy; Hu, Fung-Rong

    2016-12-01

    Western medicine was first introduced to Taiwan by medical missionaries in the mid-19 th century. Modernization of medicine was systematically transplanted to Taiwan in the Japanese colonial period, and ophthalmology was established third among hospital departments, following internal medicine and surgery. Dr Hidetaka Yamaguchi, an ophthalmologist, was the first head of the Taihoku Hospital, later known as National Taiwan University Hospital (NTUH; Taipei, Taiwan). Ophthalmologists during the colonial period conducted studies on tropical and infectious eye diseases. After World War II, ophthalmologists at NTUH played an important role in medical education, residency training, studies, and teaching. Dr Yan-Fei Yang established the Taiwan Ophthalmological Society in 1960 and instituted its official journal in 1962. Dr Ho-Ming Lin established the Department of Ophthalmology at the Tri-Service General Hospital in the 1950s and the Veterans General Hospital in the 1960s. Taiwan ophthalmologists eradicated trachoma by 1971. Cataract surgery and penetrating keratoplasty were initially performed in the 1960s. Currently, there are about 1600 ophthalmologists in Taiwan conducting an estimated 120,000 cataract surgeries and 600 corneal transplantations annually. Many subspecialty societies have been established recently that serve to educate Taiwanese ophthalmologists and to connect with international ophthalmic societies. Taiwan ophthalmologists continue to contribute to the advancement of ophthalmic knowledge globally. Copyright © 2016. Published by Elsevier B.V.

  4. A Study of Older Adult Students' Satisfaction with Web-Based Distance Learning at the National Open University of Taiwan

    ERIC Educational Resources Information Center

    Chen, Ho-Yuan

    2010-01-01

    The purpose of this study was to investigate the relationships between older learners' demographic characteristics and their satisfaction with distance learning in the Web-based environment at National Open University in Taiwan (NOUT). Increases in the older adult population have had many impacts throughout societies. The major purpose of older…

  5. The prevalence, characteristics, and factors associated with purchasing Chinese herbal medicine among adults in Taiwan.

    PubMed

    Shih, Chun -Chuan; Huang, Lu-Hsiang; Yeh, Chun-Chieh; Lane, Hsin-Long; Hsieh, Chang-Ju; Tsai, Chin-Chuan; Lin, Li-Wei; Chen, Ta-Liang; Liao, Chien-Chang

    2017-03-27

    The objective of this study was to investigate the prevalence and factors associated with purchasing Chinese herbal medicine (CHM) without a physician's prescription among adults. Using data from the 2005 National Health Interview Survey and National Health Insurance, we identified 16,756 individuals aged 20 years and older. Socio-demographic factors, lifestyle, medical services utilization and health behaviors were compared between people with and without a history of purchasing CHM by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in a multiple logistic regression analysis. The one-month prevalence of purchasing CHM without a physician' prescription was 5.2% in Taiwan. People more likely to purchase CHM included people aged ≥70 years (OR 2.84, 95% CI 2.03-3.99), women (OR 1.28, 95% CI 1.11-1.48), non-indigenous people (OR 2.61, 95% CI 1.29-5.30), and people with an illness not receiving medical care (OR 2.69, 95% CI 2.19-3.31). The prevalence of purchasing CHM without a physician's prescription is high in Taiwan and is correlated with factors such as socio-demographics, disease history, and behaviors surrounding the utilization of medical care.

  6. Herbal Medicine Research in Taiwan*

    PubMed Central

    Kaphle, Krishna; Wu, Leang-Shin; Yang, Nai-Yen Jack; Lin, Jen-Hsou

    2006-01-01

    Of all the countries in the world, why did you choose Taiwan to pursue your study? It is a question that I (comments of the first author) have answered a thousand times. My first visit to a laboratory at National Taiwan University opened my eyes to the possibilities of herbal medicine research, especially in the area of veterinary medicine. It became my ambition to link the knowledge of Traditional Chinese Medicine (TCM) and Ayurveda from the Indian subcontinent and their integration with other systems of medicine, including Western medicine (WM), to achieve the concept of Sustainable Medicine, firstly for animals and then for humans. The Ministry of Economic Affairs (MOEA) has implemented a technology development program to quickly establish the key technologies, and this is a moment of opportunity for Taiwan's traditional herbal medicine industry to upgrade and transform itself. This paper, initially intended to be a student's narration, has evolved into a multi-author treatise on the present state and likely future scenario of herbal medicine research in Taiwan. PMID:16550238

  7. Following the trend for a comprehensive healthy workplace in Taiwan.

    PubMed

    Chen, Ruey-Yu; Yu, Li-Hui

    2016-03-01

    To promote workers' health and boost corporate productivity and national competitiveness, workplace health promotion is an international trend and a vital part of national policies. Prior to 2000, Taiwan's workplace issues focused on industrial hygiene and safety improvements. Since 2003, the Health Promotion Administration (HPA) at the Ministry of Health and Welfare has established coaching centers for workplace health promotion and dispatched trained experts for teaching health promotion skills; including promoting the tobacco control program, preventing important chronic diseases, driving comprehensive programs, advocating workplace health promotion with the Ministry of Labor, establishing certification mechanisms for workplace health promotion, recognizing outstanding health-promoting workplaces, and conducting a nationwide survey for monitoring the practices of healthy behaviors and health conditions of workers. Through 2014, 12,439 workplaces have been accredited.Since 2003, the efforts of the HPA in workplace health promotion projects has shifted society's focus on workplace health from occupational diseases and injury prevention to workplace health promotion, resulting in the revision of the Occupational Safety and Health Act in 2013 by the Ministry of Labor to detail employers' responsibilities in protecting and promoting employees' health and well-being. © The Author(s) 2016.

  8. A temporary home to nurture health: lived experiences of older nursing home residents in Taiwan.

    PubMed

    Tsai, Hsiu-Hsin; Tsai, Yun-Fang

    2008-07-01

    This study explored the lived experiences of older nursing home residents in Taiwan. With more long-term care institutions in Taiwan, older people are more often placed in nursing homes than in the past. Increased understanding of their lived experience is essential to assess residents' needs and determine the effectiveness of nursing interventions. A qualitative design was used to gain a deeper understanding of the lived experiences of older nursing home residents in Taiwan. Focus groups, followed by in-depth interviews, were used to gather information from 33 older residents at eight nursing homes in northern Taiwan. Participants were asked to describe what was important to them and what impressed them most in their daily lives in the nursing home. Participants (24 females and nine males) were on an average 75.3 years old. Verbatim transcripts of audiotaped focus groups and interviews were analysed by thematic analysis via ATLAS.ti software. The core theme of older residents' nursing home experience was 'a temporary home to nurture health'. This core theme was reflected in participants' descriptions of their overall life in the nursing home as a temporary experience to nurture their health. Their everyday experience was characterised by four subthemes: highly structured lifestyle, restricted activities, safety concerns and social interactions. Our findings may enhance policy makers' and healthcare providers' understanding of the lived experience of older nursing home residents, thus guiding the evaluation and development of nursing home services to improve residents' lives. For example, residents with the same characteristics could be placed in the same room or same floor, thus increasing their interactions with other residents. Residents' interactions with family members could also be developed using the Internet or mobile telephones.

  9. Application of Frequent Itemsets Mining to Analyze Patterns of One-Stop Visits in Taiwan

    PubMed Central

    Tu, Chun-Yi; Chen, Tzeng-Ji; Chou, Li-Fang

    2011-01-01

    Background The free choice of health care facilities without limitations on frequency of visits within the National Health Insurance in Taiwan gives rise to not only a high number of annual ambulatory visits per capita but also a unique “one-stop shopping”phenomenon, which refers to a patient' visits to several specialties of the same healthcare facility in one day. The visits to multiple physicians would increase the potential risk of polypharmacy. The aim of this study was to analyze the frequency and patterns of one-stop visits in Taiwan. Methodology/Principal Findings The claims datasets of 1 million nationally representative people within Taiwan's National Health Insurance in 2005 were used to calculate the number of patients with one-stop visits. The frequent itemsets mining was applied to compute the combination patterns of specialties in the one-stop visits. Among the total 13,682,469 ambulatory care visits in 2005, one-stop visits occurred 144,132 times and involved 296,822 visits (2.2% of all visits) by 66,294 (6.6%) persons. People tended to have this behavior with age and the percentage reached 27.5% (5,662 in 20,579) in the age group ≥80 years. In general, women were more likely to have one-stop visits than men (7.2% vs. 6.0%). Internal medicine plus ophthalmology was the most frequent combination with a visited frequency of 3,552 times (2.5%), followed by cardiology plus neurology with 3,183 times (2.2%). The most frequent three-specialty combination, cardiology plus neurology and gastroenterology, occurred only 111 times. Conclusions/Significance Without the novel computational technique, it would be hardly possible to analyze the extremely diverse combination patterns of specialties in one-stop visits. The results of the study could provide useful information either for the hospital manager to set up integrated services or for the policymaker to rebuild the health care system. PMID:21747926

  10. Incidence of Hospitalization Due to Child Maltreatment in Taiwan, 1996-2007: A Nationwide Population-Based Study

    ERIC Educational Resources Information Center

    Chiang, Wan-Lin; Huang, Yu-Tung; Feng, Jui-Ying; Lu, Tsung-Hsueh

    2012-01-01

    Objectives: Little is known regarding the epidemiology of child maltreatment in Asian countries. This study aimed to examine the incidence of hospitalization coded as due to child maltreatment in Taiwan. Methods: We used inpatient claims data of the National Health Insurance for the years 1996 through 2007 for estimation. Hospitalization of…

  11. Using Organization Development Concept to Conduct Administrative Assessment of Health Promoting Schools in Taiwan--A Preliminary Study

    ERIC Educational Resources Information Center

    Huang, Jen-Jen; Yeh, Gwo-Liang; Tseng, Chie-Chien; Chen, Wei William; Hwu, Yin-Jinn; Jiang, Donald Dah-Shyong

    2009-01-01

    The Health Promoting School (HPS) programs in Taiwan were initiated and implemented with funding from Department of Health and Ministry of Education during the initial phase. The purpose of this article was to describe the application of organization development (OD) concept in the administrative assessment of HPS programs and to present results…

  12. Health Care Utilization and Expenditures of Patients with Diabetes Comorbid with Depression Disorder: A National Population-Based Cohort Study.

    PubMed

    Huang, Chun-Jen; Hsieh, Hui-Min; Chiu, Herng-Chia; Wang, Peng-Wei; Lee, Mei-Hsuan; Li, Chih-Yi; Lin, Ching-Hua

    2017-11-01

    The study investigated to compare health care utilization and expenditures between diabetic patients with and without depression in Taiwan. Health care utilization and expenditure among diabetic patients with and without depression disorder during 2000 and 2004 were examined using Taiwan's population-based National Health Insurance claims database. Health care utilization included outpatient visits and the use of inpatient services, and health expenditures were outpatient, inpatient, and total medical expenditures. Moreover, general estimation equation models were used for analyzing the factors associated with outpatient visits and expenditures. Multiple logistic regression analysis was applied for identifying the factors associated with hospitalization. The average annual outpatient visits and annual total medical expenditures in the study period were 44.23-52.20; NT$87,496-133,077 and 30.75-32.92; NT$64,411-80,955 for diabetic patients with and without depression. After adjustment for covariates, our results revealed that gender and complication were associated with out-patient visits. Moreover, the time factor was associated with the total medical expenditure, and residential urbanization and complication factors were associated with hospitalization. Health care utilization and expenditures for diabetic patients with depression were significantly higher than those without depression. Sex, complications, time, and urbanization are the factors associated with health care utilization and expenditures.

  13. A synthesized biophysical and social vulnerability assessment for Taiwan

    NASA Astrophysics Data System (ADS)

    Lee, Yung-Jaan

    2017-11-01

    Taiwan, located in the Western Pacific, is a country that is one of the most vulnerable to disasters that are associated with the changing climate; it is located within the Ring of Fire, which is the most geologically active region in the world. The environmental and geological conditions in Taiwan are sensitive and vulnerable to such disasters. Owing to increasing urbanization in Taiwan, floods and climate-related disasters have taken an increasing toll on human lives. As global warming accelerates the rising of sea levels and increasing of the frequency of extreme weather events, disasters will continue to affect socioeconomic development and human conditions. Under such circumstances, researchers and policymakers alike must recognize the importance of providing useful knowledge concerning vulnerability, disaster recovery and resilience. Strategies for reducing vulnerability and climate-related disaster risks and for increasing resilience involve preparedness, mitigation and adaptation. In the last two decades, extreme climate events have caused severe flash floods, debris flows, landslides, and other disasters and have had negative effects of many sectors, including agriculture, infrastructure and health. Since climate change is expected to have a continued impact on socio-economic development, this work develops a vulnerability assessment framework that integrates both biophysical and social vulnerability and supports synthesized vulnerability analyses to identify vulnerable areas in Taiwan. Owing to its geographical, geological and climatic features, Taiwan is susceptible to earthquakes, typhoons, droughts and various induced disasters. Therefore, Taiwan has the urgent task of establishing a framework for assessing vulnerability as a planning and policy tool that can be used to identify not only the regions that require special attention but also hotspots in which efforts should be made to reduce vulnerability and the risk of climate-related disaster. To

  14. Utilization of and Direct Expenditure for Emergency Medical 
Care in Taiwan: A Population-based Descriptive Study

    PubMed Central

    Yang, Nan-Ping; Lee, Yi-Hui; Lin, Ching-Heng; Chung, Yuan-Chang; Chen, Wen-Jone; Chou, Pesus

    2009-01-01

    Background We surveyed the emergency medical system (EMS) in Taiwan to provide information to policymakers responsible for decisions regarding the redistribution of national medical resources. Methods A systematic sampling method was used to randomly sample a representative database from the National Health Insurance (NHI) database in Taiwan, during the period from 2000 to 2004. Results We identified 10,124, 10,408, 11,209, 10,686, and 11,914 emergency room visits in 2000, 2001, 2002, 2003, and 2004, respectively. There were more males than females, and the majority of adults were younger than 50 years. Diagnose of injury/poisoning was the most frequently noted diagnostic category in emergency departments (EDs) in Taiwan. There were 13,196 (24.3%) and 2,952 (5.4%) patients with 2 and 3 concomitant diagnoses, respectively. There was a significant association between advanced age and the existence of multiple diagnoses (P < 0.001). With the exception of the ill-defined symptoms/signs/conditions, the two most frequent diagnoses were diseases of the circulatory system and diseases of the respiratory system in patients aged 65 years or older. On average, treatment-associated expenditure and drug-associated expenditure in Taiwan EDs averaged NT$1,155 ($35.0) and NT$190 ($5.8), respectively, which was equal to 64.5% and 10.6% of the total ED-associated cost. General ED medical expenditure increased with patient age; the increased cost ratio due to age was estimated at 8% per year (P < 0.001). Conclusions The frequency of major health problems diagnosed at ED visits varied by age: more complicated complaints and multiple diagnoses were more frequent in older patients. In Taiwan, the ED system remains overloaded, possibly because of the low cost of an ED visit. PMID:19164870

  15. What factors influence healthy aging? A person-centered approach among older adults in Taiwan.

    PubMed

    Liu, Li-Fan; Su, Pei-Fang

    2017-05-01

    The present study aimed to identify the health profiles of older adults by using latent class analysis to investigate health heterogeneity and to determine what factors predicted healthy aging among an oldest-old sample cohort that was followed up for 14 years in Taiwan. Data were drawn from five waves (carried out in 1993, 1996, 1999, 2003 and 2007) of the Taiwan Longitudinal Study on Aging to examine the changes in health heterogeneity in a nationally representative oldest-old cohort of Taiwanese. Overall, data from a total of 11 145 observations of 3155 older adults were considered. The influential factors predicting health changes were analyzed by using a generalized estimating equation. The results showed that four health profiles were identified among the aging population observed in the Taiwan Longitudinal Study on Aging. With increasing age, the combined effects of the physical functioning, cognitive and emotional health, and comorbidities of older adults significantly impact their health changes. Apart from health deteriorating with age and sex disparities, educational and economic status, health behaviors, and social participation at the individual level were found to be the robust factors in predicting healthy aging. In considering what factors impact healthy aging, we suggest that a person-centered approach would be useful and critical for policy makers to understand the compositions of health profiles and the influencing factors in view of a life-course perspective. Based on the factors identified as influencing healthy aging at the individual level, it is imperative from a policy-making perspective to maximize opportunities for healthy aging. Geriatr Gerontol Int 2017; 17: 697-707. © 2016 Japan Geriatrics Society.

  16. The Primary Resistance of Helicobacter pylori in Taiwan after the National Policy to Restrict Antibiotic Consumption and Its Relation to Virulence Factors—A Nationwide Study

    PubMed Central

    Chen, Mei-Jyh; Chen, Chieh-Chang; Fang, Yu-Jen; Lee, Ji-Yuh; Wu, Jeng-Yih; Luo, Jiing-Chyuan; Liou, Tai-Cherng; Chang, Wen-Hsiung; Tseng, Cheng-Hao; Wu, Chun-Ying; Yang, Tsung-Hua; Chang, Chun-Chao; Wang, Hsiu‐Po; Sheu, Bor-Shyang; Lin, Jaw-Town; Bair, Ming-Jong; Wu, Ming-Shiang

    2015-01-01

    Objective The Taiwan Government issued a policy to restrict antimicrobial usage since 2001. We aimed to assess the changes in the antibiotic consumption and the primary resistance of H. pylori after this policy and the impact of virulence factors on resistance. Methods The defined daily dose (DDD) of antibiotics was analyzed using the Taiwan National Health Insurance (NHI) research database. H. pylori strains isolated from treatment naïve (N=1395) and failure from prior eradication therapies (N=360) from 9 hospitals between 2000 and 2012 were used for analysis. The minimum inhibitory concentration was determined by agar dilution test. Genotyping for CagA and VacA was determined by PCR method. Results The DDD per 1000 persons per day of macrolides reduced from 1.12 in 1997 to 0.19 in 2008, whereas that of fluoroquinolones increased from 0.12 in 1997 to 0.35 in 2008. The primary resistance of amoxicillin, clarithromycin, metronidazole, and tetracycline remained as low as 2.2%, 7.9%, 23.7%, and 1.9% respectively. However, the primary levofloxacin resistance rose from 4.9% in 2000–2007 to 8.3% in 2008–2010 and 13.4% in 2011–2012 (p=0.001). The primary resistance of metronidazole was higher in females than males (33.1% vs. 18.8%, p<0.001), which was probably attributed to the higher consumption of nitroimidazole. Neither CagA nor VacA was associated with antibiotic resistance. Conclusions The low primary clarithromycin and metronidazole resistance of H. pylori in Taiwan might be attributed to the reduced consumption of macrolides and nitroimidazole after the national policy to restrict antimicrobial usage. Yet, further strategies are needed to restrict the consumption of fluoroquinolones in the face of rising levofloxacin resistance. PMID:25942450

  17. Gender and age differences among youth, in utilization of mental health services in the year preceding suicide in Taiwan.

    PubMed

    Chang, Hsiu-Ju; Lai, Yuen-Liang; Chang, Chia-Ming; Kao, Ching-Chiu; Shyu, Meei-Ling; Lee, Ming-Been

    2012-12-01

    The primary objective of this study was to explore gender and age differences in the use of medical services during the year preceding suicide. Data were obtained from the mortality dataset of Department of Health and National Health Insurance Database. Included in the sample were 862 persons aged 12-24 years who committed suicide in Taiwan between 2001 and 2004. We compared the records of medical service utilization of adolescents (ages 12-18 years) with young adults (ages 19-24 years). Persons in both age groups contacted general practitioners more often than other types of medical providers in the year preceding suicide, with the exception of the month before suicide. Females made greater use of medical services than males in both age groups. Suicide prevention strategies should increase the emphasis in training non-psychiatric medical practitioners to identify and treat young persons at suicide risk.

  18. Study of Patients' Willingness to Pay for a Cure of Chronic Obstructive Pulmonary Disease in Taiwan.

    PubMed

    Chen, Yi-Ting; Ying, Yung-Hsiang; Chang, Koyin; Hsieh, Ya-Hui

    2016-03-01

    Chronic Obstructive Pulmonary Disease (COPD) is one of the fastest growing causes of death worldwide. However, few studies, if any, have been conducted that have investigated patient profiles in Asia. This paper analyzes patient willingness to pay (WTP) as a function of patient disease severity, health-related quality of life (HRQL), and smoking behavior in Taiwan. A cross-sectional survey was conducted using in-person interviews with COPD patients. A hypothetical scenario was designed and presented to ascertain each subject's willingness to pay (WTP) for a cure for COPD. A survey of subjects with COPD was performed in Taiwan. The contingent valuation method (CVM) was employed to measure patient financial burden, which was analyzed along with covariates that included various types of health-related quality of life (HRQL), severity level, and demographic background. Multivariate regression and simulation methods were employed for analysis. A total of 142 subjects were interviewed, with an average annual WTP of approximately $1422 USD (or 42,662.37 NTD, New Taiwan Dollars). The annual WTP for patients 55 years of age or younger, $5709.06, was the highest and equivalent to approximately one-third of Taiwan average annual personal income or quadruple the spending amount of the Taiwan National Bureau of Health Insurance (NBHI) for each COPD patient. Current cigarette smokers were willing to pay a substantially higher amount than former smokers and nonsmokers, which reflects a psychological desire for redemption in COPD patients. The results of this study provide directions for the relevant authorities regarding the alleviation of suffering as a result of COPD. Appropriate health promotion measures, such as measures to reduce tobacco usage, early diagnosis, and active treatment, may be necessary to contain the escalating costs related to COPD and to prevent this epidemic from worsening.

  19. Study of Patients’ Willingness to Pay for a Cure of Chronic Obstructive Pulmonary Disease in Taiwan

    PubMed Central

    Chen, Yi-Ting; Ying, Yung-Hsiang; Chang, Koyin; Hsieh, Ya-Hui

    2016-01-01

    Objectives: Chronic Obstructive Pulmonary Disease (COPD) is one of the fastest growing causes of death worldwide. However, few studies, if any, have been conducted that have investigated patient profiles in Asia. This paper analyzes patient willingness to pay (WTP) as a function of patient disease severity, health-related quality of life (HRQL), and smoking behavior in Taiwan. Study Design: A cross-sectional survey was conducted using in-person interviews with COPD patients. A hypothetical scenario was designed and presented to ascertain each subject’s willingness to pay (WTP) for a cure for COPD. Methods: A survey of subjects with COPD was performed in Taiwan. The contingent valuation method (CVM) was employed to measure patient financial burden, which was analyzed along with covariates that included various types of health-related quality of life (HRQL), severity level, and demographic background. Multivariate regression and simulation methods were employed for analysis. Results: A total of 142 subjects were interviewed, with an average annual WTP of approximately $1422 USD (or 42,662.37 NTD, New Taiwan Dollars). The annual WTP for patients 55 years of age or younger, $5709.06, was the highest and equivalent to approximately one-third of Taiwan average annual personal income or quadruple the spending amount of the Taiwan National Bureau of Health Insurance (NBHI) for each COPD patient. Current cigarette smokers were willing to pay a substantially higher amount than former smokers and nonsmokers, which reflects a psychological desire for redemption in COPD patients. Conclusions: The results of this study provide directions for the relevant authorities regarding the alleviation of suffering as a result of COPD. Appropriate health promotion measures, such as measures to reduce tobacco usage, early diagnosis, and active treatment, may be necessary to contain the escalating costs related to COPD and to prevent this epidemic from worsening. PMID:26938547

  20. Expanding School-District/University Partnerships to Advance Health Promoting Schools Implementation and Efficacy in Taiwan

    ERIC Educational Resources Information Center

    Liu, Chieh-Hsing; Chang, Fong-Ching; Liao, Li-Ling; Niu, Yu-Zhen; Cheng, Chi-Chia; Shih, Shu-Fang; Chang, Tzu-Chau; Chou, Hsin-Pei

    2015-01-01

    In 2011, the Taiwan government expanded its support of school-district/university partnership programs that promote the implementation of the evidenced-based Health Promoting Schools (HPS) program. This study examined whether expanding the support for this initiative was effective in advancing HPS implementation, perceived HPS impact and perceived…

  1. Economic Recession and Obesity-Related Internet Search Behavior in Taiwan: Analysis of Google Trends Data.

    PubMed

    Wang, Ho-Wei; Chen, Duan-Rung

    2018-04-06

    Obesity is highly correlated with the development of chronic diseases and has become a critical public health issue that must be countered by aggressive action. This study determined whether data from Google Trends could provide insight into trends in obesity-related search behaviors in Taiwan. Using Google Trends, we examined how changes in economic conditions-using business cycle indicators as a proxy-were associated with people's internet search behaviors related to obesity awareness, health behaviors, and fast food restaurants. Monthly business cycle indicators were obtained from the Taiwan National Development Council. Weekly Taiwan Stock Exchange (TWSE) weighted index data were accessed and downloaded from Yahoo Finance. The weekly relative search volumes (RSV) of obesity-related terms were downloaded from Google Trends. RSVs of obesity-related terms and the TWSE from January 2007 to December 2011 (60 months) were analyzed using correlation analysis. During an economic recession, the RSV of obesity awareness and health behaviors declined (r=.441, P<.001; r=.593, P<.001, respectively); however, the RSV for fast food restaurants increased (r=-.437, P<.001). Findings indicated that when the economy was faltering, people tended to be less likely to search for information related to health behaviors and obesity awareness; moreover, they were more likely to search for fast food restaurants. Macroeconomic conditions can have an impact on people's health-related internet searches. ©Ho-Wei Wang, Duan-Rung Chen. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 06.04.2018.

  2. Impact of Excellence Programs on Taiwan Higher Education in Terms of Quality Assurance and Academic Excellence, Examining the Conflicting Role of Taiwan's Accrediting Agencies

    ERIC Educational Resources Information Center

    Hou, Angela Yung-chi

    2012-01-01

    Higher Education Evaluation & Accreditation Council of Taiwan (HEEACT) was established in 2005 and began to accredit 76 four-year comprehensive universities and colleges in Taiwan in 2006. Commissioned officially with a dual mission, HEEACT has been encouraged to conduct various ranking research projects, including global and national ones…

  3. Building a portable data and information interoperability infrastructure-framework for a standard Taiwan Electronic Medical Record Template.

    PubMed

    Jian, Wen-Shan; Hsu, Chien-Yeh; Hao, Te-Hui; Wen, Hsyien-Chia; Hsu, Min-Huei; Lee, Yen-Liang; Li, Yu-Chuan; Chang, Polun

    2007-11-01

    Traditional electronic health record (EHR) data are produced from various hospital information systems. They could not have existed independently without an information system until the incarnation of XML technology. The interoperability of a healthcare system can be divided into two dimensions: functional interoperability and semantic interoperability. Currently, no single EHR standard exists that provides complete EHR interoperability. In order to establish a national EHR standard, we developed a set of local EHR templates. The Taiwan Electronic Medical Record Template (TMT) is a standard that aims to achieve semantic interoperability in EHR exchanges nationally. The TMT architecture is basically composed of forms, components, sections, and elements. Data stored in the elements which can be referenced by the code set, data type, and narrative block. The TMT was established with the following requirements in mind: (1) transformable to international standards; (2) having a minimal impact on the existing healthcare system; (3) easy to implement and deploy, and (4) compliant with Taiwan's current laws and regulations. The TMT provides a basis for building a portable, interoperable information infrastructure for EHR exchange in Taiwan.

  4. Urbanicity-Related Variation in Help-Seeking and Services Utilization among Preschool-Age Children with Autism in Taiwan

    ERIC Educational Resources Information Center

    Chen, Chuan-Yu; Liu, Chieh-Yu; Su, Wen-Chuan; Huang, Su-Ling; Lin, Keh-Ming

    2008-01-01

    The present study examines urbanicity-related differences in help-seeking process among preschool children with autism and investigates the factors associated with utilization of autism-related services within the year of diagnosis. Using the 1997-2004 National Health Insurance Research Database (NHIRD) in Taiwan, we identified a total of 3495…

  5. The heterogeneous health latent classes of elderly people and their socio-demographic characteristics in Taiwan.

    PubMed

    Liu, Li-Fan; Tian, Wei-Hua; Yao, Hui-Ping

    2014-01-01

    The health care needs of elderly people were influenced by their heterogeneity. This study aimed to identify the health latent classes of elderly people by using latent class analysis to deal with heterogeneity and examine their socio-demographic characteristics. Data came from the 2005 National Health Interview Survey (NHIS) in Taiwan. In total, 2449 elderly individuals with available health indicators were examined in latent class analysis (LCA), and 2217 elderly community-dwellings with complete socio-demographic data were analyzed by multinomial logistic regression. Four health latent classes were identified which included 1066 (43.5%) people in the High Comorbidity (HC), 152 (6.2%) in the Functional Impairment (FI), 252 (10.3%) in the Frail (FR), and 979 (40.0%) in the Relatively Healthy (RH) group. Multinomial logistic regressions revealed socio-demographic characteristics among health classes. The variables associated with an increased likelihood of being in the FR group were age, female, and living with families. They were also correlated to ethnicity and educations. Apart from age and gender, the Functional Impairment group was less likely to be ethnicity of Hakka, more likely to live with others than were the RH group. The HC group tended to be younger, with higher educations, and more likely to live in urban area than the Functional Impairment group. The correlations between health classes and socio-demographic factors were discussed. The health status of elderly people includes a variety of health indicators. A person-centered approach is critical to identify the health heterogeneity of elderly people and manage their care needs by targeting differential aging. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Quality assessment and improvement of nationwide cancer registration system in Taiwan: a review.

    PubMed

    Chiang, Chun-Ju; You, San-Lin; Chen, Chien-Jen; Yang, Ya-Wen; Lo, Wei-Cheng; Lai, Mei-Shu

    2015-03-01

    Cancer registration provides core information for cancer surveillance and control. The population-based Taiwan Cancer Registry was implemented in 1979. After the Cancer Control Act was promulgated in 2003, the completeness (97%) and data quality of cancer registry database has achieved at an excellent level. Hospitals with 50 or more beds, which provide outpatient and hospitalized cancer care, are recruited to report 20 items of information on all newly diagnosed cancers to the central registry office (called short-form database). The Taiwan Cancer Registry is organized and funded by the Ministry of Health and Welfare. The National Taiwan University has been contracted to operate the registry and organized an advisory board to standardize definitions of terminology, coding and procedures of the registry's reporting system since 1996. To monitor the cancer care patterns and evaluate the cancer treatment outcomes, central cancer registry has been reformed since 2002 to include detail items of the stage at diagnosis and the first course of treatment (called long-form database). There are 80 hospitals, which count for >90% of total cancer cases, involved in the long-form registration. The Taiwan Cancer Registry has run smoothly for >30 years, which provides essential foundation for academic research and cancer control policy in Taiwan. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Real-world use of ranibizumab for neovascular age-related macular degeneration in Taiwan.

    PubMed

    Chang, Yi-Sheng; Lee, Wan-Ju; Lim, Chen-Chee; Wang, Shih-Hao; Hsu, Sheng-Min; Chen, Yi-Chian; Cheng, Chia-Yi; Teng, Yu-Ti; Huang, Yi-Hsun; Lai, Chun-Chieh; Tseng, Sung-Huei

    2018-05-10

    This study investigated the "real-world" use of ranibizumab for neovascular age-related macular degeneration (nAMD) in Taiwan and assessed the visual outcome. We reviewed the medical records at National Cheng Kung University Hospital, Taiwan, during 2012-2014 for 264 consecutive eyes of 229 patients with nAMD, who applied for ranibizumab covered by national health insurance. A total of 194 eyes (73.5%) in 179 patients (65.5% men; mean ± standard deviation age 69.4 ± 10.7 years) were pre-approved for treatment. Applications for treatment increased year by year, but approval rates decreased during this time. The major causes of rejection for funding were diseases mimicking nAMD, including macular pucker/epiretinal membrane, macular scarring, dry-type AMD, and possible polypoidal choroidal vasculopathy. After completion of three injections in 147 eyes, visual acuity significantly improved, gaining ≥1 line in 51.8% of eyes and stabilising in 38.3% of 141 eyes in which visual acuity was measured. The 114 eyes approved with only one application had a better visual outcome than the 27 eyes approved after the second or third applications. In conclusion, ranibizumab is effective for nAMD; however, approval after the second or third application for national health insurance cover is a less favourable predictor of visual outcome.

  8. Incidence of eye cancer in Taiwan: an 18-year review.

    PubMed

    Cheng, C-Y; Hsu, W-M

    2004-02-01

    To describe the incidence and histologic patterns of eye cancers in Chinese in Taiwan. Beginning in 1979, cases of cancer in Taiwan were reported to the Taiwan National Cancer Registry. Information on all Chinese patients diagnosed with eye malignancies under the International Classification of Disease, Ninth Revision, site 190, was retrieved for analysis from the data bank of the Taiwan National Cancer Registry. In all, 733 cases with primary eye cancers were identified from 1979 to 1996, an 18-year period. The average annual age-standardized incidence of eye cancers was 2.46 per million population (2.57 for male and 2.33 for female). For cases less than 15 years of age, the most common eye malignancy was retinoblastoma (86.0%), followed by rhabdomyosarcoma (3.9%) and lymphoma (2.8%). For cases 15 years of age or older, the most common eye malignancy was melanoma (28.6%), followed by squamous cell sarcoma (21.0%) and lymphoma (20.8%). The time trends of the incidence of eye cancers were relatively stable over the 18-year period in Taiwan. Retinobalstoma, melanoma, and lymphoma were the three most common eye cancers in this Chinese population.

  9. Gender and Geographic Differences in Developmental Delays among Young Children: Analysis of the Data from the National Registry in Taiwan

    ERIC Educational Resources Information Center

    Lai, Der-Chung; Tseng, Yen-Cheng; Guo, How-Ran

    2011-01-01

    Although developmental delays are not uncommon in children, the incidence is seldom assessed, and the reported prevalence varies widely. In Taiwan, the government mandates the reporting of suspected cases. Using the national registry data, we conducted a study to estimate the incidence and prevalence of developmental delays in young children in…

  10. Facilitating the implementation and efficacy of health-promoting schools via an action-research approach in Taiwan.

    PubMed

    Chang, Fong-Ching; Liu, Chieh-Hsing; Liao, Li-Ling; Niu, Yu-Zhen; Cheng, Chi-Chia; Chou, Hsin-Pei; Chang, Tzu-Chau

    2014-06-01

    Taiwan launched its evidence-based health-promoting school (HPS) program via an action-research approach in 2010. The program featured a collaborative partnership between schools, local education authorities and university support networks. This study was focused on examining whether an HPS action-research approach was effective in advancing HPS implementation, perceived HPS impact and perceived HPS efficacy in Taiwan. In 2011, questionnaires were sent to 900 sample schools in Taiwan. A total of 621 schools returned the questionnaire, including 488 primary schools and 133 middle schools. The response rate was 69%. This study compared the difference in HPS implementation status, perceived HPS impact and perceived HPS efficacy between those schools that had implemented action-research HPS (138 schools) and those that had not (483 schools). The univariate analysis results indicated that the HPS implementation levels for components that included school health policies, physical environment, social environment, teaching activities and school-community relations were significantly higher in action-research schools than in non-action-research schools. Teachers in action-research schools reported significantly higher levels of HPS impact and HPS efficacy than non-action-research schools. The multivariate analysis results indicated that after controlling for school level and HPS funding, the HPS action-research approach was significantly positively related to greater levels of HPS implementation, perceived HPS impact and perceived HPS efficacy.

  11. From waste minimization to ISO 14000: Taiwan`s experience and prospects

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wen-Huei Chen; Wain-Sun Hou

    Taiwan has completed a very successful five-year industrial waste minimization (IWM) demonstration and promotion project sponsored by the government. From 1990 to 1995, the project successfully disseminated the IWM concept of pollution prevention (P2) to industries. It effectively reduced industrial waste while significantly benefitting the economy by assisting industries in implementing in-plant IWM programs. In July 1995, the second stage of the five-year IWM and ISO 14000 promotion project was initiated for further promoting the IWM, P2, and cleaner production and, in particular, coping with the upcoming international environmental management standards (ISO 14000). To assist industries in establishing an environmentalmore » management system (EMS) and accumulating related experience, an EMS pilot demonstration project of five model industries and an ISO 14001 EMS demonstration and promotion project for 22 factories in 13 industries were initiated in October 1995 and August 1996, respectively. These projects can assist Taiwan`s industries in changing the constitution of their enterprises, enhancing competition in the international market, and helping our nation achieve the forerunner`s profits in sustainable development. 9 refs., 3 figs.« less

  12. A study for safety and health management problem of semiconductor industry in Taiwan.

    PubMed

    Chao, Chin-Jung; Wang, Hui-Ming; Feng, Wen-Yang; Tseng, Feng-Yi

    2008-12-01

    The main purpose of this study is to discuss and explore the safety and health management in semiconductor industry. The researcher practically investigates and interviews the input, process and output of the safety and health management of semiconductor industry by using the questionnaires and the interview method which is developed according to the framework of the OHSAS 18001. The result shows that there are six important factors for the safety and health management in Taiwan semiconductor industry. 1. The company should make employee clearly understand the safety and health laws and standards. 2. The company should make the safety and health management policy known to the public. 3. The company should put emphasis on the pursuance of the safety and health management laws. 4. The company should prevent the accidents. 5. The safety and health message should be communicated sufficiently. 6. The company should consider safety and health norm completely.

  13. Economic Recession and Obesity-Related Internet Search Behavior in Taiwan: Analysis of Google Trends Data

    PubMed Central

    2018-01-01

    Background Obesity is highly correlated with the development of chronic diseases and has become a critical public health issue that must be countered by aggressive action. This study determined whether data from Google Trends could provide insight into trends in obesity-related search behaviors in Taiwan. Objective Using Google Trends, we examined how changes in economic conditions—using business cycle indicators as a proxy—were associated with people’s internet search behaviors related to obesity awareness, health behaviors, and fast food restaurants. Methods Monthly business cycle indicators were obtained from the Taiwan National Development Council. Weekly Taiwan Stock Exchange (TWSE) weighted index data were accessed and downloaded from Yahoo Finance. The weekly relative search volumes (RSV) of obesity-related terms were downloaded from Google Trends. RSVs of obesity-related terms and the TWSE from January 2007 to December 2011 (60 months) were analyzed using correlation analysis. Results During an economic recession, the RSV of obesity awareness and health behaviors declined (r=.441, P<.001; r=.593, P<.001, respectively); however, the RSV for fast food restaurants increased (r=−.437, P<.001). Findings indicated that when the economy was faltering, people tended to be less likely to search for information related to health behaviors and obesity awareness; moreover, they were more likely to search for fast food restaurants. Conclusions Macroeconomic conditions can have an impact on people’s health-related internet searches. PMID:29625958

  14. Taiwan-U.S. Relations: Developments and Policy Implications

    DTIC Science & Technology

    2009-05-01

    ally, China’s situation changed dramatically after the civil war victory of Mao Tse-tung in 1949. The reigning Chinese government, led by Chiang Kai ...Congressional Research Service 5 Changing Political Dynamics in Taiwan Until the mid-1980s, Taiwan had a one-party system in which Chiang Kai -shek’s...Taipei Times, January 23, 2009, p. 1. 21 Xie Yu , “Taiwan put under WHO health rules,” China Daily, February 12, 2009. 22 Chen, Jian, “WHA arrangements

  15. Risk factors of suicide mortality among multiple attempters: A national registry study in Taiwan.

    PubMed

    Chen, I-Ming; Liao, Shih-Cheng; Lee, Ming-Been; Wu, Chia-Yi; Lin, Po-Hsien; Chen, Wei J

    2016-05-01

    Little is known about the risk factors of suicide mortality among multiple attempters. This study aims to investigate the predictors of suicidal mortality in a prospective cohort of attempters in Taiwan, focusing on the time interval and suicide method change between the last two nonfatal attempts. The representative data retrieved from the National Suicide Surveillance System (NSSS) was linked with National Mortality Database to identify the causes of death in multiple attempters during 2006-2008. Cox-proportional hazard models were applied to calculate the hazard ratios for the predictors of suicide. Among the 55,560 attempters, 6485 (11.7%) had survived attempts ranging from one to 11 times; 861 (1.5%) eventually died by suicide. Multiple attempters were characterized by female (OR = 1.56, p < 0.0001), nonrecipient of national aftercare service (OR = 1.62, p < 0.0001), and current contact with mental health services (OR = 3.17, p < 0.0001). Most multiple attempters who survived from hanging (68.1%) and gas poisoning (61.9%) chose the same method in the following fatal episode. Predictors of suicidal death were identified as male, older age (≥ 45 years), shorter interval and not maintaining methods of low lethality in the last two nonfatal attempts. Receipt of nationwide aftercare was associated with lower risk of suicide but the effect was insignificant. The time interval of the last two nonfatal attempts and alteration in the lethality of suicide method were significant factors for completed suicide. Risk assessment involving these two factors may be necessary for multiple attempters in different clinical settings. Effective strategies for suicide prevention emphasizing this high risk population should be developed in the future. Copyright © 2015. Published by Elsevier B.V.

  16. Use of Seasonal Influenza Vaccination and Its Associated Factors among Elderly People with Disabilities in Taiwan: A Population-Based Study.

    PubMed

    Chang, Yu-Chia; Tung, Ho-Jui; Hsu, Shang-Wei; Chen, Lei-Shin; Kung, Pei-Tseng; Huang, Kuang-Hua; Chiou, Shang-Jyh; Tsai, Wen-Chen

    2016-01-01

    Influenza immunization among elderly people with disabilities is a critical public health concern; however, few studies have examined the factors associated with vaccination rates in non-Western societies. By linking the National Disability Registration System and health service claims dataset from the National Health Insurance program, this population-based study investigated the seasonal influenza vaccination rate among elderly people with disabilities in Taiwan (N = 283,172) in 2008. A multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 32.7% of Taiwanese elderly people with disabilities received influenza vaccination. The strongest predictor for getting vaccinated among older Taiwanese people with disabilities was their experience of receiving an influenza vaccination in the previous year (adjusted odds ratio [AOR] = 6.80, 95% confidence interval [CI]: 6.67-6.93). Frequent OPD use (AOR = 1.85, 95% CI: 1.81-1.89) and undergoing health examinations in the previous year (AOR = 1.66, 95% CI: 1.62-1.69) also showed a moderate and significant association with receiving an influenza vaccination. Although free influenza vaccination has been provided in Taiwan since 2001, influenza immunization rates among elderly people with disabilities remain low. Policy initiatives are required to address the identified factors for improving influenza immunization rates among elderly people with disabilities.

  17. Functional health status among rural and urban older adults in Taiwan: the effect of personal control and social control.

    PubMed

    Chiu, Tzu-I; Spencer, Gale A

    2010-09-01

    To assess the relationship between perceived social control/personal control and functional health status among older adults in rural and urban Taiwan. The ageing of the population is poised to emerge as a preeminent worldwide phenomenon. It is assumed that even though older adults experience many decades of autonomy and independence, the potential for illness or bodily decline will induce a serious reduction in the level of perceived control in older adult populations. This is a descriptive correlational study using a secondary data base, Social Environment and Biomarkers of Aging Study. Social Environment and Biomarkers of Aging Study is a nationally representative study of health outcomes in the Taiwanese population. Both perceived levels of social control and personal control had a statistically significant relationship with functional health status. Functional health status was significantly higher for urban older adults than their rural counterparts. Personal control and social control were both found to be predictors of functional health status. Major findings are supported by previous studies. Nurses should create programs and plan activities to assist older adults to enhance their perceptions of social control or personal control in order to improve the health status of older adults and minimize associated health care costs. © 2009 Blackwell Publishing Ltd.

  18. Prognostic impact of peritonitis in hemodialysis patients: A national-wide longitudinal study in Taiwan

    PubMed Central

    Lee, Cheng-Chia; Wu, Patricia W.; Chang, Chee-Jen; Tian, Ya-Chung; Yang, Chih-Wei

    2017-01-01

    Background Peritonitis has been independently associated with increased morbidity and mortality in peritoneal dialysis patients. However, there are few reports on peritonitis in hemodialysis patients. We aim at investigating both the risk profiles and prognostic impact of peritonitis in hemodialysis patients. Methods This nation-wide longitudinal study uses claims data obtained from the Taiwan National Health Insurance Research Database. A total of 80,733 incident hemodialysis patients of age ≥ 20 years without a history of peritonitis were identified between January 1, 1998 and December 31, 2009. Predictors of peritonitis events were estimated using Cox proportional hazard models. Time-dependent Cox proportional hazard models were used to estimate hazard ratio for mortality attributed to peritonitis exposure. Results Of 80,733 incident hemodialysis patients over a 13-year study period, peritonitis was diagnosed in 935 (1.16%), yielding an incidence rate of 2.91 per 1000 person-years. Female gender, liver cirrhosis and polycystic kidney disease were three of the most significant factors for peritonitis in both non-diabetic and diabetic hemodialysis patients. The cumulative survival rate of patients with peritonitis was 38.8% at 1 year and 10.1% at 5 years. A time-dependent Cox multivariate analysis showed that peritonitis had significantly increased hazard ratio for all cause mortality. Additionally, the risk of mortality remained significantly higher for non-diabetic hemodialysis patients that experienced peritonitis. Conclusions The risk of peritonitis in hemodialysis patients is higher in female gender, liver cirrhosis and polycystic kidney disease. Although peritonitis is a rare condition, it is associated with significantly poorer outcome in hemodialysis patients. PMID:28301536

  19. Prognostic impact of peritonitis in hemodialysis patients: A national-wide longitudinal study in Taiwan.

    PubMed

    Lu, Yueh-An; Tu, Kun-Hua; Lee, Cheng-Chia; Wu, Patricia W; Chang, Chee-Jen; Tian, Ya-Chung; Yang, Chih-Wei; Chu, Pao-Hsien

    2017-01-01

    Peritonitis has been independently associated with increased morbidity and mortality in peritoneal dialysis patients. However, there are few reports on peritonitis in hemodialysis patients. We aim at investigating both the risk profiles and prognostic impact of peritonitis in hemodialysis patients. This nation-wide longitudinal study uses claims data obtained from the Taiwan National Health Insurance Research Database. A total of 80,733 incident hemodialysis patients of age ≥ 20 years without a history of peritonitis were identified between January 1, 1998 and December 31, 2009. Predictors of peritonitis events were estimated using Cox proportional hazard models. Time-dependent Cox proportional hazard models were used to estimate hazard ratio for mortality attributed to peritonitis exposure. Of 80,733 incident hemodialysis patients over a 13-year study period, peritonitis was diagnosed in 935 (1.16%), yielding an incidence rate of 2.91 per 1000 person-years. Female gender, liver cirrhosis and polycystic kidney disease were three of the most significant factors for peritonitis in both non-diabetic and diabetic hemodialysis patients. The cumulative survival rate of patients with peritonitis was 38.8% at 1 year and 10.1% at 5 years. A time-dependent Cox multivariate analysis showed that peritonitis had significantly increased hazard ratio for all cause mortality. Additionally, the risk of mortality remained significantly higher for non-diabetic hemodialysis patients that experienced peritonitis. The risk of peritonitis in hemodialysis patients is higher in female gender, liver cirrhosis and polycystic kidney disease. Although peritonitis is a rare condition, it is associated with significantly poorer outcome in hemodialysis patients.

  20. Coprescription of Chinese herbal medicine and Western medication among female patients with breast cancer in Taiwan: analysis of national insurance claims.

    PubMed

    Wang, Bih-Ru; Chang, Yuh-Lih; Chen, Tzeng-Ji; Chiu, Jen-Hwey; Wu, Jing Chong; Wu, Min-Shan; Chou, Chia-Lin; Chou, Yueh-Ching

    2014-01-01

    Many female breast cancer (FBC) patients take Chinese herbal medicine (CHM) and Western medication (WM) concurrently in Taiwan. Despite the possibility of interactions between the CHM and WM mentioned in previous studies, the pattern of these coprescriptions in FBC patients remains unclear. Hence, the aim of the present study is to investigate the utilization of coprescriptions of CHM and WM among the FBC patients in Taiwan. The study was a cross-sectional survey using the sampled cohort in 2009 obtained from the National Health Insurance Research Database in Taiwan. There were 3,507 FBC patients identified from the registry for catastrophic illness patients. Ambulatory visit records, corresponding prescriptions, and the data of beneficiaries belonging to the FBC patients were further extracted. A total of 1,086 FBC patients used CHM at least once. CHM and WM prescribed within any overlapping duration were defined as coprescriptions. There were 868 (80.0%) patients simultaneously receiving CHM and WM. A total of 4,927 CHM prescriptions and 6,358 WM prescriptions were prescribed concurrently. Among these coprescriptions, the most frequently used CHM was jia-wei-xiao-yao-san (21.2%), and the most frequently coprescribed WM was acetaminophen (38.9%), followed by tamoxifen (25.5%). There were 346 patients using systemic adjuvant therapy and CHM concurrently. The most commonly coprescribed CHM with chemotherapy, endocrine therapy, and trastuzumab was xiang-sha-liu-jun-zi-tang, jia-wei-xiao-yao-san, and zhi-gan-cao-tang, respectively. The combined use of CHM with WM is prevalent. The main purpose of combining CHM with systemic cancer treatment is to alleviate the treatment-related adverse effects. However, the combination may result in the potential risk of drug-herb interactions. Further clinical studies are needed to evaluate the efficacy and safety of the CHM and WM coprescriptions for FBC patients.

  1. Prevalence, Incidence, and Factor Concentrate Usage Trends of Hemophiliacs in Taiwan

    PubMed Central

    Tu, Tsu-Chiang; Liou, Wen-Shyong; Chou, Tsui-Yun; Lin, Tsung-Kun; Lee, Chuan-Fang; Chen, Jye-Daa; Cham, Thau-Ming

    2013-01-01

    Purpose Hemophilia A and B (HA, HB) are the most common X-linked inherited bleeding disorders. The introduction of factor concentrates has allowed for control of the lifelong chronic disease. However, no studies have been published regarding the epidemiology of hemophilia in Taiwan. Our aim was to determine the prevalence, incidence, and mortality rate, as well as trends in the use of factor concentrates, in individuals with hemophilia in Taiwan. Materials and Methods A retrospective study was conducted using the National Health Insurance Research Database between 1997 and 2007. Results We identified 988 males with hemophilia (HA : HB ratio=5.4 : 1). The mean prevalence per 100000 males was 6.7±0.1 for HA and 1.2±0.1 for HB. The estimated mean annual incidence per live male birth was 1 in 10752 for HA and 1 in 47619 for HB. Standardized mortality ratios for males with hemophilia (all severities) or severe hemophilia were 1.3- and 2.1-fold higher than that of the general male population, respectively. Mean factor VIII (FVIII) and factor IX (FIX) usage was 1.5003±0.4029 and 0.3126±0.0904 international units (IUs) per capita, respectively. Mean FVIII and FIX usage per patient with hemophilia (all severities) or severe hemophilia was 44027±11532 and 72341±17298, respectively, and 49407±13015 and 74369±18411 IUs per person with HA or HB, respectively. Conclusion Our data revealed epidemiologic and factor concentrate usage trends in males with hemophilia in Taiwan, highlighting a need for improvements in the mandatory National Health Insurance registry. A better-designed, patient-centered registry system would enable more detailed patient information collection and analysis, improving subsequent care. PMID:23225801

  2. Health Risk-Based Assessment and Management of Heavy Metals-Contaminated Soil Sites in Taiwan

    PubMed Central

    Lai, Hung-Yu; Hseu, Zeng-Yei; Chen, Ting-Chien; Chen, Bo-Ching; Guo, Horng-Yuh; Chen, Zueng-Sang

    2010-01-01

    Risk-based assessment is a way to evaluate the potential hazards of contaminated sites and is based on considering linkages between pollution sources, pathways, and receptors. These linkages can be broken by source reduction, pathway management, and modifying exposure of the receptors. In Taiwan, the Soil and Groundwater Pollution Remediation Act (SGWPR Act) uses one target regulation to evaluate the contamination status of soil and groundwater pollution. More than 600 sites contaminated with heavy metals (HMs) have been remediated and the costs of this process are always high. Besides using soil remediation techniques to remove contaminants from these sites, the selection of possible remediation methods to obtain rapid risk reduction is permissible and of increasing interest. This paper discusses previous soil remediation techniques applied to different sites in Taiwan and also clarified the differences of risk assessment before and after soil remediation obtained by applying different risk assessment models. This paper also includes many case studies on: (1) food safety risk assessment for brown rice growing in a HMs-contaminated site; (2) a tiered approach to health risk assessment for a contaminated site; (3) risk assessment for phytoremediation techniques applied in HMs-contaminated sites; and (4) soil remediation cost analysis for contaminated sites in Taiwan. PMID:21139851

  3. Workplace stress, job satisfaction, job performance, and turnover intention of health care workers in rural Taiwan.

    PubMed

    Chao, Ming-Che; Jou, Rong-Chang; Liao, Cing-Chu; Kuo, Chung-Wei

    2015-03-01

    Workplace stress (WS) has been found to affect job satisfaction (JS), performance, and turnover intentions (TIs) in developed countries, but there is little evidence from other countries and especially rural areas. In rural Taiwan, especially, there is an insufficient health care workforce, and the situation is getting worse. To demonstrate the relationship, we used a cross-sectional structured questionnaire, and data from 344 licensed professionals in 1 rural regional hospital were analyzed using the structural equation model. The results showed that WS had a positive effect on both TI and job performance (JP) but a negative effect on satisfaction. JS did improve performance. For the staff with an external locus of control, stress affected JP and satisfaction significantly. For the staff with lower perceived job characteristics, JS affected performance significantly. The strategies to decrease stress relating to work load, role conflict, family factors, and working environment should be focused and implemented urgently to lower the turnover rate of health care workers in rural Taiwan. © 2013 APJPH.

  4. Cluster analysis of medical service resources at district hospitals in Taiwan, 2007-2011.

    PubMed

    Tseng, Shu-Fang; Lee, Tian-Shyug; Deng, Chung-Yeh

    2015-12-01

    A vast amount of the annual/national budget has been spent on the National Health Insurance program in Taiwan. However, the market for district hospitals has become increasingly competitive, and district hospitals are under pressure to optimize the use of health service resources. Therefore, we employed a clustering method to explore variations in input and output service volumes, and investigate resource allocation and health care service efficiency in district hospitals. Descriptive and cluster analyses were conducted to examine the district hospitals included in the Ministry of Health and Welfare database during 2007-2011. The results, according to the types of hospital ownership, suggested that the number of public hospitals has decreased and that of private hospitals increased; the largest increase in the number of district hospitals occurred when Taichung City was merged into Taichung County. The descriptive statistics from 2007 to 2011 indicated that 43% and 36.4% of the hospitals had 501-800 occupied beds and 101-200 physicians, respectively, and > 401 medical staff members. However, the number of outpatients and discharged patients exceeded 6001 and 90,001, respectively. In addition, the highest percentage of hospitals (43.9%) had 30,001-60,000 emergency department patients. In 2010, the number of patients varied widely, and the analysis of variance cluster results were nonsignificant (p > 0.05). District hospitals belonging to low-throughput and low-performance groups were encouraged to improve resource utilization for enhancing health care service efficiency. Copyright © 2015. Published by Elsevier Taiwan.

  5. National Disability Registers Report on Causes of Intellectual Disability in Taiwan: 2000-2007

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Yen, Chia-Feng; Wu, Jia-Ling; Kang, Shih-Wan

    2009-01-01

    The main purposes of the present analysis were to describe the causes of intellectual disability (ID) and examine its overtime change from 2000 to 2007 in Taiwan. Data of the present study mainly come from the public web-access information which collected by the Department of Statistics, Ministry of the Interiors, Taipei, Taiwan. Data were…

  6. The effectiveness and barriers of implementing a workplace health promotion program to improve metabolic disorders in older workers in Taiwan.

    PubMed

    Chen, Meei-Maan; Tsai, Alan C; Wang, Jiun-Yi

    2016-06-01

    To determine the effectiveness of a pragmatic health promotion program to improve the metabolic disorders in older workers in Taiwan, we conducted a 24-week quasi-experiment in three worksites in southern Taiwan in 2010. Among 1,245 workers, 108 met the inclusion criteria (full-time workers aged over 50 years) and agreed to participate in the study. They were assigned to either the intervention (n = 58) or the reference group (n = 50) according to their availability to participate in health-promoting activities. The intervention group received training in behavioral modifications to improve diet, time-use, stress management and physical activity. Motivational lectures, group activities, and team competitions were used to improve participants' knowledge and skills in managing own health. Subjects in the reference group received no intervention. Lifestyle, anthropometric and biochemical indicators were measured at baseline and end-point. Mixed effects linear models were used to determine the intervention effects. The intervention significantly lowered body weight (intervention vs. reference = -1.22 vs. -0.30kg, p = 0.026), BMI (-0.46 vs. -0.02kg/m2, p = 0.006), and waist circumference (-2.68 vs. +0.79cm, p <0.001), but had no effect on biochemical parameters. These findings suggest the workplace-based health promotion can be effective and useful in reducing the risk of metabolic disorders in older workers in Taiwan. © The Author(s) 2014.

  7. Impact of universal health coverage on suicide risk in newly diagnosed cancer patients: Population-based cohort study from 1985 to 2007 in Taiwan.

    PubMed

    Lin, Po-Hsien; Liao, Shih-Cheng; Chen, I-Ming; Kuo, Po-Hsiu; Shan, Jia-Chi; Lee, Ming-Been; Chen, Wei J

    2017-11-01

    National Health Insurance (NHI), launched in 1995 in Taiwan, lightens patient's financial burdens but its effect on the suicide risk in cancer patients is unclear. We aimed to investigate the impacts of the NHI on the suicide in newly diagnosed cancer patients. We identified patients with newly diagnosed cancer from the nationwide Taiwan Cancer Registration from 1985 to 2007, and ascertained suicide deaths from the national database of registered deaths between 1985 and 2009. Standardized mortality ratio (SMR) of suicide risk among patients with cancer was calculated, and the suicide risk ratios were examined by gender, age group, and prognosis. For the 916 337 registered cancer patients with 4 300 953 person-years, 2 543 died by suicide, with a suicide rate of 59.1 per 100 000 person-years. Compared to the general population, cancer patients had an SMR of 2.47 for suicide, with a higher figure for males (2.73), age 45 to 64 (2.89), and cancer of poor prognosis (3.19). The suicide risk was highest in the first 2 years after the initial diagnosis. Comparing the cohorts of the period before (1985 to 1992) and after (1996 to 2007) the launch of NHI, we saw a reduction in the SMR within the first 2 years after cancer diagnosis (20%), with more prominent reduction for females (29%), age under 45 (69%), and cancer of good prognosis (33%). A universal health coverage relieving both physical and psychological distress may account for the post-NHI reduction of immediate suicide risk in patients of newly diagnosed cancer. Copyright © 2017 John Wiley & Sons, Ltd.

  8. Administrative Prevalence of Autism Spectrum Disorders Based on National Disability Registers in Taiwan

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Lin, Lan-Ping; Wu, Jia-Ling

    2009-01-01

    The aim of this paper was to describe the over time prevalence of autism from 2000 to 2007 in Taiwan, with particular focus on the age, gender, prevalence and causes. We analyzed data from the public web-access information collected by the Department of Statistics, Ministry of the Interiors, Taipei, Taiwan. The data included: (1) the physically…

  9. A coalition partnership of vision health through a health-promoting school program for primary school students in Taiwan.

    PubMed

    Chang, Li-Chun; Guo, Jong-Long; Liao, Li-Ling; Peng, Hsiu-Ying; Hsieh, Pei-Lin

    2017-09-01

    Myopia, the most common refractive error, is the most common cause of avoidable visual impairment among children and has reached epidemic proportions among children and young adults in urban areas of East and Southeast Asia that contain populations of Chinese ancestry. Moreover, vision health is an important theme of the health-promoting school program issued by the Ministry of Education in Taiwan. The aim of this study is to assess the impact of pre- and post-intervention proposed by the health-promoting school (HPS) model. The objectives are to understand whether the HPS model influenced the vision screening results and the attitude, knowledge level, and vision care behavior of the students involved. A prospective cohort study design was used to evaluate a vision health program. Four elementary schools, local education authorities, and one university in northern Taiwan established a coalition partnership to design a six-month program to combat myopia among students. The target population was 6668 school children from local elementary schools. For the purpose of this study, the outcome of visual acuity testing (in logMAR) was analyzed with a sampling of 373 school children (aged 11-12 years old) who were chosen from high prevalence of poor vision classes. After the HPS program, the attitudes, behaviors, and knowledge levels of the school children regarding vision health were significantly improved. The pre-intervention mean logMAR of all participating students ( N = 373) was -.10, which increased to -.19 after the intervention. Analysis using the Wilcoxon signed-rank test showed that the logMAR value was significantly improved after the intervention ( t = 2.13, p < 0.05). Our findings highlight the relevance and effectiveness of the coalition's efforts, which reinforces the usefulness of co-operatively implementing the HPS program.

  10. Barriers to and facilitators of the implementation of health promoting hospitals in Taiwan: a top-down movement in need of ground support.

    PubMed

    Lee, Chiachi Bonnie; Chen, Michael S; Wang, Ying Wei

    2014-01-01

    This study investigates barriers to and facilitators of health promoting hospitals (HPH) in Taiwan. The findings are based on a cross-sectional questionnaire survey involving 55 hospitals committed to health promotion (HP) as of the end of 2009, and 52 of them completed the questionnaire. The five most reported barriers are inadequate national health insurance coverage of HP, staff detachment, incoherence of government policies, weak inter-sectoral link and resistance to change. The five most reported facilitators are support from hospital superintendents, support from unit/department directors, HP-inclusive hospital development mission and goals, funding from the government, founding of HP-related committees, resources and healthy policies. The study also found that organizational capacity building (OCB) had a significantly negative association with the number of barriers and a positive association with the number of facilitators. Stepwise linear regressions further found that OCB in structure was a significant predictor of the fewer number of barriers and that in-staff participation was a significant predictor of the more perceived facilitators. It also confirmed the significant role of organizational capacity building and that of coordinators in the effective implementation of HPH. The transformational factors as well as transactional factors are very much at work as facilitators, but the transactional factors are trapped in a less-than-friendly environment. Comprehensive support from transformational factors as well as transactional factors is essential and further support for daily routine operations and staff participation are required to sustain the implementation of HPH in Taiwan. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Kindergartener's Technology Education in Taiwan.

    ERIC Educational Resources Information Center

    Lai, Chun-Chin

    According to the American Association for Advancement of Sciences, the National Academy of Engineering, and the International Technology Education Association (ITEA) and its Technology for All Americans Project (TfAAP), technology education should begin in kindergarten. Educators in Taiwan have also advocated beginning technology education in…

  12. The General Picture of Supportive Health Environments for Persons with Intellectual Disabilities among 121 Disability Welfare Institutions in Taiwan

    ERIC Educational Resources Information Center

    Lin, J.-D.; Yen, C.-F.; Loh, C.-H.; Chwo, M.-J.; Lee, J.-T.; Wu, J.-L.; Chu, C. M.; Tang, C.-C.

    2006-01-01

    Background: Little information is available on the provision of supportive health environments for persons with intellectual disabilities (ID) in institutions. The aim of this study was to present an overview of supportive environments for health in institutions in Taiwan. Methods: A cross-sectional survey was conducted to examine the perceptions…

  13. Quantifying Morbidity Burdens and Medical Utilization of Children with Intellectual Disabilities in Taiwan: A Nationwide Study Using the ACG Case-Mix Adjustment System

    ERIC Educational Resources Information Center

    Lee, Wui-Chiang; Chen, Tzeng-Ji

    2012-01-01

    The purpose of this study was to quantify morbidity burdens of children with intellectual disability (ID) and to examine its association with total medical utilization and expenditure on a national basis in Taiwan. People under 18 years of age that had been continuously enrolled in the National Health Insurance (NHI) between year 2008 and 2010…

  14. Travel-related mosquito-transmitted disease questionnaire survey among health professionals in Taiwan.

    PubMed

    Huang, Hsien-Liang; Chiu, Tai-Yuan; Huang, Kuo-Chin; Cheng, Shao-Yi; Yao, Chien-An; Lee, Long-Teng

    2011-01-01

    Health-care professionals can help travelers by providing accurate pre-travel counseling for mosquito-transmitted diseases such as malaria, yellow fever, and dengue fever. Governments and international organizations will benefit from knowledge survey among health professionals in this field to promote the development of travel health profession. This study investigates physicians' and nurses' knowledge regarding malaria, yellow fever, and dengue fever. A cross-sectional questionnaire survey was distributed to physicians and nurses in Taiwan interested in travel medicine between April and September of 2008. The self-administered, single-choice questionnaire evaluated knowledge regarding epidemiology, prophylactic medication for malaria, yellow fever, and dengue fever, and vaccinations for yellow fever as well as background information of participants. Complete information was collected from 82 physicians and 203 nurses. (Out of 289, effective response rate = 99.9%). The mean percentage of accurate responses was similar for all three diseases: malaria 67.3% (range, 16.8%-90.5%); yellow fever 65.4% (39.6%-79.3%); and dengue fever 74.4% (14.4%-96.5%). The items with the lowest accuracy were (1) behavior of the dengue fever vector Aedes aegypti mosquito (14.4%) and (2) incubation period of malaria (16.8%). There were 60.4% participants who did not know the current revaccination interval for the yellow fever vaccine. The average knowledge scores for all three diseases were statistically significantly higher in the physician group. Analysis of the results revealed significant deficits in travel medicine knowledge among health-care providers. Emphasis on continuing medical education for disease vector behavior, prophylactic drug prescription, and preventative vaccination is important to travel safety. Health professionals in Taiwan should actively participate in the International Society of Travel Medicine to follow the international standard of travel medicine

  15. Exploring Factors Affecting Learner's Perception of Learning Information and Communication Technology: A HLM Analysis of a National Farmers' Training Program in Taiwan

    ERIC Educational Resources Information Center

    Yueh, Hsiu-Ping; Chen, Tzy-Ling; Chiu, Li-An; Lin, Wei-Chien

    2013-01-01

    The present study, pertaining to a national information literacy training program for both farmers and rural communities in Taiwan, explores factors that affect learners' perception of learning information and communication technology (ICT). It further analyzes effects of individual characteristics and varied training designs on learners'…

  16. Health care utilization and expenditures of persons with diabetes comorbid with anxiety disorder: a national population-based cohort study.

    PubMed

    Huang, Chun-Jen; Chiu, Herng-Chia; Hsieh, Hui-Min; Yen, Ju-Yu; Lee, Mei-Hsuan; Chang, Kao-Ping; Li, Chih-Yi; Lin, Ching-Hua

    2015-01-01

    The aim of this study was to investigate and compare health care utilization and expenditures between persons with diabetes comorbid with and without anxiety disorder in Taiwan. Health care utilization and expenditures among persons with diabetes with and without comorbid anxiety disorder in the period 2000-2004 were examined using the Taiwan's National Health Insurance claims data. Health care utilization included outpatient visits and use of hospital inpatient services, while expenditures included outpatient, inpatient and total medical expenditures. General estimation equation (GEE) models were used to analyze the factors associated with outpatient visits and expenditures, and multiple logistic regression analysis was applied to identify factors associated with hospitalization. In the study period, the average number of annual outpatient visits was 43.11-50.37 and 29.82-31.42 for persons with diabetes comorbid with anxiety disorder and for those without anxiety disorder, respectively. The average annual total expenditure was NT$74,875-92,781 and NT$63,764-81,667, respectively. Controlling for covariates, the GEE models revealed that age and time were associated with outpatient visits. Income and time factor were associated with total expenditure. Health care utilization and expenditures for persons with diabetes with comorbid anxiety disorder are significantly higher than those without anxiety disorder. The factors associated with health care utilization and expenditures are age, income and time. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. National health spending trends in 1996. National Health Accounts Team.

    PubMed

    Levit, K R; Lazenby, H C; Braden, B R

    1998-01-01

    The National Health Accounts, produced annually by the Health Care Financing Administration's Office of the Actuary, present estimates for 1960-1996 of nationwide spending for health care and the sources funding that care. This year's estimates set two records: Spending topped $1 trillion for the first time, and expenditure growth slowed to the lowest rate seen in thirty-seven years of measuring health care spending--4.4 percent. The combination of decelerating health spending and a growing economy has kept national health spending as a share of the nation's gross domestic product unchanged for the fourth consecutive year.

  18. Geographic variation in the age- and gender-specific prevalence and incidence of epilepsy: analysis of Taiwanese National Health Insurance-based data.

    PubMed

    Chen, Chih-Chuan; Chen, Li-Sheng; Yen, Ming-Fang; Chen, Hsiu-Hsi; Liou, Horng-Huei

    2012-02-01

    We studied geographic variation in age- and gender-specific prevalence and incidence of epilepsy in four different areas of Taiwan. By using large-scale, National Health Insurance (NHI)-based data from 2000-2003 in Taiwan, we identified 131,287 patients diagnosed with epilepsy (ICD code 345) receiving at least of one of 11 antiepileptic drugs (AEDs). Information on age, gender, and location were also collected. The multivariable Poisson regression analysis was used to assess the heterogeneity of the morbidity of epilepsy in different regions. External data validation was also performed to assess the accuracy of capturing epilepsy cases through our NHI data set. The age-adjusted prevalence and incidence of epilepsy were 5.85 (per 1,000) between 2000 and 2003 and 97 (per 100,000 person-years) during the follow-up time from 2001 to 2003 in Taiwan. The sensitivity and specificity of ICD-9 coding for epilepsy in the NHI data set were 83.91% and 99.83%, respectively, resulting in a slight overestimation. Male patients had a higher probability of having epilepsy than did females. East Taiwan had significantly higher prevalence and incidence than did other areas. The age-specific incidence pattern in east Taiwan was atypical in that it revealed clustering in young and middle-aged groups. Our study demonstrated geographic variation in epidemiologic patterns of epilepsy within Taiwan. The findings are informative and provide insight into the clinical management of epilepsy based on consideration of different target groups in different areas. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  19. The behaviour of purchasing smuggled cigarettes in Taiwan.

    PubMed

    Tsai, Y-W; Sung, H-Y; Yang, C-L; Shih, S-F

    2003-03-01

    Since market liberalization in 1987, the Taiwan Tobacco and Wine Monopoly Bureau (TTWMB) annual statistics indicate that both the demand for imported cigarettes as well as the number of seized smuggled packs have increased with an average revenue loss of NT dollars 4942 million over the past 15 years. The NT dollars 10 average increase in cigarette prices after Taiwan entered the World Trade Organization (WTO) and the implementation of the Tobacco and Alcohol Tax Law in 2002 are forcing policy makers to examine smuggling even more closely. This study evaluates factors that affect an individual smoker's decision to purchase smuggled cigarettes, particularly when faced with higher prices. 437 male smokers of imported cigarettes were drawn from a national interview survey on cigarette consumption, which the Division of Health Policy Research at the National Health Research Institutes conducted during the year 2000. Multiple logistic regression models were used to analyse the behaviour of purchasing smuggled cigarettes with respect to demographic factors, economic factors, smoking behaviour, and other variables. Cigarette price was the driving factor most closely linked to the purchase of smuggled cigarettes--a 1% increase in cigarette price raised the likelihood of purchasing smuggled cigarettes at least 2.60 times (95% confidence interval (CI) 1.08 to 6.26). Smokers who spent more than NT 1000/month dollars on cigarettes were twice as likely to purchase smuggled cigarettes as those who spent less than NT 1000 dollars (odds ratio (OR) 2.34, 95% CI 1.48 to 3.70). Betel nut chewers were more likely to purchase smuggled cigarettes (OR 1.80, 95% CI 1.09 to 2.90). Smokers who opposed cigarette taxation policy were 1.69 times more likely to buy smuggled cigarettes. Personal income was not significantly associated with smuggled cigarettes purchases. This study evaluates what causes smokers to purchase smuggled cigarettes. We have determined that cigarette price is the most

  20. Elucidating challenges that electronic cigarettes pose to tobacco control in Asia: a population-based national survey in Taiwan.

    PubMed

    Chang, Hui-Chin; Tsai, Yi-Wen; Shiu, Ming-Neng; Wang, Ying-Ting; Chang, Po-Yin

    2017-03-27

    This study investigated the prevalence and correlates of electronic cigarettes (e-cigarettes) use in Taiwan. We studied a nationally representative random sample in the 2015 Taiwan Adult Smoking Behavior Survey. This study included 26 021 participants aged 15 years or older (51% women, 79% non-smokers, 16% aged 15-24 years), after excluding 31 persons (0.1%) who had missing information on e-cigarette use. The prevalence of ever having used e-cigarettes was calculated in the overall sample and by smoking status (current, former and never) or age (15-24, 25-44 and ≥45 years). We performed multivariable log-binomial regression to assess correlates of ever having used e-cigarettes among all participants and separately for subgroups by smoking status and age. Approximately 3% of all participants had ever used e-cigarettes. The prevalence of ever having used e-cigarettes was high in current smokers (14%) and people aged 18-24 years (7%). E-cigarette use was particularly common in people aged 15-24 years who were current (49-52%) or former (22-39%) smokers. Ever having used e-cigarettes was positively associated with tobacco smoking (adjusted prevalence ratio (aPR): 21.5, 95% CI 15.4 to 29.8, current smokers; aPR: 8.3, 95% CI 15.2 to 13.1, former smokers), younger age and high socioeconomic status. Age remained a significant factor of ever having used e-cigarettes across smoking status groups. Among non-smokers, men had a 2.4-fold (95% CI 1.5 to 3.8) greater prevalence of e-cigarette use than women. E-cigarette use was uncommon in the general population in Taiwan, but prevalence was high among smokers and young people. This study highlights challenges that e-cigarettes pose to tobacco control, which warrant high priority action by policymakers and public health professionals. E-cigarette regulations should focus on young people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Climatic factors associated with amyotrophic lateral sclerosis: a spatial analysis from Taiwan.

    PubMed

    Tsai, Ching-Piao; Tzu-Chi Lee, Charles

    2013-11-01

    Few studies have assessed the spatial association of amyotrophic lateral sclerosis (ALS) incidence in the world. The aim of this study was to identify the association of climatic factors and ALS incidence in Taiwan. A total of 1,434 subjects with the primary diagnosis of ALS between years 1997 and 2008 were identified in the national health insurance research database. The diagnosis was also verified by the national health insurance programme, which had issued and providing them with "serious disabling disease (SDD) certificates". Local indicators of spatial association were employed to investigate spatial clustering of age-standardised incidence ratios in the townships of the study area. Spatial regression was utilised to reveal any association of annual average climatic factors and ALS incidence for the 12-year study period. The climatic factors included the annual average time of sunlight exposure, average temperature, maximum temperature, minimum temperature, atmospheric pressure, rainfall, relative humidity and wind speed with spatial autocorrelation controlled. Significant correlations were only found for exposure to sunlight and rainfall and it was similar in both genders. The annual average of the former was found to be negatively correlated with ALS, while the latter was positively correlated with ALS incidence. While accepting that ALS is most probably multifactorial, it was concluded that sunlight deprivation and/or rainfall are associated to some degree with ALS incidence in Taiwan.

  2. Smoking-related changes or brand switching? Smokers' anticipated responses to a large increase in Taiwan's Tobacco Health and Welfare Surcharge.

    PubMed

    Yeh, C-Y; Schafferer, C; Lee, J-M; Hsieh, C-J

    2016-07-01

    This study examines the impact on smokers' behaviour of a planned increase in the Health and Welfare Surcharge of Tobacco Products in Taiwan. This study used a structured questionnaire to perform telephone interviews. Stratified random sampling was applied to interview current smokers aged 18-65 years in Taiwan. Based on nationwide survey data of smokers' responses to future increases in cigarette prices, this study used multinomial logistic regression to perform its analyses. After the proposed increase in the Health and Welfare Surcharge of Tobacco Products, subsequent cigarette price increases would motivate nearly 30% of the smokers to adopt smoking-related changes and 10% to change to lower-priced brands. The study suggests that a large increase in the Health and Welfare Surcharge of Tobacco Products would lead to considerable changes in smoking behaviour, which in turn would increase cessation rate at the population level. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. National Health Information Center

    MedlinePlus

    ... About ODPHP National Health Information Center National Health Information Center The National Health Information Center (NHIC) is ... of interest View the NHO calendar . Federal Health Information Centers and Clearinghouses Federal Health Information Centers and ...

  4. Use of selected ambulatory dental services in Taiwan before and after global budgeting: a longitudinal study to identify trends in hospital and clinic-based services

    PubMed Central

    2012-01-01

    Background The Taiwan government adopted National Health Insurance (NHI) in 1995, providing universal health care to all citizens. It was financed by mandatory premium contributions made by employers, employees, and the government. Since then, the government has faced increasing challenges to control NHI expenditures. The aim of this study was to determine trends in the provision of dental services in Taiwan after the implementation of global budgeting in 1998 and to identify areas of possible concern. Methods This longitudinal before/after study was based on data from the National Health Insurance Research Database from 1996 to 2001. These data were subjected to logistic regression analysis. Linear regression analysis was used to examine changes in delivery of specific services after global budgeting implementation. Utilization of hospital and clinic services was compared. Results Reimbursement for dental services increased significantly while the number of visits per patient remained steady in both hospitals and clinics. In hospitals, visits for root canal procedures, ionomer restoration, tooth extraction and tooth scaling increased significantly. In dental clinics, visits for amalgam restoration decreased significantly while those for ionomer restoration, tooth extraction, and tooth scaling increased significantly. After the adoption of global budgeting, expenditures for dental services increased dramatically while the number of visits per patient did not, indicating a possible shift in patients to hospital facilities that received additional National Health Insurance funding. Conclusions The identified trends indicate increased utilization of dental services and uneven distribution of care and dentists. These trends may be compromising the quality of dental care delivered in Taiwan. PMID:23009095

  5. Use of selected ambulatory dental services in Taiwan before and after global budgeting: a longitudinal study to identify trends in hospital and clinic-based services.

    PubMed

    Lin, Chienhung; Chao, Hailun

    2012-09-25

    The Taiwan government adopted National Health Insurance (NHI) in 1995, providing universal health care to all citizens. It was financed by mandatory premium contributions made by employers, employees, and the government. Since then, the government has faced increasing challenges to control NHI expenditures. The aim of this study was to determine trends in the provision of dental services in Taiwan after the implementation of global budgeting in 1998 and to identify areas of possible concern. This longitudinal before/after study was based on data from the National Health Insurance Research Database from 1996 to 2001. These data were subjected to logistic regression analysis. Linear regression analysis was used to examine changes in delivery of specific services after global budgeting implementation. Utilization of hospital and clinic services was compared. Reimbursement for dental services increased significantly while the number of visits per patient remained steady in both hospitals and clinics. In hospitals, visits for root canal procedures, ionomer restoration, tooth extraction and tooth scaling increased significantly. In dental clinics, visits for amalgam restoration decreased significantly while those for ionomer restoration, tooth extraction, and tooth scaling increased significantly. After the adoption of global budgeting, expenditures for dental services increased dramatically while the number of visits per patient did not, indicating a possible shift in patients to hospital facilities that received additional National Health Insurance funding. The identified trends indicate increased utilization of dental services and uneven distribution of care and dentists. These trends may be compromising the quality of dental care delivered in Taiwan.

  6. Maternity Leave in Taiwan

    PubMed Central

    Feng, Joyce Yen; Han, Wen-Jui

    2011-01-01

    Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk versus formula. We found that the time when mothers returned to work coincided with the duration of guaranteed leave. In particular, mothers with a labor pension plan resumed work significantly earlier than mothers with no pension plan, and mothers with no pension plan returned to work significantly later than those with pension plans. The short leave of absence guaranteed under existing policies translated into mothers spending less time with their children and being more likely to exclusively use formula by 6 months after birth. In contrast, mothers who resumed work later than 6 months after birth were more likely to have not worked before birth or to have quit their jobs during pregnancy. Implications and recommendations for parental leave policy in Taiwan are discussed. PMID:21603074

  7. Maternity Leave in Taiwan.

    PubMed

    Feng, Joyce Yen; Han, Wen-Jui

    2010-07-01

    Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk versus formula. We found that the time when mothers returned to work coincided with the duration of guaranteed leave. In particular, mothers with a labor pension plan resumed work significantly earlier than mothers with no pension plan, and mothers with no pension plan returned to work significantly later than those with pension plans. The short leave of absence guaranteed under existing policies translated into mothers spending less time with their children and being more likely to exclusively use formula by 6 months after birth. In contrast, mothers who resumed work later than 6 months after birth were more likely to have not worked before birth or to have quit their jobs during pregnancy. Implications and recommendations for parental leave policy in Taiwan are discussed.

  8. Temporal trend analysis of avoidable mortality in Taiwan, 1971-2008: overall progress, with areas for further medical or public health investment

    PubMed Central

    2013-01-01

    Background Avoidable mortality (AM), or “unnecessary untimely death,” is considered an indicator of health care quality. We investigated trends in the age-standardized mortality rates (ASMRs) and associated standard expected years of life lost (SEYLL) for deaths amenable to medical care or public health measures in Taiwan from 1971-2008, with an emphasis on identifying areas where additional medical or public health investment may help reduce the burden of AM. Methods Taiwan’s ASMRs per 100,000 for AM and other causes of death were calculated using data from the National Death Certificate Registry in five-year bins from 1971 to 2008. SEYLL rates per 100,000 were calculated annually from 1971 to 2008 using the same data source. Results ASMR for almost all AM and other causes of death declined dramatically from 1971 to 2008 except for lung cancer (16.6% and 7.4% increase among men and women, respectively) and breast cancer (109.8% increase among women). In the same period, SEYLL due to lung cancer increased from 269.2 to 555.7 for men and 249.7 to 342.5 for women. For women, SEYLL due to breast cancer increased from 263.5 in 1971 to 659.3 in 2008. There were gender-specific differences in the reduction (or increase) in AM rates, with women showing larger rates of reduction or smaller rates of increase. Among men, AM fell by 65.9% from 1971-1975 to 2006-2008, and deaths from other causes increased by 15.6%. Among women, AM and deaths from other causes fell by 80.8% and 59.8% respectively. SEYLL decreased, respectively among males and females, from 23,147.3 and 24,081.1 in 1971 to 11,261.8 and 5,929.6 in 2008. Conclusion From 1971 to 2008, Taiwan experienced a dramatic reduction in most AM and corresponding SEYLL except for lung cancer (for both males and females) and breast cancer (for females). Additional effort should be devoted to public health measures to combat the rising prevalence of smoking in Taiwan, which may be responsible for the increasing AM from

  9. Expanding school-district/university partnerships to advance health promoting schools implementation and efficacy in Taiwan.

    PubMed

    Liu, Chieh-Hsing; Chang, Fong-Ching; Liao, Li-Ling; Niu, Yu-Zhen; Cheng, Chi-Chia; Shih, Shu-Fang; Chang, Tzu-Chau; Chou, Hsin-Pei

    2015-08-01

    In 2011, the Taiwan government expanded its support of school-district/university partnership programs that promote the implementation of the evidenced-based Health Promoting Schools (HPS) program. This study examined whether expanding the support for this initiative was effective in advancing HPS implementation, perceived HPS impact and perceived HPS efficacy in Taiwan. In 2011 and 2013, a total of 647 and 1195 schools, respectively, complemented the questionnaire. Univariate analysis results indicated that the HPS implementation levels for six components were significantly increased from 2011 to 2013. These components included school health policies, physical environment, social environment, teaching activities and school-community relationships. Participant teachers also reported significantly greater levels of perceived HPS impact and HPS efficacy after the expansion of support for school-district/university partnership programs. Multivariate analysis results indicated that after controlling for school level, HPS funding and HPS action research approach variables, the expansion had a positive impact on increasing the levels of HPS implementation, perceived HPS impact and perceived HPS efficacy. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  10. Taiwan’s Transition to Democracy

    DTIC Science & Technology

    1997-03-01

    hard authoritarianism established by Chiang-Kai Shek’s regime allowed the institutions of private property and free enterprise to promote economic ... stability . Rapid growth followed and Taiwan transitioned from an agrarian based economy to a modem industrialized nation. The pressures from economic

  11. A Cross-Sectional Study of the Characteristics and Determinants of Emergency Care Utilization among People with Intellectual Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Yen, Chia-Feng; Loh, Ching-Hui; Hsu, Shang-Wei; Huang, Hui-Chi; Tang, Chi-Chieh; Li, Chi-Wei; Wu, Jia-Ling

    2006-01-01

    Aims: The purpose of this study was to identify health characteristics of people with intellectual disabilities (ID) and to assess the use of emergency care facilities by these people and factors affecting this utilization. Method: A cross-sectional study was employed. Subjects were recruited from the Taiwan National Disability Registration…

  12. Changes in the marine pollution management system in response to the Amorgos oil spill in Taiwan.

    PubMed

    Chiau, Wen-Yen

    2005-01-01

    The Marine Pollution Control Act (MPCA) of Taiwan was promulgated on November 1, 2000, with the specific aim of controlling marine pollution, safeguarding public health, and promoting the sustainable use of marine resources. In addition to land-based pollution, oil spills are one of the most significant threats to the local marine environment largely on account of the some 30,000 tankers which pass through Taiwan's coastal waters each year. In January 2001, two months after the enactment of this newly-introduced law, a Greek merchant vessel, the Amorgos ran aground in the vicinity of a national park on the southern tip of Taiwan, causing a serious oil spill and leading to considerable changes with regard to the marine pollution management system. The incident brought to the forefront many serious problems, such as a lack of experience, expertise as well as equipment required to respond to such disasters, as well as the ambiguous, unclear jurisdiction among related agencies. Thus, this paper reviews the incident of the Amorgos spill, identifies the major issues and lessons learned, and proposes several recommendations in an effort for Taiwan to further improve its marine pollution management system.

  13. The role of community mental health nurses caring for people with schizophrenia in Taiwan: a substantive grounded theory.

    PubMed

    Huang, Xuan-Yi; Yen, Wen-Jiuan; Liu, Shwu-Jiuan; Lin, Chouh-Jiuan

    2008-03-01

    The aim was to develop a practice theory that can be used to guide the direction of community nursing practice to help clients with schizophrenia and those who care for them. Substantive grounded theory was developed through use of grounded theory method of Strauss and Corbin. Two groups of participants in Taiwan were selected using theoretical sampling: one group consisted of community mental health nurses and the other group was clients with schizophrenia and those who cared for them. The number of participants in each group was determined by theoretical saturation. Semi-structured one-to-one in-depth interviews and unstructured non-participant observation were utilized for data collection. Data analysis involved three stages: open, axial and selective coding. During the process of coding and analysis, both inductive and deductive thinking were utilized and the constant comparative analysis process continued until data saturation occurred. To establish trustworthiness, the four criteria of credibility, transferability, dependability and confirmability were followed along with field trial, audit trial, member check and peer debriefing for reliability and validity. A substantive grounded theory, the role of community mental health nurses caring for people with schizophrenia in Taiwan, was developed through utilization of grounded theory method of Strauss and Corbin. In this paper, results and discussion focus on causal conditions, context, intervening conditions, consequences and phenomenon. The theory is the first to contribute knowledge about the field of mental health home visiting services in Taiwan to provide guidance for the delivery of quality care to assist people in the community with schizophrenia and their carers.

  14. [Considering the current state of fire safety in Taiwan's care environment from the perspective of the nation's worst recent hospital fire].

    PubMed

    Tseng, Wei-Wen; Shih, Chung-Liang; Chien, Shen-Wen

    2013-04-01

    Taiwan's worst hospital fire in history on October 23rd, 2012 at Sinying Hospital's Bei-Men Branch resulted in 13 elderly patient deaths and over 70 injuries. The heavy casualties were due in part to the serious condition of patients. Some patients on life-support machines were unable to move or be moved. This disaster highlights the issue of fire safety in small-scale hospitals that have transformed existing hospital space into special care environments for elderly patients. Compared with medical centers and general hospitals, these small-scale health facilities are ill equipped to deal properly with fire safety management and emergency response issues due to inadequate fire protection facilities, fire safety equipment, and human resources. Small-scale facilities that offer health care and medical services to mostly immobile patients face fire risks that differ significantly from general health care facilities. This paper focuses on fire risks in small-scale facilities and suggests a strategy for fire prevention and emergency response procedures, including countermeasures for fire risk assessment, management, and emergency response, in order to improve fire safety at these institutions in Taiwan.

  15. Is there a disparity in the hospital care received under a universal health insurance program in Taiwan?

    PubMed

    Hsiao, Yu-Yu; Cheng, Shou-Hsia

    2013-07-01

    To analyze the disparity in hospital care among people of various socio-economic status (SES) under a universal health insurance scheme. A survey questionnaire was mailed to discharged patients in October 2010. This study included 183 large-scale hospitals in Taiwan. A total of 3015 patients/caregivers completed the questionnaires, which yielded a response rate of 58%. Three variables were included. The two access-to-care variables were admission route and accreditation level of the hospital in which the patient stayed. A structured questionnaire, the patient-reported hospital quality (PRHQ), was included to characterize patient's experience of hospital stay. Patients with lower education were less likely to be admitted to a hospital according to a planned schedule, or to choose an Medical Center Hospital. However, SES was not associated with the PRHQ scores. Furthermore, patients with unplanned admission were associated with lower PRHQ scores than those with planned admission to the hospital. Under the universal health insurance system in Taiwan, lower education is associated with unplanned admission to a hospital, which might result in poorer perceived quality of care. Reducing unplanned admission is a challenge for health authorities in the future.

  16. Impact of the 2009 Taiwan tobacco hazards prevention act on smoking cessation.

    PubMed

    Chang, Fong-Ching; Sung, Hai-Yen; Zhu, Shu-Hong; Chiou, Shu-Ti

    2014-01-01

    In January 2009, the government of Taiwan amended the 1997 Tobacco Hazards Prevention Act by extending smoke-free areas to include almost all enclosed work-places and public places, adding graphic health warnings to cigarette packages, totally banning tobacco advertisements, promotion and sponsorship and increasing tobacco taxes. This study examined the impact of the 2009 amended Act on smoking cessation in Taiwan. Taiwan Adult Tobacco Surveys 2007 and 2010, each with a nationally representative sample of adults aged 18 years and older (n = 16 588, and n = 16 295, respectively). All recent active smokers (current smokers plus former smokers who quit smoking within the past 12 months) were used for the analyses (n = 3783 in 2007, and n = 2777 in 2010). Quit attempt rate and annual cessation rate (defined as having succeeded in quitting for at least 3 months) among recent active smokers were compared between the pre-Act (2007) and post-Act (2010) periods. The quit attempt rate increased significantly from 39.4% in 2007 to 42.9% in 2010. The annual cessation rate increased significantly from 7.1 to 8.9%. A multivariate analysis, controlling for demographic characteristics, showed that the implementation of the 2009 Act was associated with an increase in the quit attempt rate [odds ratio (OR) = 1.14; 95% confidence interval (CI) = 1.03-1.25] and the annual cessation rate (OR = 1.28; 95% CI = 1.08-1.53). The comprehensive tobacco control programme introduced in 2009 in Taiwan, which combined smoke-free legislation with a tobacco tax increase, graphic health warning labels and a total ban on tobacco advertisements, was associated with increases in quit attempt rate and annual cessation rate. © 2013 Society for the Study of Addiction.

  17. Comparing and decomposing differences in preventive and hospital care: USA versus Taiwan.

    PubMed

    Hsiou, Tiffany R; Pylypchuk, Yuriy

    2012-07-01

    As the USA expands health insurance coverage, comparing utilization of healthcare services with countries like Taiwan that already have universal coverage can highlight problematic areas of each system. The universal coverage plan of Taiwan is the newest among developed countries, and it is known for readily providing access to care at low costs. However, Taiwan experiences problems on the supply side, such as inadequate compensation for providers, especially in the area of preventive care. We compare the use of preventive, hospital, and emergency care between the USA and Taiwan. The rate of preventive care use is much higher in the USA than in Taiwan, whereas the use of hospital and emergency care is about the same. Results of our decomposition analysis suggest that higher levels of education and income, along with inferior health status in the USA, are significant factors, each explaining between 7% and 15% of the gap in preventive care use. Our analysis suggests that, in addition to universal coverage, proper remuneration schemes, education levels, and cultural attitudes towards health care are important factors that influence the use of preventive care. Copyright © 2011 John Wiley & Sons, Ltd.

  18. Current Trends in Aerospace Engineering Education on Taiwan.

    ERIC Educational Resources Information Center

    Hsieh, Sheng-Jii

    A proposal for current trends in Aerospace Engineering Education on Taiwan has been drawn from the suggestions made after a national conference of "Workshop on Aerospace Engineering Education Reform." This workshop was held in January 18-20, 1998, at the Institute of Aeronautics and Astronautics, National Cheng Kung University, Tainan,…

  19. Estimating Source Duration for Moderate and Large Earthquakes in Taiwan

    NASA Astrophysics Data System (ADS)

    Chang, Wen-Yen; Hwang, Ruey-Der; Ho, Chien-Yin; Lin, Tzu-Wei

    2017-04-01

    Estimating Source Duration for Moderate and Large Earthquakes in Taiwan Wen-Yen Chang1, Ruey-Der Hwang2, Chien-Yin Ho3 and Tzu-Wei Lin4 1 Department of Natural Resources and Environmental Studies, National Dong Hwa University, Hualien, Taiwan, ROC 2Department of Geology, Chinese Culture University, Taipei, Taiwan, ROC 3Department of Earth Sciences, National Cheng Kung University, Tainan, Taiwan, ROC 4Seismology Center, Central Weather Bureau, Taipei, Taiwan, ROC ABSTRACT To construct a relationship between seismic moment (M0) and source duration (t) was important for seismic hazard in Taiwan, where earthquakes were quite active. In this study, we used a proposed inversion process using teleseismic P-waves to derive the M0-t relationship in the Taiwan region for the first time. Fifteen earthquakes with MW 5.5-7.1 and focal depths of less than 40 km were adopted. The inversion process could simultaneously determine source duration, focal depth, and pseudo radiation patterns of direct P-wave and two depth phases, by which M0 and fault plane solutions were estimated. Results showed that the estimated t ranging from 2.7 to 24.9 sec varied with one-third power of M0. That is, M0 is proportional to t**3, and then the relationship between both of them was M0=0.76*10**23(t)**3 , where M0 in dyne-cm and t in second. The M0-t relationship derived from this study was very close to those determined from global moderate to large earthquakes. For further understanding the validity in the derived relationship, through the constructed relationship of M0-, we inferred the source duration of the 1999 Chi-Chi (Taiwan) earthquake with M0=2-5*10**27 dyne-cm (corresponding to Mw = 7.5-7.7) to be approximately 29-40 sec, in agreement with many previous studies for source duration (28-42 sec).

  20. Retrospective study on the utilization and cost of immunosuppressive agents among kidney transplant recipients in Taiwan: a 5-year review.

    PubMed

    Lee, E K L; Tseng, P L

    2008-09-01

    This study examined the utilization and cost of immunosuppressive agents among kidney transplant recipients in view of the growth under the Taiwan National Health Insurance payment system. Using inpatient expenditures by admissions and the files of the Registry for contracted medical facilities released from the Taiwan National Health Insurance Research Database, we totalled all renal implantations from 1999--2003, sorting them by drug expenditures reimbursed by contracted hospitals. The systematic sampling files of ambulatory care files were used to compute the Defined Daily Dose (DDD) and track drug utilization. The batch analysis was completed using the SPSS English version 13.0 for Windows. During the 5-year period, a total of 663 kidney transplantation surgeries were identified at 26 hospitals. Up to 90% of transplantation surgeries were performed at medical centers with about 55% in Northern Taiwan. Ninety-nine percent of drug expenditures were claimed by the top 12 hospitals. According to the Anatomical Therapeutic Chemical Classification, the most frequently prescribed immunosuppressive agents were Sandimmum Neoral cyclosporine (43%), mycophenolate (30.8%), and tacrolimus (21.3%) with DDDs of 137.5, 1187, and 5.54 mg, respectively. The ambulatory drug expenditure for patients increased 2-fold within the first 5 years, and 11.8 million in 2003 was estimated to be approximately 20 million Taiwanese dollars in 2010.

  1. Doctor Shopping Behavior for Zolpidem Among Insomnia Patients in Taiwan: A Nationwide Population-Based Study

    PubMed Central

    Lu, Tzu-Hsuan; Lee, Yen-Ying; Lee, Hsin-Chien; Lin, You-Meei

    2015-01-01

    Objectives: Although zolpidem is listed as a controlled drug in Taiwan, patients' behavior has not been restricted and has led to the problem of doctor shopping behavior (DSB), leading to overutilization of medical resources and excess spending. The National Health Insurance Administration in Taiwan has instituted a new policy to regulate physicians' prescribing behavior and decrease DSB. This retrospective study aimed to analyze the DSB for zolpidem by insomnia patients and assess related factors. Design and Participants: Data were extracted from the Longitudinal Health Insurance Database in Taiwan. Individuals with a diagnosis of insomnia who received more than one prescription of zolpidem in 2008 were followed for 24 mo. Doctor shopping was defined as ≥ 2 prescriptions by different doctors within ≥ 1 day overlapping in the duration of therapy. The percentage of zolpidem obtained through doctor shopping was used as an indicator of the DSB of each patient. Results: Among the 6,947 insomnia patients who were prescribed zolpidem, 1,652 exhibited DSB (23.78%). The average dose of zolpidem dispensed for each patient during 24 mo was 244.21 daily defined doses. The doctor shopping indicator (DSI) was 0.20 (standard deviation, 0.23) among patients with DSB. Younger age, chronic diseases, high number of diseases, higher premium status, high socioeconomic status, and fewer people served per practicing physicians were all factors significantly related to doctor shopping behavior. Conclusion: Doctor shopping for zolpidem appears to be an important issue in Taiwan. Implementing a proper referral system with efficient data exchange by physician or pharmacist-led medication reconciliation process might reduce DSB. Citation: Lu TH, Lee YY, Lee HC, Lin YM. Doctor shopping behavior for zolpidem among insomnia patients in Taiwan: a nationwide population-based study. SLEEP 2015;38(7):1039–1044. PMID:25761979

  2. Increased risks of tic disorders in children with epilepsy: A nation-wide population-based case-control study in Taiwan.

    PubMed

    Weng, Wen-Chin; Huang, Hui-Ling; Wong, Lee Chin; Jong, Yuh-Jyh; Yin, Yun-Ju; Chen, Hong-An; Lee, Wang-Tso; Ho, Shinn-Ying

    2016-01-01

    Both epilepsy and tic disorders may share common mechanisms with the involvement of abnormal cortical-basal ganglion circuit connection and dopaminergic dysfunction. However, the association between epilepsy and tic disorders has never been studied. This study investigated the risks of developing tic disorders among children with epilepsy using databases of a universal health insurance system in Taiwan. The data analyzed in this study were retrieved from the National Health Insurance Research Database in Taiwan. The study cohort included children with epilepsy between 2001 and 2007 (n=2629) and a three-fold age- and gender-matched controls (n=7887). All subjects were followed up for 3 years from the date of cohort entry to identify their admissions due to tic disorders (ICD-9-CM codes 307.2, 307.20-307.23). Cox hazard regression analysis was performed to estimate the effect of epilepsy on the occurrence of tics. The epilepsy cohort had a higher prevalence of tics (1.7% vs. 0.2%), and a 8.70-fold increased risk of developing a tic disorder compared with the controls (adjusted hazard ratio (AHR) 8.70, 95% confidence interval (CI) 4.26-16.37, p<0.001). Male patients were observed to have a higher risk of developing a tic disorder (AHR 1.90, 95% CI=1.04-3.46, p<0.001) compared to female individuals. Patients with multiple antiepileptic drugs treatment also exhibited higher crude OR for developing tic disorders. This nationwide population-based cohort study, for the first time, demonstrated that there is a significantly increased risk for tic disorders among children with epilepsy. We also found males, attention deficit disorder and the use of multiple AEDs to be independent risk factors of tic disorders. Closely evaluating possible tic disorders would be crucial for improving the outcome and life quality in children with epilepsy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Application of INCSEA principles to the Taiwan Strait.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wen-Chung, Chai

    2003-06-01

    The waters surrounding Taiwan are important international waterways. In addition to merchant ships of every nation, the warships of the United States, Japan, Russia, and China may appear in these waters. No hostility is expected between Taiwan and the United States, Japan, or Russia; however, Taiwan and China have a tense relationship, and both sides face a potential for naval incidents. As Taiwan and China expand their naval capability, the International Maritime Organization Convention for the lnternational Regulations for Preventing Collisions at Sea may not be sufficient to prevent naval incidents, any of which might develop into conflict or war.more » Therefore, China and Taiwan need to develop maritime confidence building measures (CBMs) that could reduce the chance of naval incidents and strengthen mutual trust and confidence. Among the variety of maritime CBM concepts for military purposes, the most successful and effective measure has been the 1972 U.S.-Soviet Union Agreement on the Prevention of Incidents On and Over the High Seas (INCSEA). The success of the agreement demonstrates that CBMs represent a workable alternative to traditional arms controls. The purpose of this paper is to suggest a concrete approach to the constraint of naval activities between China and Taiwan to reduce accidents and misunderstandings. This paper outlines the categories and characteristics of incidents at sea. Next, the author identifies the successful factors of the U.S.-Soviet INCSEA and applies the INCSEA concept to the Taiwan Strait. Finally, the author develops a framework of options and a step-by-step approach for establishing an INCSEA between Taiwan and China.« less

  4. NRAO Welcomes Taiwan as a New North American ALMA Partner

    NASA Astrophysics Data System (ADS)

    2008-12-01

    The National Radio Astronomy Observatory (NRAO) has announced a formal agreement enabling Taiwanese astronomers to participate in the North American component of the international ALMA partnership, alongside American and Canadian astronomers. Taiwan's efforts will be led by the Academia Sinica Institute of Astronomy and Astrophysics (ASIAA). ALMA, the Atacama Large Millimeter/submillimeter Array, is the most ambitious ground-based astronomical observatory in history. Currently under construction in Chile’s Atacama Desert at an altitude of 16,500 feet, it promises to revolutionize our understanding of the formation of planets, stars, and galaxies when it begins full science operations early in the next decade. The agreement, signed by the Taipei Economic and Cultural Representative Office and the American Institute in Taiwan, provides for approximately $20 million in ALMA construction funding through the National Science Council (NSC), Taiwan’s equivalent to the US National Science Foundation (NSF) and Canada's National Research Council (NRC), which have jointly funded North America's existing contribution to the international ALMA project. Activities under the agreement will include joint research projects, development projects, collaboration on construction, support of observatory operations and other forms of cooperation. Access to ALMA observing time will be shared, as will membership on advisory committees. “Taiwan is a world-class center for submillimeter-wavelength astronomical research, and we’re delighted that the ALMA project and all its future users will benefit from the resources and expertise that Taiwan’s deepening participation brings to this great, global endeavor,” said Dr. Fred Lo, NRAO's director. This new agreement increases and diversifies Taiwan’s Academia Sinica investment in ALMA beyond the levels achieved through its participation in the East Asian component of the ALMA partnership, which is led by the National Astronomical

  5. Recent research and development of functional food in Taiwan.

    PubMed

    Sun Hwang, Lucy

    2007-08-01

    As the living standard rises, people are more concerned with the health benefits of foods. Functional foods are, therefore, receiving increasing attention worldwide. The functional food market in Taiwan reached 1.78 billion US dollars in 2005. Only those which have been certified by the Department of Health can claim their health benefits. Until January 2007, only 88 functional foods have received the certificates. In addition to the product development in the food industry, research institutes and universities are also actively engaged in the technology development and basic research of functional foods. Many raw materials harvested in Taiwan, including edible plants, herbs, medicinal mushrooms, and sea foods, are investigated for their health benefits, bioactive components and suitable processing technologies.

  6. Correlates of health-promoting lifestyle behaviors among Vietnamese female immigrants in Taiwan.

    PubMed

    Hsiao, Chiu-Yueh; Chien, Maio-Ju; Wu, Hua-Shan; Chiao, Chia-Yi

    2017-03-01

    Immigration is a demanding and challenging life event that may cause married immigrant women to be likely to adopt unhealthy lifestyle behaviors. The aim of the authors of this study was to assess the prevalence of health-promoting lifestyle behaviors and their correlates among Vietnamese female immigrants in Taiwan. A cross-sectional study was conducted with 140 Vietnamese female immigrants from November 2012 to October 2013. Measures included demographic information, the Chinese Health Questionnaire, the General Functioning Scale of the Family Assessment Device, and a short version of the Chinese Health-Promoting Lifestyle Profile. Data analyses included descriptive statistics, Pearson's product-moment correlation coefficients, t-tests, one-way analysis of variance, and a hierarchical multiple regression analysis. Vietnamese female immigrants with better individual health status, higher education from their original country, greater communication ability, better health status of the husband, and adaptive family functioning demonstrated greater participation in health-promoting lifestyle behaviors. Particularly, better husband's health status and family functioning correlated with greater practices of health-promoting lifestyle behaviors after controlling for individual characteristics and experiences, with 38% of the total variance explained. Findings may serve to guide and design culturally specific, family-focused health promotion interventions to assist Vietnamese female immigrants and their families.

  7. Effects of an empowerment-based education program for public health nurses in Taiwan.

    PubMed

    Chang, Li-Chun; Liu, Chieh-Hsing; Yen, Edwin Han-Wen

    2008-10-01

    The aim of this study was to examine the effects of an empowerment-based education program (EBEP) on employee empowerment, job satisfaction, job productivity and innovative behaviours for public health nurses (PHN) in Taiwan. Empowerment is an important consideration among nurses trying to function in ever-changing health care and education settings. Several studies focused on the trend of public health nursing revealed that PHN have experienced a severe feeling of powerlessness. Developing empowerment strategies through organisations may be a means of helping employees recognise powerlessness in difficult situations and take appropriate action. Quasi-experimental design. PHN in two health bureaus in Taiwan were assigned into an empowerment group (n = 29) and a control group (n = 32). Twenty-four hours of the EBEP lasted four weeks included four empowerment classes and four group workshops following each curriculum for PHN to apply principles of empowerment in their work environment. Data were collected at baseline and four weeks after the intervention. Analysis of covariance (ancova) was used to examine the intervention effect. The experimental group reported significantly higher psychological empowerment [F (1,47) = 5.09, MSE = 3.25, p = 0.001, eta(2) = 0.18] and competence [F (1,47) = 3.96, MSE = 28.78, p = 0.05, eta(2) = 0.22] and impact [F (1,47) = 4.98, MSE = 44.79, p = 0.002, eta(2) = 0.20] subscales, job productivity [F (1,47) = 4.88, MSE = 5.18, p = 0.002, eta(2) = 0.19] and innovative behaviours [F (1,47) = 5.09, MSE = 3.25, p = 0.001, eta(2) = 0.24] than the control group after the EBEP. The EBEP had significant effect on psychological empowerment and subscales of competence and impact, innovative behaviour and job productivity but no effect on organisational empowerment and job satisfaction for PHN. Our findings suggest public health administration could design empowerment-based education to improve employee empowerment and job productivity for PHN

  8. Effect of Workplace Counseling Interventions Launched by Workplace Health Promotion and Tobacco Control Centers in Taiwan: An Evaluation Based on the Ottawa Charter

    PubMed Central

    Chen, Tzu-Hua; Huang, Joh-Jong; Chang, Fong-Ching; Chang, Yu-Tsz; Chuang, Hung-Yi

    2016-01-01

    Workplace health promotion (WHP) is important to prevent work-related diseases, reduce workplace hazards, and improve personal health of the workers. Health promotion projects were launched through the centers of WHP funded by the Taiwan Bureau of Health Promotion since 2003. Hence, the aim of this study is to evaluate the impact of WHP programs intervention from 2003 to 2007. The intervention group consisted of 838 business entities which had ever undergone counseling of the three centers in northern, central, and southern Taiwan from 2003 to 2007. The control group was composed of 1000 business entities randomly selected from the business directories of the Ministry of Economic Affairs, Taiwan. The questionnaire survey included general company profiles and the assessment of workplace health according to the five action areas of the Ottawa Charter for Health Promotion. We have received 447 (53.3%) questionnaires from the intervention group and 97 questionnaires from the control group. The intervention group was more effective in using the external resources and medical consultation, and they had better follow-up rates of the abnormal results of annual health examinations. Compared to the control group, the intervention group had a significantly decreased smoking rate in 246 companies (61.2%) and a reduced second-hand smoke exposure in 323 companies (78.6%) (p<0.001). By means of the intervention of WHP programs, we can enhance the awareness of the enterprises and the employees to improve worksite health and to create a healthy work environment. PMID:26954498

  9. Epidemiology and mortality of liver abscess in end-stage renal disease dialysis patients: Taiwan national cohort study.

    PubMed

    Hong, Chon-Seng; Chung, Kun-Ming; Huang, Po-Chang; Wang, Jhi-Joung; Yang, Chun-Ming; Chu, Chin-Chen; Chio, Chung-Ching; Chang, Fu-Lin; Chien, Chih-Chiang

    2014-01-01

    To determine the incidence rates and mortality of liver abscess in ESRD patients on dialysis. Using Taiwan's National Health Insurance Research Database, we collected data from all ESRD patients who initiated dialysis between 2000 and 2006. Patients were followed until death, end of dialysis, or December 31, 2008. Predictors of liver abscess and mortality were identified using Cox models. Of the 53,249 incident dialysis patients identified, 447 were diagnosed as having liver abscesses during the follow-up period (224/100,000 person-years). The cumulative incidence rate of liver abscess was 0.3%, 1.1%, and 1.5% at 1 year, 5 years, and 7 years, respectively. Elderly patients and patients on peritoneal dialysis had higher incidence rates. The baseline comorbidities of diabetes mellitus, polycystic kidney disease, malignancy, chronic liver disease, biliary tract disease, or alcoholism predicted development of liver abscess. Overall in-hospital mortality was 10.1%. The incidence of liver abscess is high among ESRD dialysis patients. In addition to the well known risk factors of liver abscess, two other important risk factors, peritoneal dialysis and polycystic kidney disease, were found to predict liver abscess in ESRD dialysis patients.

  10. The effects of pay-for-performance on tuberculosis treatment in Taiwan.

    PubMed

    Li, Ya-Hsin; Tsai, Wen-Chen; Khan, Mahmud; Yang, Wen-Ta; Lee, Tsuey-Fong; Wu, Yi-Chun; Kung, Pei-Tseng

    2010-07-01

    In order to make tuberculosis (TB) treatment more effective and to lower the transmission rate of the disease, the Bureau of National Health Insurance (BNHI) in Taiwan implemented the 'Pay-for-Performance on Tuberculosis' programme (P4P on TB) in 2004. This study investigates the effectiveness of the P4P system in terms of cure rate and length of treatment. This retrospective study obtained information on all TB cases in the national data sets of Taiwan for the years 2002 to 2005. The number of cases in pre-P4P years (2002 and 2003) was 25 754, compared with 33 536 in the post-P4P implementation years (2004 and 2005). The effectiveness of the programme was evaluated by comparing the TB cure rate and length of treatment before and after the implementation of the P4P programme, and between participating and non-participating hospitals. Logistic regression analysis was conducted to explore the factors affecting TB patients' cure rate within a 12-month treatment period. The cure rate and the average length of treatment before the implementation of P4P were 46.9% and 256.24 days, respectively, compared with 63.0% and 249.74 days after implementation of P4P. The cure rate and length of treatment in P4P hospitals were 68.1% and 249.13 days, respectively, compared with 42.4% and 53.71 days in non-P4P hospitals. This study found that both the cure rate and average length of treatment for cured cases improved significantly after the implementation of the P4P on TB programme in Taiwan. Compared with non-P4P hospitals, P4P hospitals had significantly better treatment outcomes. Patients' age, income level, the physician density of a patient's place of residence, and whether the hospital has joined the P4P on TB programme are factors affecting the treatment outcomes of TB patients in Taiwan.

  11. Determinants of psychogeriatric inpatient length of stay and direct medical costs: a 6-year longitudinal study using a national database in Taiwan.

    PubMed

    Liu, Chin-Ming; Li, Chu-Shiu; Liu, Chwen-Chi; Tu, Chu-Chin

    2012-08-01

    This research examined factors related to the average length of hospital stay (LOS) and average direct medical costs (DMC) for 2291 psychogeriatric inpatients (aged 65 and over) admitted for the first time to a psychiatric ward in 2002. Hospitalization claim data of these inpatients were traced for the subsequent 6 years (2002-2007) from the dataset of Taiwan's National Health Insurance program. Analysis was carried out using the t-test, χ(2) -test and zero truncated Tobit regression. Mean LOS and mean DMC were significantly different according to sex, psychiatric diagnosis, institution type, ownership type, and number of hospitalizations, but age was the exception. Both LOS and DMC exhibited downward U-shape for the number of hospitalizations. Factors significantly associated with longer LOS and higher DMC were: male sex; schizophrenic and delusional disorders (compared with dementia); and public institution (compared with private hospital). Compared with dementia, organic mental and anxiety disorders had significantly shorter LOS, and affective disorders had shorter LOS but higher DMC. Community and psychiatric hospitals (compared with general hospital) significantly influenced LOS but not DMC. Our results can be used as a reference for providers and policymakers to improve psychiatric care efficiency and carry out National Health Insurance financial reform for psychogeriatric inpatients. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.

  12. Paradoxical increase in cigarette smuggling after the market opening in Taiwan.

    PubMed

    Wen, C P; Peterson, R A; Cheng, T Y D; Tsai, S P; Eriksen, M P; Chen, T

    2006-06-01

    To assess the magnitude of cigarette smuggling after the market opened in Taiwan. Review of tobacco industry documents for references to smuggling activities related to Taiwan and government statistics on seizure of smuggled cigarettes. The market opening in 1987 led to an increase in smuggling. Contraband cigarettes became as available as legal ones, with only a small fraction (8%) being seized. Being specifically excluded from the market-opening, Japan entered the Taiwan market by setting up a Swiss plant as a legal cover for smuggling 10-20 times its legal quota of exports to Taiwan. Smuggling in Taiwan contributed to increased consumption of foreign brands, particularly by the young. Taiwan, not a member of the World Health Organization, was excluded from the East Asian 16-member "Project Crocodile", a regional anti-smuggling collaborative effort to implement the Framework Convention on Tobacco Control. Taiwan showed a sharp increase in smuggling after market liberalisation. Being excluded from the international community, Taiwan faces an uphill battle to fight smuggling alone. If Taiwan remained as its weakest link, global efforts to reduce tobacco use will be undermined, particularly for countries in the East Asian region.

  13. National health expenditures, 1990

    PubMed Central

    Levit, Katharine R.; Lazenby, Helen C.; Cowan, Cathy A.; Letsch, Suzanne W.

    1991-01-01

    During 1990, health expenditures as a share of gross national product rose to 12.2 percent, up from 11.6 percent in 1989. This dramatic increase is the second largest increase in the past three decades. The national health expenditure estimates presented in this article document rapidly rising health care costs and provide a context for understanding the health care financing crisis facing the Nation today. The 1990 national health expenditures incorporate the most recently available data. They differ from historical estimates presented in the preceding article. The length of time and complicated process of producing projections required use of 1989 national health expenditures—data available prior to the completion of the 1990 estimates presented here. PMID:10114934

  14. An integrated approach for improving occupational health and safety management: the voluntary protection program in Taiwan.

    PubMed

    Su, Teh-Sheng; Tsai, Way-Yi; Yu, Yi-Chun

    2005-05-01

    A voluntary compliance program for occupational health and safety management, Voluntary Protection Programs (VPP), was implemented with a strategy of cooperation and encouragement in Taiwan. Due to limitations on increasing the human forces of inspection, a regulatory-based guideline addressing the essence of Occupational Health and Safety Management Systems (OHSMS) was promulgated, which combined the resources of third parties and insurance providers to accredit a self-improving worksite with the benefits of waived general inspection and a merit contributing to insurance premium payment reduction. A designated institute accepts enterprise's applications, performs document review and organizes the onsite inspection. A final review committee of Council of Labor Affairs (CLA) confers a two-year certificate on an approved site. After ten years, the efforts have shown a dramatic reduction of occupational injuries and illness in the total number of 724 worksites granted certification. VPP worksites, in comparison with all industries, had 49% lower frequency rate in the past three years. The severity rate reduction was 80% in the same period. The characteristics of Taiwan VPP program and international occupational safety and health management programs are provided. A Plan-Do-Check-Act management cycle was employed for pursuing continual improvements to the culture fostered. The use of a quantitative measurement for assessing the performance of enterprises' occupational safety and health management showed the efficiency of the rating. The results demonstrate that an employer voluntary protection program is a promising strategy for a developing country.

  15. Hospital-Owned Apps in Taiwan: Nationwide Survey

    PubMed Central

    Liu, Hao-Yen; Sun, Ying-Chou; Fen, Jun-Jeng; Chen, Tzeng-Ji; Chou, Li-Fang; Hwang, Shinn-Jang

    2018-01-01

    Background Over the last decade, the use of mobile phone apps in the health care industry has grown rapidly. Owing to the high penetration rate of Internet use in Taiwan, hospitals are eager to provide their own apps to improve the accessibility of medical care for patients. Objective The aims of this study were to provide an overview of the currently available hospital-owned apps in Taiwan and to conduct a cross-hospital comparison of app features. Methods In May 2017, the availability of apps from all 414 hospitals in Taiwan was surveyed from the hospital home pages and the Google Play app store. The features of the downloaded apps were then examined in detail and, for each app, the release date of the last update, download frequency, and rating score were obtained from Google Play. Results Among all the 414 hospitals in Taiwan, 150 (36.2%) owned Android apps that had been made available for public use, including 95% (18/19) of the academic medical centers, 77% (63/82) of the regional hospitals, and 22.0% (69/313) of the local community hospitals. Among the 13 different functionalities made available by the various hospital-owned apps, the most common were the doctor search (100%, 150/150), real-time queue monitoring (100%, 150/150), and online appointment scheduling (94.7%, 142/150) functionalities. The majority of apps (57.3%, 86/150) had a rating greater than 4 out of 5, 49.3% (74/150) had been updated at some point in 2017, and 36.0% (54/150) had been downloaded 10,000 to 50,000 times. Conclusions More than one-third of the hospitals owned apps intended to increase patient access to health care. The most common app features might reflect the health care situation in Taiwan, where the overcrowded outpatient departments of hospitals operate in an open-access mode without any strict referral system. Further research should focus on the effectiveness and safety of these apps. PMID:29339347

  16. The general picture of supportive health environments for persons with intellectual disabilities among 121 disability welfare institutions in Taiwan.

    PubMed

    Lin, J-D; Yen, C-F; Loh, C-H; Chwo, M-J; Lee, J-T; Wu, J-L; Chu, C M; Tang, C-C

    2006-01-01

    Little information is available on the provision of supportive health environments for persons with intellectual disabilities (ID) in institutions. The aim of this study was to present an overview of supportive environments for health in institutions in Taiwan. A cross-sectional survey was conducted to examine the perceptions of 121 Taiwanese Institutional Directors on their setting's implementation of supportive healthy physical, social, and economic environments. Analyses showed that first-aid kits (97.5%) and medicine cabinets (85.5%) were the most common health facilities in institutions. Seventy-three per cent of institutions had set up specific areas to be used for rehabilitation practice, while only 43.1% thought their rehabilitation equipment/devices adequate for their real needs. Eighty-eight per cent of institutions implemented health promotion plans for people with ID, while 76.6% had appropriated specific health promotion plans. Sixty-three institutions (52.1%) reported employment of skilled nurses to serve people with ID, and these institutions showed statistically significant differences in implementation of each health facility. The present paper is the first to analyze supportive environments for health in disability institutions in Taiwan. An important focus of future research will be the extension of the present findings to consider the appropriateness of each area of supportive environments for improving the quality of institutional care for people with ID.

  17. Comparison of illegal drug use pattern in Taiwan and Korea from 2006 to 2014.

    PubMed

    Feng, Ling-Yi; Yu, Wen-Jing; Chang, Wei-Ting; Han, Eunyoung; Chung, Heesun; Li, Jih-Heng

    2016-09-23

    Illegal drug use has long been a global concern. Taiwan and Korea are geographically adjacent and both countries have experienced the illegal use problems of methamphetamine, a predominant prototype of New Psychoactive Substances (NPS). NPS, a term coined by the United Nations Office on Drugs and Crime (UNODC) in recent years, have not been scrutinized for their safety and may become a new threat to public health and security worldwide. To conduct evidence-based drug policy, it is imperative to estimate the trend and pattern of illegal drug use. Therefore, this study aims to analyze and compare the current status of drug-related seizures, arrests and illegal drug use, with a focus on methamphetamine and NPS, between Taiwan and Korea. Data of illegal drug (including NPS)-related seizures and arrests were collected via anti-drug related agencies of both countries from 2006 through 2014.Since listing of NPS as controlled substances was a result of NPS abuse liability through official evaluation, the items of controlled NPS were used as an indicator of emerging use. These data obtained from Taiwan and Korea was then compared. The results showed that while methamphetamine remained as a predominant drug in both Taiwan and Korea for decades, different illegal drug use patterns have been observed in these two countries. In Taiwan, the major illegal drugs were methamphetamine, heroin, and ketamine, whereas in Korea those were methamphetamine and cannabis. By comparison of per capita illicit drug seizures, the illegal drug use situation in Taiwan was at a higher stake than that in Korea. In terms of NPS use, ketamine has been a major drug in Taiwan, but it was seldom found in Korea. Besides ketamine, the major type of NPS was synthetic cathinones in Taiwan whereas it was synthetic cannabinoids and phenethylamines in Korea. The difference in the numbers of controlled NPS items between Taiwan (23) and Korea (93) may be due to the implementation of temporary control on NPS in

  18. Examining national trends in worker health with the National Health Interview Survey.

    PubMed

    Luckhaupt, Sara E; Sestito, John P

    2013-12-01

    To describe data from the National Health Interview Survey (NHIS), both the annual core survey and periodic occupational health supplements (OHSs), available for examining national trends in worker health. The NHIS is an annual in-person household survey with a cross-sectional multistage clustered sample design to produce nationally representative health data. The 2010 NHIS included an OHS. Prevalence rates of various health conditions and health behaviors among workers based on multiple years of NHIS core data are available. In addition, the 2010 NHIS-OHS data provide prevalence rates of selected health conditions, work organization factors, and occupational exposures among US workers by industry and occupation. The publicly available NHIS data can be used to identify areas of concern for various industries and for benchmarking data from specific worker groups against national averages.

  19. Pharmaceutical penetration of new drug and pharmaceutical market structure in Taiwan: hospital-level prescription of thiazolidinediones for diabetes.

    PubMed

    Tsai, Yi-Wen; Wen, Yu-Wen; Huang, Weng-Foung; Kuo, Ken N; Chen, Pei-Fen; Shih, Hsin-Wei; Lee, Yue-Chune

    2010-06-01

    This study used Taiwan's National Health Insurance claim database (years 2000-2005) to examine how thiazolidinediones (TZD), a new class of drugs for diabetes, penetrated into Taiwan's hospitals, and its association with the concentration of all diabetes drugs at the hospital level. We collected 72 monthly summaries of diabetes prescriptions from all hospitals in Taiwan. Hospital-level pharmaceutical concentration was measured by penetration of TZD, defined as monthly market share of TZD in each hospital. Concentration of diabetes drugs was measured by Herfindahl-Hirschman indices. We found a negative association (coefficient = -0.3610) between TZD penetration and concentration of diabetes drug but a positive association between penetration of TZD and the volume of prescribed diabetes drugs (coefficient = 0.4088). In conclusion, hospital characteristics and volume of services determined the concentration of pharmaceuticals at the institution level, reflecting the heterogeneous competition between pharmaceutical companies within each hospital. Institution-level pharmaceutical concentration influences the adoption and penetration of new drugs.

  20. Gender and Geographic Differences in the Prevalence of Autism Spectrum Disorders in Children: Analysis of Data from the National Disability Registry of Taiwan

    ERIC Educational Resources Information Center

    Lai, Der-Chung; Tseng, Yen-Cheng; Hou, Yuh-Ming; Guo, How-Ran

    2012-01-01

    The prevalence of autism spectrum disorders (ASD) in the world has increased dramatically in the recent decades. However, data at the national level are limited, and geographic differences are seldom evaluated. According to the law, the local governments in Taiwan began to certify disabled residents and provide various services in 1980, and the…

  1. Groundwater Molybdenum from Emerging Industries in Taiwan.

    PubMed

    Tsai, Kuo-Sheng; Chang, Yu-Min; Kao, Jimmy C M; Lin, Kae-Long

    2016-01-01

    This study determined the influence of emerging industries development on molybdenum (Mo) groundwater contamination. A total of 537 groundwater samples were collected for Mo determination, including 295 samples from potentially contaminated areas of 3 industrial parks in Taiwan and 242 samples from non-potentially contaminated areas during 2008-2014. Most of the high Mo samples are located downstream from a thin film transistor-liquid crystal display (TFT-LCD) panel factory. Mean groundwater Mo concentrations from potentially contaminated areas (0.0058 mg/L) were significantly higher (p < 0.05) than those from non-potentially contaminated areas (0.0022 mg/L). The highest Mo wastewater concentrations in the effluent from the optoelectronics industry and following wastewater batch treatment were 0.788 and 0.0326 mg/L, respectively. This indicates that wastewater containing Mo is a possible source of both groundwater and surface water contamination. Nine samples of groundwater exceed the World Health Organization's suggested drinking water guideline of 0.07 mg/L. A non-carcinogenic risk assessment for Mo in adults and children using the Mo concentration of 0.07 mg/L yielded risks of 0.546 and 0.215, respectively. These results indicate the importance of the development of a national drinking water quality standard for Mo in Taiwan to ensure safe groundwater for use. According to the human health risk calculation, the groundwater Mo standard is suggested as 0.07 mg/L. Reduction the discharge of Mo-contaminated wastewater from factories in the industrial parks is also the important task in the future.

  2. Neonatal outcomes of extremely preterm infants from taiwan: comparison with Canada, Japan, and the USA.

    PubMed

    Su, Bai-Horng; Hsieh, Wu-Shiun; Hsu, Chyong-Hsin; Chang, Jui-Hsing; Lien, Reyin; Lin, Chyi-Her

    2015-02-01

    This study compared the current trend in survival rates and morbidity for very low birth weight (VLBW) infants in five Medical Training Centers of Prematurity for the Premature Baby Foundation of Taiwan (PBFT), with the outcomes from the USA, National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN), the Canadian Neonatal Network (CNN), and the Neonatal Research Network of Japan (NRNJ). The survival rates of VLBW infants according to gestational age (GA) and major morbidities were compared between networks (Taiwan, USA, Canada, and Japan). Taiwanese data for VLBW infants of GA ≤28 weeks between 2007 and 2012 were obtained from the "PBFT Annual Conferences of Premature Care" reports defining survival rate as neonates that survived to the time of discharge. Major morbidities included severe neurological injury (Grade 3 or 4 intraventricular hemorrhage or periventricular leukomalacia), bronchopulmonary dysplasia, severe retinopathy of prematurity, necrotizing enterocolitis, late-onset sepsis, and patent ductus arteriosus. The survival rates of VLBW infants of GA ≤28 weeks from the PBFT (Taiwan), NICHD NRN (USA), CNN (Canada), and NRNJ (Japan) were 77% (1323/1718), 72% (6859/9575), 82% (2353/2872), and 89% (4489/5069), respectively. The annual survival rates in Taiwan from 2007 to 2012 were 72%, 76%, 76%, 74%, 77%, and 78%, respectively. When GA from ≤23 weeks to 28 weeks was assessed in Taiwan, the survival rates of VLBW infants according to each week were 22%, 50%, 70%, 80%, 88%, and 92%, respectively. The survival rate, especially at lower GAs, was highest in the NRNJ (Japan). The major difference between Taiwan and Japan was attributed to the lower survival rates at lower GA (≤26 weeks) in Taiwan. Japan had the lowest rates of major morbidities among the four countries. The survival rate of VLBW infants has improved over the past 6 years in Taiwan. It is higher than the USA, but lower than Canada and Japan. However, the

  3. Geotransects in the Taiwan region

    NASA Astrophysics Data System (ADS)

    Yen, T. P.; Yeh, Yih-Hsing

    The Republic of China National Committee for the Inter-Union Commission on the Lithosphere organized an ad hoc working group in 1988 for compilation and construction of geotransects in the Taiwan region, a region considered by the scientific world as a classic example of collision and subduction of plates.Three geotransects have been constructed, with insufficient data: geotransect N along latitude 24°30‧N, geotransect M along latitude 23°30‧, and geotransect S along latitude 22°30‧N. The data used in the constructions are mainly scattered in publications on the geology and geophysics of Taiwan. The purpose of the study is to promote further investigation of the mechanism of plate motion in terms of geology and geophysics, to improve interpretation of the geotectonics of the region.

  4. Taiwan-U.S. Relations: Recent Developments and Their Policy Implications

    DTIC Science & Technology

    2008-10-03

    Olympics (August) and the Paralympic Games (September). For instance, while appearing more conciliatory in a reported letter to U.N. Secretary-General... Games . A 1989 agreement stipulated that Taiwan be called “Zhonghua Taipei” — or “Chinese Taipei,” a term suggesting a more ambiguous Chinese...would use to refer to Taiwan during the 2008 Olympic Games .22 Taiwan’s Ministry of National Defense also has said that acquiring submarines — a move

  5. Clients' outcomes of home health nursing in Taiwan.

    PubMed

    Yeh, L; Wen, M J

    2001-09-01

    The home health nursing movement is expanding rapidly. Home health nursing agencies (HHNAs) are expected to demonstrate that the care provided does make a difference for the client receiving the services. The purpose of this study was to explore client outcomes from home health nursing. Outcome indicators include: Services utilized (emergency services, re-hospitalization), physiological status (catheter indwelling status, consciousness level, wound severity-number and wound stages) and functional status (reflected by Barthel Index). A prospective research design was used to collect the results. Five hospital-based HHNAs were invited to participate in this research. Clients newly admitted to HHNAs and diagnosed as non-cancer patients were recruited, and the researchers gathered outcome indicators over a six-month period. Data were analyzed using SPSS 8.0 computer software. There were 75 clients in this study. Results showed that most of the clients (64.0%) received service for more than 180 days. The client characteristics were dominated by elderly (66.6% age above 70), female (53.3%) and married (74.7%). The three leading care needs were NG tubing service (84.0%), Foley tubing service (45.3%) and wound care (38.7%). The Kruscal Wallis Test revealed that there was no difference in emergency service frequency and re-hospitalization between clients who received service for more than 180 days and those who received service for less than 180 days. The Wilcoxon Sign rank test showed that within one half-year, catheter indwelling status, functional status, and wound severity were not significantly different, with the exception only of conscious level (p = .001). The results of this study can be viewed as preliminary data to assist in shaping home health nursing services in Taiwan.

  6. Comparative cost-effectiveness of metformin-based dual therapies associated with risk of cardiovascular diseases among Chinese patients with type 2 diabetes: Evidence from a population-based national cohort in Taiwan.

    PubMed

    Ou, Huang-Tz; Chen, Yen-Ting; Liu, Ya-Ming; Wu, Jin-Shang

    2016-06-01

    To assess the cost-effectiveness of metformin-based dual therapies associated with cardiovascular disease (CVD) risk in a Chinese population with type 2 diabetes. We utilized Taiwan's National Health Insurance Research Database (NHIRD) 1997-2011, which is derived from the claims of National Health Insurance, a mandatory-enrollment single-payer system that covers over 99% of Taiwan's population. Four metformin-based dual therapy cohorts were used, namely a reference group of metformin plus sulfonylureas (Metformin-SU) and metformin plus acarbose, metformin plus thiazolidinediones (Metformin-TZD), and metformin plus glinides (Metformin-glinides). Using propensity scores, each subject in a comparison cohort was 1:1 matched to a referent. The effectiveness outcome was CVD risk. Only direct medical costs were included. The Markov chain model was applied to project lifetime outcomes, discounted at 3% per annum. The bootstrapping technique was performed to assess uncertainty in analysis. Metformin-glinides was most cost-effective in the base-case analysis; Metformin-glinides saved $194 USD for one percentage point of reduction in CVD risk, as compared to Metformin-SU. However, for the elderly or those with severe diabetic complications, Metformin-TZD, especially pioglitazone, was more suitable; as compared to Metformin-SU, Metformin-TZD saved $840.1 USD per percentage point of reduction in CVD risk. Among TZDs, Metformin-pioglitazone saved $1831.5 USD per percentage point of associated CVD risk reduction, as compared to Metformin-rosiglitazone. When CVD is considered an important clinical outcome, Metformin-pioglitazone is cost-effective, in particular for the elderly and those with severe diabetic complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. National health expenditures, 1989

    PubMed Central

    Lazenby, Helen C.; Letsch, Suzanne W.

    1990-01-01

    Spending for health care in the United States grew to $604.1 billion in 1989, an increase of 11.1 percent from the 1988 level. Growth in national health expenditures has been edging upward since 1986, when the annual growth in the health care bill was 7.7 percent. Health care spending continues to command a larger and larger proportion of the resources of the Nation: In 1989, 11.6 percent of the Nation's output, as measured by the gross national product, was consumed by health care, up from 11.2 percent in 1988. PMID:10113559

  8. The development and achievement of a healthy cities network in Taiwan: sharing leadership and partnership building.

    PubMed

    Hu, Susan C; Kuo, Hsien-Wen

    2016-03-01

    The World Health Organization (WHO) Healthy Cities (HC) projects are the best known of the settings-based approaches to health promotion. They engage local governments in health development through a process of political commitment, institutional change, capacity-building, partnership-based planning and innovative projects. Many cities have promoted HC projects in Taiwan since 2002. In 2008, the Taiwan Alliance for Healthy Cities (TAHC) was launched to assist local governments in effectively establishing, operating and promoting HC projects. In this article, we share our experiences of establishing a platform and network to promote the HC program in Taiwan. Based on individual city profiles and governance in Taiwan, the TAHC developed a well-organized framework and model to encourage strong leadership in local governments and to promote participation and engagement in their communities. In the last 6 years, leaders from Taiwan's local governments in HC networks have integrated the HC concepts into their governance models, actively engaging and combining various resources with practical expertise and private sectors. The network of health in Taiwan allows each city to develop its unique perspective on the HC projects. Using this method, not only local government meets its needs, but also increases governance efficiency and effectiveness, resulting in the promotion of its citizens' overall sustainable urban health development. This HC network in Taiwan has partnerships with government and non-governmental organizations (NGOs), with academic support and citizen involvement, a dynamic data collection system and demonstrated leadership in the sharing of information in the Asian region. © The Author(s) 2016.

  9. Paradoxical increase in cigarette smuggling after the market opening in Taiwan

    PubMed Central

    Wen, C P; Peterson, R A; Cheng, T Y D; Tsai, S P; Eriksen, M P; Chen, T

    2006-01-01

    Objectives To assess the magnitude of cigarette smuggling after the market opened in Taiwan. Methods Review of tobacco industry documents for references to smuggling activities related to Taiwan and government statistics on seizure of smuggled cigarettes. Results The market opening in 1987 led to an increase in smuggling. Contraband cigarettes became as available as legal ones, with only a small fraction (8%) being seized. Being specifically excluded from the market‐opening, Japan entered the Taiwan market by setting up a Swiss plant as a legal cover for smuggling 10–20 times its legal quota of exports to Taiwan. Smuggling in Taiwan contributed to increased consumption of foreign brands, particularly by the young. Taiwan, not a member of the World Health Organization, was excluded from the East Asian 16‐member “Project Crocodile”, a regional anti‐smuggling collaborative effort to implement the Framework Convention on Tobacco Control. Conclusions Taiwan showed a sharp increase in smuggling after market liberalisation. Being excluded from the international community, Taiwan faces an uphill battle to fight smuggling alone. If Taiwan remained as its weakest link, global efforts to reduce tobacco use will be undermined, particularly for countries in the East Asian region. PMID:16728745

  10. Epidemiology of digital amputation and replantation in Taiwan: A population-based study.

    PubMed

    Chang, Dun-Hao; Ye, Shih-Yu; Chien, Li-Chien; Ma, Hsu

    2015-10-01

    Publications on digital amputation and replantation have been mostly derived from case series in high-volume hand surgery practices, and epidemiological studies are few. This study used a population-based dataset to illustrate the incidence of digital amputation, patient and hospital characteristics, and their relationships with replantation. A claim for reimbursement dataset (2008) was provided as a research database by the Bureau of National Health Insurance, Taiwan. Patients with ICD-9-CM coded as digital amputation (885 and 886) were included. These were cross-referenced with procedure codes for replantation procedures (84.21 and 84.22). We defined the patients who underwent thumb replantation (84.21) and thumb amputation (84.01) during a single hospitalization as replantation failure. Patient and hospital characteristics were studied with statistical analysis. In total, 2358 patients with digital amputation were admitted (1859 male, 499 female), mean age 39.2 ± 15.5 years. The incidence was 10.2/100,000 person-years. The highest incidence was 14.7/100,000 person-years in the age group 45-54 years. Machinery and powered hand tools caused 68.8% of digital amputations. Thumb amputation [odds ratio (OR): 1.35, p = 0.01], private hospital (OR: 1.40, p = 0.01), medical center (OR: 2.38, p < 0.001), regional hospital (OR: 2.41, p < 0.001) and hospitals with an annual volume >20 digital amputations (OR: 4.23, p < 0.001) were associated with higher attempt rates for replantation. Elderly patients (age >65 years) had higher risk of thumb replantation failure (OR: 32.30, p = 0.045), while hospitals with >20 annual replantations had lower risk (OR: 0.11, p = 0.02). Our study of the National Health Insurance database characterized the epidemiology of digital amputation patients undergoing replantation and the facilities in Taiwan where these procedures are performed. The hospitals treating more digital amputation patients had higher attempt rates and lower

  11. Doctor Shopping Behavior for Zolpidem Among Insomnia Patients in Taiwan: A Nationwide Population-Based Study.

    PubMed

    Lu, Tzu-Hsuan; Lee, Yen-Ying; Lee, Hsin-Chien; Lin, You-Meei

    2015-07-01

    Although zolpidem is listed as a controlled drug in Taiwan, patients' behavior has not been restricted and has led to the problem of doctor shopping behavior (DSB), leading to overutilization of medical resources and excess spending. The National Health Insurance Administration in Taiwan has instituted a new policy to regulate physicians' prescribing behavior and decrease DSB. This retrospective study aimed to analyze the DSB for zolpidem by insomnia patients and assess related factors. Data were extracted from the Longitudinal Health Insurance Database in Taiwan. Individuals with a diagnosis of insomnia who received more than one prescription of zolpidem in 2008 were followed for 24 mo. Doctor shopping was defined as ≥ 2 prescriptions by different doctors within ≥ 1 day overlapping in the duration of therapy. The percentage of zolpidem obtained through doctor shopping was used as an indicator of the DSB of each patient. Among the 6,947 insomnia patients who were prescribed zolpidem, 1,652 exhibited DSB (23.78%). The average dose of zolpidem dispensed for each patient during 24 mo was 244.21 daily defined doses. The doctor shopping indicator (DSI) was 0.20 (standard deviation, 0.23) among patients with DSB. Younger age, chronic diseases, high number of diseases, higher premium status, high socioeconomic status, and fewer people served per practicing physicians were all factors significantly related to doctor shopping behavior. Doctor shopping for zolpidem appears to be an important issue in Taiwan. Implementing a proper referral system with efficient data exchange by physician or pharmacist-led medication reconciliation process might reduce DSB. © 2015 Associated Professional Sleep Societies, LLC.

  12. The relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan.

    PubMed

    Yang, Ya-Ting; Iqbal, Usman; Ko, Hua-Lin; Wu, Chia-Rong; Chiu, Hsien-Tsai; Lin, Yi-Chieh; Lin, Wender; Elsa Hsu, Yi-Hsin

    2015-06-01

    The purpose of this study was to explore the relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan. Cross-sectional study from 2007 Taiwan Longitudinal Study on Ageing (TLSA) survey. Community-based study. A total of 4249 middle-aged and elderly subjects were recruited. None. Outpatient visits within 1 month, and hospitalization, emergency visits as well as to shop in pharmacy stores within 1 year, respectively. Adjusting for important confounding variables, the middle-aged and elderly with National Health Insurance (NHI) and commercial insurance compared with those with NHI alone tended to have outpatient visits. The middle-aged and elderly with longer time to access healthcare facilities were less likely to shop in pharmacy stores compared with those with <30 min. The middle-aged and elderly who perceived inconvenient to access health care tended to shop in pharmacy stores compared with those with perceived convenience. Our study of Taiwan's experience could provide a valuable lesson for countries that are planning to launch universal health insurance system, locate budgets in health care and transportation. The middle-aged and elderly who were facing more challenges in accessing health care, no matter in perceived accessibility or real time to access health care, had less outpatient visits and more drug stores shopping. Strategic policies are needed to improve accessibility in increasing patients' perception on access and escalating convenience of transportation system for improving accessibility. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  13. Improving but Inferior Survival in Patients with Chronic Lymphocytic Leukemia in Taiwan: A Population-Based Study, 1990–2004

    PubMed Central

    Wu, Shang-Ju; Chiang, Chun-Ju; Lin, Chien-Ting; Tien, Hwei-Fang; Lai, Mei-Shu

    2013-01-01

    Background Chronic lymphocytic leukemia (CLL) is much less prevalent in Asian countries. Whether there are differences in survival outcomes between the East and West, however, remain unclear. Methods The survival data for CLL patients identified in the Taiwan Cancer Registry database between 1990 and 2004, together with corresponding data in the US Surveillance, Epidemiology, and End Results database, were retrieved. The relative survivals (RS, adjusted for the expected survival in the general population) were estimated in patients diagnosed in three 5-year periods of time. Results CLL drastically shortened patients’ life expectancy; more importantly, this negative impact in Taiwan was much larger than that in the US: the 5-year RS in Taiwan and US were 59% and 76%, and the 10-year RS, 45% and 56%, respectively. Nevertheless, survival in Taiwan was better in the periods after 1995 (5-year RS, from 53.0% to 60.6%), a time period corresponding to the introduction of the Taiwan National Health Insurance scheme. Such improvement was largely due to decreased mortality in patients younger than 65 (5-year RS, from 53.5% to 69.1%). Despite the improvement, patients’ RS in Taiwan in recent periods remain steadily 15∼20% inferior to that in the US in both younger and older patient groups. Conclusions The improved RS in Taiwan implies that therapeutic advances are changing the prognosis of CLL. The stable RS gap between Taiwanese and the US patients suggests the existence of an ethnic difference in CLL patients’ outcomes. PMID:23638168

  14. Use of HLA-B*58:01 genotyping to prevent allopurinol induced severe cutaneous adverse reactions in Taiwan: national prospective cohort study

    PubMed Central

    Ko, Tai-Ming; Tsai, Chang-Youh; Chen, Shih-Yang; Chen, Kuo-Shu; Yu, Kuang-Hui; Chu, Chih-Sheng; Huang, Chung-Ming; Wang, Chrong-Reen; Weng, Chia-Tse; Yu, Chia-Li; Hsieh, Song-Chou; Tsai, Jer-Chia; Lai, Wen-Ter; Tsai, Wen-Chan; Yin, Guang-Dar; Ou, Tsan-Teng; Cheng, Kai-Hung; Yen, Jeng-Hsien; Liou, Teh-Ling; Lin, Tsung-Hsien; Chen, Der-Yuan; Hsiao, Pi-Jung; Weng, Meng-Yu; Chen, Yi-Ming; Chen, Chen-Hung; Liu, Ming-Fei; Yen, Hsueh-Wei; Lee, Jia-Jung; Kuo, Mei-Chuan; Wu, Chen-Ching; Hung, Shih-Yuan; Luo, Shue-Fen; Yang, Ya-Hui; Chuang, Hui-Ping; Chou, Yi-Chun; Liao, Hung-Ting; Wang, Chia-Wen; Huang, Chun-Lin; Chang, Chia-Shuo; Lee, Ming-Ta Michael; Chen, Pei; Wong, Chih-Shung; Chen, Chien-Hsiun; Wu, Jer-Yuarn; Chen, Yuan-Tsong

    2015-01-01

    Objective To evaluate the use of prospective screening for the HLA-B*58:01 allele to identify Taiwanese individuals at risk of severe cutaneous adverse reactions (SCARs) induced by allopurinol treatment. Design National prospective cohort study. Setting 15 medical centres in different regions of Taiwan, from July 2009 to August 2014. Participants 2926 people who had an indication for allopurinol treatment but had not taken allopurinol previously. Participants were excluded if they had undergone a bone marrow transplant, were not of Han Chinese descent, and had a history of allopurinol induced hypersensitivity. DNA purified from 2910 participants’ peripheral blood was used to assess the presence of HLA-B*58:01. Main outcome measures Incidence of allopurinol induced SCARs with and without screening. Results Participants who tested positive for HLA-B*58:01 (19.6%, n=571) were advised to avoid allopurinol, and were referred to an alternate drug treatment or advised to continue with their prestudy treatment. Participants who tested negative (80.4%, n=2339) were given allopurinol. Participants were interviewed once a week for two months to monitor symptoms. The historical incidence of allopurinol induced SCARs, estimated by the National Health Insurance research database of Taiwan, was used for comparison. Mild, transient rash without blisters developed in 97 (3%) participants during follow-up. None of the participants was admitted to hospital owing to adverse drug reactions. SCARs did not develop in any of the participants receiving allopurinol who screened negative for HLA-B*58:01. By contrast, seven cases of SCARs were expected, based on the estimated historical incidence of allopurinol induced SCARs nationwide (0.30% per year, 95% confidence interval 0.28% to 0.31%; P=0.0026; two side one sample binomial test). Conclusions Prospective screening of the HLA-B*58:01 allele, coupled with an alternative drug treatment for carriers, significantly decreased the incidence

  15. Financial incentives and use of Cesarean delivery: Taiwan birth data 2003 to 2007.

    PubMed

    Hong, Yi-Chen; Linn, George Chinhung

    2012-01-01

    The Cesarean section (CS) rate in Taiwan has exceeded 30% since 2000. To lower the CS rate, the Bureau of National Health Insurance in Taiwan raised the payment for vaginal delivery (VD) in May 2005, and also increased the insured's copayment for elective CS in May 2006. This study clarifies the influences of these financial incentives, and explores whether the 2 policies lowered the CS rate. The materials used are birth cases obtained from a systematic sampling of the original inpatient claim data in the National Health Insurance research database between 2003 and 2007. The empirical analysis of this study groups the birth data into 4 types: VD, unplanned CS, planned CS, and elective CS. The 4 delivery types represent the dependent variable. A multinomial logistic regression model was adopted as the empirical method. The policy changes, hospital attributes, and insured status were considered independent variables. Results indicate that the supply-side policy change in May 2005 reduced the number of CS cases. However, the policy effect was not very significant, and the CS rate decreased mainly because of planned CS cases. The demand-side policy change in May 2006 did not lower the rate of elective CS. The results imply that the financial incentives were not the main consideration for both the demand and supply sides. To encourage more VDs and lower the CS rate, the authorities could consider mechanisms other than adjusting the payment or changing the copayment.

  16. Integration in primary community care networks (PCCNs): examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

    PubMed Central

    Lin, Blossom Yen-Ju

    2007-01-01

    Background Taiwan's primary community care network (PCCN) demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals) within individual PCCNs. Methods The thorough questionnaire items, covering the network working infrastructures – governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003–2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at the early stage of network

  17. Integration in primary community care networks (PCCNs): examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan.

    PubMed

    Lin, Blossom Yen-Ju

    2007-06-19

    Taiwan's primary community care network (PCCN) demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals) within individual PCCNs. The thorough questionnaire items, covering the network working infrastructures--governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003-2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at the early stage of network forming in this study, the detailed surveyed

  18. Building core capacities at the designated points of entry according to the International Health Regulations 2005: a review of the progress and prospects in Taiwan

    PubMed Central

    Chiu, Hsiao-Hsuan; Hsieh, Jui-Wei; Wu, Yi-Chun; Chou, Jih-Haw; Chang, Feng-Yee

    2014-01-01

    Background As designated points of entry (PoEs) play a critical role in preventing the transmission of international public health risks, huge efforts have been invested in Taiwan to improve the core capacities specified in the International Health Regulations 2005 (IHR 2005). This article reviews how Taiwan strengthened the core capacities at the Taoyuan International Airport (TIA) and the Port of Kaohsiung (PoK) by applying a new, practicable model. Design An IHR PoE program was initiated for implementing the IHR core capacities at designated PoEs. The main methods of this program were 1) identifying the designated PoEs according to the pre-determined criteria, 2) identifying the competent authority for each health measure, 3) building a close collaborative relationship between stakeholders from the central and PoE level, 4) designing three stages of systematic assessment using the assessment tool published by the World Health Organization (WHO), and 5) undertaking action plans targeting the gaps identified by the assessments. Results Results of the self-assessment, preliminary external assessment, and follow-up external assessment revealed a continuous progressive trend at the TIA (86, 91, and 100%, respectively), and at the PoK (77, 97, and 99.9%, respectively). The results of the follow-up external assessment indicated that both these designated PoEs already conformed to the IHR requirements. These achievements were highly associated with strong collaboration, continuous empowerment, efficient resource integration, and sustained commitments. Conclusions Considering that many countries had requested for an extension on the deadline to fulfill the IHR 2005 core capacity requirements, Taiwan's experiences can be a source of learning for countries striving to fully implement these requirements. Further, in order to broaden the scope of public health protection into promoting global security, Taiwan will keep its commitments on multisectoral cooperation, human

  19. Building core capacities at the designated points of entry according to the International Health Regulations 2005: a review of the progress and prospects in Taiwan.

    PubMed

    Chiu, Hsiao-Hsuan; Hsieh, Jui-Wei; Wu, Yi-Chun; Chou, Jih-Haw; Chang, Feng-Yee

    2014-01-01

    As designated points of entry (PoEs) play a critical role in preventing the transmission of international public health risks, huge efforts have been invested in Taiwan to improve the core capacities specified in the International Health Regulations 2005 (IHR 2005). This article reviews how Taiwan strengthened the core capacities at the Taoyuan International Airport (TIA) and the Port of Kaohsiung (PoK) by applying a new, practicable model. An IHR PoE program was initiated for implementing the IHR core capacities at designated PoEs. The main methods of this program were 1) identifying the designated PoEs according to the pre-determined criteria, 2) identifying the competent authority for each health measure, 3) building a close collaborative relationship between stakeholders from the central and PoE level, 4) designing three stages of systematic assessment using the assessment tool published by the World Health Organization (WHO), and 5) undertaking action plans targeting the gaps identified by the assessments. Results of the self-assessment, preliminary external assessment, and follow-up external assessment revealed a continuous progressive trend at the TIA (86, 91, and 100%, respectively), and at the PoK (77, 97, and 99.9%, respectively). The results of the follow-up external assessment indicated that both these designated PoEs already conformed to the IHR requirements. These achievements were highly associated with strong collaboration, continuous empowerment, efficient resource integration, and sustained commitments. Considering that many countries had requested for an extension on the deadline to fulfill the IHR 2005 core capacity requirements, Taiwan's experiences can be a source of learning for countries striving to fully implement these requirements. Further, in order to broaden the scope of public health protection into promoting global security, Taiwan will keep its commitments on multisectoral cooperation, human resource capacity building, and

  20. Factors associated with intensiveness of use of child preventive health services in Taiwan: a comparative study between cross-cultural immigrant families and native-born families.

    PubMed

    Chien, Su-Chen; Yeh, Yen-Po; Wu, Jyun-Yi; Lin, Chun-Hsiu; Chang, Pei-Chi; Fang, Chiung-Hui; Yang, Hao-Jan

    2013-01-01

    To compare intensiveness of use of child preventive health services (CPHS) between cross-cultural immigrant families and native-born families in Taiwan and to explore factors associated with differences in intensiveness of CPHS use. Cross-cultural immigrant families were defined as families where the mother was an immigrant from another southeast Asian country. In native-born families, both parents were Taiwanese-born. Data were collected from 318 immigrant mothers and 340 native-born mothers of children aged 7 years or younger in a cross-sectional survey in central Taiwan. A social determinants framework of health inequities was constructed, and ordinal logistic regression models were used to examine the effect of four domains of intermediary determinants on the relationship between family type and underuse of CPHS: CPHS-related factors, medical-related factors, maternal acculturation factors, and sociodemographic/socioeconomic characteristics. Cross-cultural immigrant families were less likely to intensively use CPHS than native-born families. This difference appeared to be mediated by the greater likelihood of having an older child or a lower educated father in cross-cultural families. Findings of this study highlight the importance of promoting health behaviors and combating health inequities and social inequalities for cross-cultural immigrant families in Taiwan from a sociodemographic/socioeconomic and political context.

  1. The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis.

    PubMed

    Chang, Shu-Sen; Lu, Tsung-Hsueh; Sterne, Jonathan Ac; Eddleston, Michael; Lin, Jin-Jia; Gunnell, David

    2012-04-02

    Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan. Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models. In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95). Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides.

  2. Human Freshwater Demand for Economic Activity and Ecosystems in Taiwan

    NASA Astrophysics Data System (ADS)

    Ferng, Jiun-Jiun

    2007-12-01

    Freshwater is necessary to economic activity, and humans depend on goods and services generated by water-dependent ecosystems. However, national freshwater management usually focuses on direct use of domestic freshwater. With an increasing scarcity of freshwater, attention has turned to two indirect uses of freshwater by humans. The first indirect use is freshwater used by foreign countries when producing products for export. The second use is freshwater required by local ecosystems: human survival and development depend on goods and services generated in these ecosystems. This work adopted Taiwan as a case study. In addition to two widely recognized ecosystem freshwater demands, evapotranspiration and reversed river flow, this study suggests that freshwater is a constituent of some abiotic components, such as groundwater in aquifers, because excessive withdrawal has already caused significant land subsidence in Taiwan. Moreover, the estimated results show that Taiwan’s net imports of freshwater through trade amounts to approximately 25% of its total freshwater use for economic production. Integrating industrial policy, trade policy, and national freshwater management is a useful approach for developing strategies to limit the growing use of freshwater in Taiwan. Policy implications are then developed by further analyzing withdrawal sources of freshwater (domestic and foreign) for supporting economic production in Taiwan and identifying the factors (domestic final demand and export) driving freshwater-intensive products.

  3. Health risk assessment of groundwater arsenic pollution in southern Taiwan.

    PubMed

    Liang, Ching-Ping; Wang, Sheng-Wei; Kao, Yu-Hsuan; Chen, Jui-Sheng

    2016-12-01

    Residents of the Pingtung Plain, Taiwan, use groundwater for drinking. However, monitoring results showed that a considerable portion of groundwater has an As concentration higher than the safe drinking water regulation of 10 μg/L. Considering residents of the Pingtung Plain continue to use groundwater for drinking, this study attempted to evaluate the exposure and health risk from drinking groundwater. The health risk from drinking groundwater was evaluated based on the hazard quotient (HQ) and target risk (TR) established by the US Environmental Protection Agency. The results showed that the 95th percentile of HQ exceeded 1 and TR was above the safe value of threshold value of 10 -6 . To illustrate significant variability of the drinking water consumption rate and body weight of each individual, health risk assessments were also performed using a spectrum of daily water intake rate and body weight to reasonably and conservatively assess the exposure and health risk for the specific subgroups of population of the Pingtung Plain. The assessment results showed that 0.01-7.50 % of the population's HQ levels are higher than 1 and as much as 77.7-93.3 % of the population being in high cancer risk category and having a TR value >10 -6 . The TR estimation results implied that groundwater use for drinking purpose places people at risk of As exposure. The government must make great efforts to provide safe drinking water for residents of the Pingtung Plain.

  4. A trend analysis of ergonomic research themes in Taiwan.

    PubMed

    Lin, Chih-Long

    2015-01-01

    This paper examines the development of ergonomics in Taiwan by analysing 1404 scientific articles published by 113 permanent members of the Ergonomics Society of Taiwan (EST). Each article was classified by key words and abstract content. Each article was also coded by period of publication (1971-1992 (first period), 1993-1997 (second period), 1998-2002 (third period), 2003-2007 (fourth period), and 2008-2012 (fifth period), and against 13 topic categories. The results show that rate of publication has increased by approximately 100 articles every five years since 1993.The most popular topic was ergonomics assessment and analysis techniques in the first period, force exertion-related research in the second period, product design and evaluation in the third period, occupational safety and health in the fourth period and human-computer interface in the fifth period. Each of these is highly relevant to current contemporary issues around the world. Finally, potential areas for future ergonomics research in Taiwan are discussed. This study investigates the trends in academic papers published by members of the EST. Over time, topics have shifted from ergonomics evaluation methods to occupational safety and health, and human–computer interaction. The findings should be considered as important references for planning the future of ergonomics in Taiwan.

  5. Sustainability of Higher Education Institutions in Taiwan

    ERIC Educational Resources Information Center

    Su, H. Jenny; Chang, Tzu-chau

    2010-01-01

    Purpose: The purpose of this paper is to provide the rationale and context for recent national policy and funded initiatives to support sustainability developments within higher education in Taiwan, including practical and educational aspects. Concrete examples and specific outcomes are reviewed, to produce a profile across the higher education…

  6. Parental Body Mass Index Is Associated With Adolescent Obesity in Taiwan.

    PubMed

    Chen, Chen-Mei; Lou, Meei-Fang; Gau, Bih-Shya

    2016-12-01

    Adolescent obesity is a crucial public health concern, and understanding its risk factors can facilitate the establishment of prevention policies. In this study we investigated the prevalence of adolescent obesity in Taiwan, determined the influential factors, and compared the prevalence of obesity in our study population with international indices. The cross-sectional study was an analysis of data from the 2010-2011 Nutrition and Health Survey in Taiwan, an anthropometric measurement and questionnaire survey of adolescents aged 11-18 years. Our sample was 1,826 adolescents (910 males and 916 females). Data were analyzed using logistic regression modeling. Based on body mass index standards specific to Taiwan norms, the prevalence of overweight and obesity in Taiwan adolescents was 12.4% and 16.8%, respectively. The prevalence was lower when international indices of overweight and obesity were applied. In logistic regression, obesity was linked to male gender, an obese father, overweight or obese mother, poor dietary attitudes, and perceived low dietary benefits. Monitoring and preventing adolescent obesity should focus on both adolescents and their parents. When planning behavioral change and education for adolescent obesity, health professionals and policy-makers should view the family as a unit. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. Impact of Safety-Related Regulations on Codeine Use in Children: A Quasi-Experimental Study Using Taiwan's National Health Insurance Research Database.

    PubMed

    Lin, Chih-Wan; Wang, Ching-Huan; Huang, Wei-I; Ke, Wei-Ming; Chao, Pi-Hui; Chen, Wen-Wen; Hsiao, Fei-Yuan

    2017-07-01

    Safety concerns regarding potential life-threatening adverse events associated with codeine have resulted in policy decisions to restrict its use in pediatrics. However, whether these drug safety communications have had an immediate and strong impact on codeine use remains in question. We aimed to investigate the impact of the two implemented safety-related regulations (label changes and reimbursement regulations) on the use of codeine for upper respiratory infection (URI) or cough. A quasi-experimental study was performed using Taiwan's National Health Insurance Research Database. Quarterly data of codeine prescription rates for URI/cough visits were reported, and an interrupted time series design was used to assess the impact of the safety regulations on the uses of codeine among children with URI/cough visits. Multivariable logistic regression models were used to explore patient and provider characteristics associated with the use of codeine. The safety-related regulations were associated with a significant reduction in codeine prescription rates of -4.24% (95% confidence interval [CI] -4.78 to -3.70), and the relative reduction compared with predicted rates based on preregulation projections was 60.4, 56.6, and 53.2% in the first, second, and third year after the regulations began, respectively. In the postregulation period, physicians specializing in otolaryngology (odds ratio [OR] 1.47, 95% CI 1.45-1.49), practicing in district hospitals (OR 6.84, 95% CI 5.82-8.04) or clinics (OR 6.50, 95% CI 5.54-7.62), and practicing in the least urbanized areas (OR 1.60, 95% CI 1.55-1.64) were more likely to prescribe codeine to children than their counterparts. Our study provides a successful example of how to effectively reduce the codeine prescriptions in children in the 'real-world' settings, and highlights areas where future effort could be made to improve the safety use of codeine. Future research is warranted to explore whether there was a simultaneous decrease in

  8. Public Health Responses to Reemergence of Animal Rabies, Taiwan, July 16–December 28, 2013

    PubMed Central

    Huang, Angela Song-En; Chen, Wan-Chin; Huang, Wan-Ting; Huang, Shih-Tse; Lo, Yi-Chun; Wei, Sung-Hsi; Kuo, Hung-Wei; Chan, Pei-Chun; Hung, Min-Nan; Liu, Yu-Lun; Mu, Jung-Jung; Yang, Jyh-Yuan; Liu, Ding-Ping; Chou, Jih-Haw; Chuang, Jen-Hsiang; Chang, Feng-Yee

    2015-01-01

    Taiwan had been free of indigenous human and animal rabies case since canine rabies was eliminated in 1961. In July 2013, rabies was confirmed among three wild ferret-badgers, prompting public health response to prevent human rabies cases. This descriptive study reports the immediate response to the reemergence of rabies in Taiwan. Response included enhanced surveillance for human rabies cases by testing stored cerebrospinal fluids (CSF) from patients with encephalitides of unknown cause by RT-PCR, prioritizing vaccine use for postexposure prophylaxis (PEP) during periods of vaccine shortage and subsequent expansion of PEP, surveillance of animal bites using information obtained from vaccine application, roll out of preexposure prophylaxis (PrEP) with vaccine stock restoration, surveillance for adverse events following immunization (AEFI), and ensuring surge capacity to respond to general public inquiries by phone and training for healthcare professionals. Enhanced surveillance for human rabies found no cases after testing 205 stored CSF specimens collected during January 2010–July 2013. During July 16 to December 28, 2013, we received 8,241 rabies PEP application; 6,634 (80.5%) were consistent with recommendations. Among the 6,501persons who received at least one dose of rabies vaccine postexposure, 4,953 (76.2%) persons who were bitten by dogs; only 59 (0.9%) persons were bitten by ferret-badgers. During the study period, 6,247 persons received preexposure prophylaxis. There were 23 reports of AEFI; but no anaphylaxis, Guillain-Barré syndrome, or acute disseminated encephalomyelitis were found. During the study period, there were 40,312 calls to the Taiwan Centers for Disease Control hotline, of which, 8,692 (22%) were related to rabies. Recent identification of rabies among ferret-badgers in a previously rabies-free country prompted rapid response. To date, no human rabies has been identified. Continued multifaceted surveillance and interministerial

  9. Carer Reports of Health Status among Adults with Intellectual/Developmental Disabilities in Taiwan Living at Home and in Institutions

    ERIC Educational Resources Information Center

    Wang, K.-Y.; Hsieh, K.; Heller, T.; Davidson, P. W.; Janicki, M. P.

    2007-01-01

    Background: The aim of the present study was to assess the health status of a cohort of adults with intellectual/developmental disabilities (I/DD) residing in family homes or institutions in Taiwan and to examine whether morbidity varied with age, sex, existing diagnosis [Down syndrome (DS), seizures, cerebral palsy (CP), intellectual disability…

  10. National health expenditures, 1983

    PubMed Central

    Gibson, Robert M.; Levit, Katharine R.; Lazenby, Helen; Waldo, Daniel R.

    1984-01-01

    Although growing more slowly than in recent years, spending for health continued to account for an increasing share of the Nation's gross national product. In 1983, spending for health amounted to 10.8 percent of the gross national product, or $1,459 per person. Public programs financed 40 percent of all personal health care spending. Medicare and Medicaid expended $91 billion in benefits, 29 percent of all spending for personal health. New estimates of spending in calendar year 1983, along with revised measures of the benefits paid by private health insurers, are presented here. PMID:10310949

  11. National Health Expenditures, 1979

    PubMed Central

    Gibson, Robert M

    1980-01-01

    Outlays for health care in the nation reached $212.2 billion in calendar year 1979—12.5 percent higher than in 1978, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $943 per person in the United States and was equal to 9.0 percent of the Gross National Product. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. PMID:10309255

  12. The Risk of Stroke in Physicians: A Population-based Cohort Study in Taiwan.

    PubMed

    Tam, Hon-Pheng; Lin, Hung-Jung; Weng, Shih-Feng; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

    2017-10-01

    Physicians in Taiwan work in stressful workplaces and have heavy workloads, both of which may contribute to the occurrence of a stroke. However, it is not clear whether they have a higher risk of stroke. Therefore, we conducted a population-based cohort study to compare the risks of stroke between physicians and the general population and among subgroups of physicians in Taiwan. In the National Health Insurance Research Database of Taiwan, we identified 28,062 physicians and selected 84,186 age- and sex-matched nonmedical staff beneficiaries as the references. Using conditional logistic regression, we compared the prevalence of stroke between physicians and references. In addition, we made comparisons among subgroup of physicians defined by age, sex, comorbidity, specialty, and the level of hospital. During the study period, physicians had higher prevalence rates of hypertension (23.6% vs. 19.1%), hyperlipidemia (21.4% vs. 12.9%), and coronary artery disease (CAD) (6.4% vs. 5.7%) than the referent group, but they had a lower risk of stroke with an odds ratio of 0.61 (95% confidence interval = 0.55, 0.66) after adjusting for hypertension, diabetes, hyperlipidemia, CAD, and active worker. Among physicians, the risks were higher in those who were older or had hypertension, diabetes, hyperlipidemia, or CAD. Despite having higher prevalence rates of hypertension, hyperlipidemia, and CAD and working in stressful workplaces with heavy workloads, our study suggests that physicians in Taiwan have a lower risk of stroke compared with the general population. These results may indicate the benefits of higher awareness and more knowledge of diseases.

  13. Impact of negative media publicity on attention-deficit/hyperactivity disorder medication in Taiwan.

    PubMed

    Wang, Liang-Jen; Lee, Sheng-Yu; Yuan, Shin-Sheng; Yang, Chun-Ju; Yang, Kang-Chung; Lee, Tung-Liang; Shyu, Yu-Chiau

    2016-01-01

    This study explores trends in attention-deficit/hyperactivity disorder (ADHD) medications in Taiwan from 2000 to 2011 and whether negative media coverage of Ritalin in January 2010 impacted ADHD prescriptions throughout the country. Patients throughout Taiwan who had been newly diagnosed with ADHD (n = 145,269) between January 2000 and December 2011 were selected from Taiwan's National Health Insurance database as subjects for this study. We analyzed monthly and yearly data on person-days of treatment with immediate-release methylphenidate (IR-MPH), osmotic controlled-release formulation of methylphenidate (OROS-MPH), and atomoxetine (ATX) using linear models of curve estimation and the time series expert modeler. Of our sample, 57.8%, 28.9%, and 4.3% had been prescribed one or more doses of IR-MPH, OROS-MPH, or ATX, respectively. The annual person-days of IR-MPH use increased regularly from 2000 to 2009, dropped abruptly in 2010, and then increased again the next year. Furthermore, the person-days of OROS-MPH prescriptions did not reach their expected goal in 2010; however, the person-days of ATX prescriptions have increased constantly since entering the market in 2007. Compared with patients newly diagnosed with ADHD in 2009, those newly diagnosed in 2010 were less likely to be treated with medication. These findings suggest that negative publicity affected the writing of stimulant prescriptions for ADHD patients throughout Taiwan. Media reporting has a vital role in influencing children with ADHD, their parents, and their willingness to accept pharmacotherapy as treatment. Copyright © 2015 John Wiley & Sons, Ltd.

  14. Forecasting the Incidence of Dementia and Dementia-Related Outpatient Visits With Google Trends: Evidence From Taiwan.

    PubMed

    Wang, Ho-Wei; Chen, Duan-Rung; Yu, Hsiao-Wei; Chen, Ya-Mei

    2015-11-19

    Google Trends has demonstrated the capability to both monitor and predict epidemic outbreaks. The connection between Internet searches for dementia information and dementia incidence and dementia-related outpatient visits remains unknown. This study aimed to determine whether Google Trends could provide insight into trends in dementia incidence and related outpatient visits in Taiwan. We investigated and validated the local search terms that would be the best predictors of new dementia cases and outpatient visits. We further evaluated the nowcasting (ie, forecasting the present) and forecasting effects of Google Trends search trends for new dementia cases and outpatient visits. The long-term goal is to develop a surveillance system to help early detection and interventions for dementia in Taiwan. This study collected (1) dementia data from Taiwan's National Health Insurance Research Database and (2) local Internet search data from Google Trends, both from January 2009 to December 2011. We investigated and validated search terms that would be the best predictors of new dementia cases and outpatient visits. We then evaluated both the nowcasting and the forecasting effects of Google Trends search trends through cross-correlation analysis of the dementia incidence and outpatient visit data with the Google Trends data. The search term "dementia + Alzheimer's disease" demonstrated a 3-month lead effect for new dementia cases and a 6-month lead effect for outpatient visits (r=.503, P=.002; r=.431, P=.009, respectively). When gender was included in the analysis, the search term "dementia" showed 6-month predictive power for new female dementia cases (r=.520, P=.001), but only a nowcasting effect for male cases (r=.430, P=.009). The search term "neurology" demonstrated a 3-month leading effect for new dementia cases (r=.433, P=.008), for new male dementia cases (r=.434, P=.008), and for outpatient visits (r=.613, P<.001). Google Trends established a plausible relationship

  15. The lifetime cost of hepatocellular carcinoma : a claims data analysis from a medical centre in Taiwan.

    PubMed

    Lang, Hui-Chu; Wu, Jaw-Ching; Yen, Sang-Hue; Lan, Chung-Fu; Wu, Shi-Liang

    2008-01-01

    Hepatocellular carcinoma (HCC) is the second most common cancer in Taiwan. For males in Taiwan, it is the most dangerous cancer, with both the highest incidence and mortality rate. To determine cancer-related medical care costs for long-term survivors of HCC. The estimation of the lifetime cost was based on the insurer perspective and adopted an incidence-based approach. Data was sourced from the 1999-2002 cancer registry statistics of patients with HCC and the claims data of Taipei Veterans General Hospital (TVGH). In total there were 2873 HCC patients at TVGH. In addition to this data, the research used population National Health Insurance claims data from the National Health Research Institutes (1996-2002) as the comparison group. The probabilities of survival, dying of cancer or dying of other causes were estimated using cancer registry statistics. To estimate lifetime (10-year) cost, we divided the disease process into three phases: initial, continuing and terminal. The cost of HCC was calculated as the sum of the average cost of each phase. The expected lifetime cost for treatment of an HCC patient was estimated by incorporating the phase-specific costs with the survival and mortality rates. The results showed that 895 patients survived <1 year, and treatment for each of these patients cost on average New Taiwan dollars ($NT) 206 573 ($US 1 = $NT 33, year 2002 value) over this period. For those who survived > or =1 year, the terminal phase of treatment resulted in the highest costs, $NT 237 032. On average, for each patient, the initial phase cost was $NT 140 403 and the monthly cost for the continuing phase was $NT 8687. For the average HCC patient, the 10-year lifetime cost was $NT 418 554 (in nominal $NT). Our study showed that the terminal phase cost the most out of the three treatment phases. The aggregate lifetime cost of HCC is useful for health policy making and clinical decision making.

  16. Sediment characteristics and provenance of the Taiwan Shoal in the southern Taiwan Strait

    NASA Astrophysics Data System (ADS)

    Koo, W. S.; Lin, A. T.; Kuo, L. W.; Lee, Y. H.

    2016-12-01

    The Taiwan Shoal in the southern Taiwan Strait exhibits a lobe-shaped shallow water area, with a depth less than around 40 m and an area approximately of 13,000 km2. The Shoal consists of relict sediments remnant from deltaic deposits during the last glacial period and associated with the paleo-Min River. We collected seafloor sediments in and around the Taiwan Shoal to study the sediment characteristics and provenance of the Shoal as well as Taiwanese river sediments to characterize sediment sourced from southern Taiwan. Our results help to understand possible sediment delivery pathways in a source-to-sink context from the southern Taiwan Strait to the northern South China Sea. The method of X-ray diffraction is used to identify mineral compositions for muds and mineral compositions are examined under polarized microscope for sands. Zircon grains are separated from heavy minerals for U-Pb dating in order to understand the sediment source terranes. Sediments of the Taiwan Shoal are mostly tawny-colored, medium to coarse-grained sands with abundant shell fragments and shallow-water benthic foraminifera. Sediments to the south of the Taiwan Shoal and in the outer shelf consist of dark brown-colored and fine-grained sands with rare shell fragments. Siliciclastic compositions of the Taiwan Shoal sediments are mostly quartz. The second abundant composition is rock fragments with more occurrences near the Chinese coastline and the Penghu archipelago. Slate fragments are found to occur near Taiwan, especially in the Penghu Channel area. Clay minerals from the Penghu Channels and south of the Taiwan Shoal are dominated by illite and chlorite with minor smectite and kaolinite. The sediment colors and mineral species are very different for the sediments of the Taiwan Shoal and outer shelf, revealing that these two areas featuring different oceanographic processes and sediment provenance.

  17. Taiwan`s experience with municipal waste recycling

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lee, C.H.

    1998-12-31

    Currently, each person on the average produces 1.15 kg of the municipal waste per day and a total of 9 million metric tons were generated annually in Taiwan. The disposal of such a huge amount of waste presents tremendous challenge for the island due to the scarcity of landfills and incineration facilities available locally. EPA of Taiwan, R.O.C. thus takes an active role in promoting waste recycling to reduce the garbage produced in municipalities. In order to efficiently utilize the government`s human and financial resources used in recycling, started from January 31, 1989, EPA has mandated the producer responsibility recyclingmore » program for several designated post-consumer products such as PET, PVC bottles, scrap tires, scrap motor vehicles, etc. Producer responsibility recycling program specifies that the manufacturers, importers and sellers of these designated products have the responsibility to retrieve their products and recycle them properly. Several negative effects have been encountered while the implementation of this producer responsibility recycling program in Taiwan which resulted in a modification of this recycling program recently. This paper presents the encountered experiences on the implementation of municipal waste recycling program in Taiwan.« less

  18. The dilemma of "to be or not to be": developing electronically e-health & cloud computing documents for overseas transplant patients from Taiwan organ transplant health professionals' perspective.

    PubMed

    Shih, F-J; Fan, Y-W; Chiu, C-M; Shih, F-Ji; Wang, S-S

    2012-05-01

    The development of mutually accessible e-health documents (ehD) and cloud computing (CC) for overseas organ transplant health professionals (OTHP) in two medical parties (domestic and overseas) would ensure better quality of care. This project attempted to compare pro and con arguments from the perspective of Taiwan's OTHP. A sample was obtained from three leading medical centers in Taiwan. Eighty subjects including transplant surgeons (n = 20), registered nurses (RN; n = 30), coordinating nurses (OTCN; n = 15), and e-health information and communication technologies experts (ehICTs; n = 15) participated in this research. The pros of developing ehD were: (1) better and continuous care through communication and cooperation in two parties (78%); (2) better collaborative efforts between health professionals, information technology experts in two medical parties is (74%); (3) easier retrieval and communication of personal health documents with the trustworthy OTHP in the different countries (71%); and (4) CC may help develop transplant patients medical cloud based on the collaboration between medical systems in political parties of Taiwan and mainland China (69%). The cons of developing ehD and CC included: (1) inadequate knowledge of benefits and manuals of developing ehD and CC (75%); (2) no reliable communication avenues in developing ehD and CC (73%); (3) increased workload in direct care and documentation in developing new ehD and CC (70%); (4) lack of coaching and accreditation systems in medical, electronic, and law aspects to settle discrepancies in medical diagnosis and treatment protocols between two parties (68%); and (5) lacking systematic ehD and CC plans developed by interdisciplinary teams in two parties (60%). In this initial phase, the establishment of an interdisciplinary team including transplant leaders, transplant surgeon, RN, OTCN, ehICTs, and law experts from two parties might be helpful in working out developing plans with careful monitoring

  19. Implementation of the IHR Joint External Evaluation: Taiwan's Experiences.

    PubMed

    Lo, Yi-Chun

    In February 2016, the World Health Organization developed the Joint External Evaluation (JEE) tool to independently assess country capacity to prevent, detect, and respond to public health threats as part of the International Health Regulations (IHR) (2005) monitoring and evaluation framework. In light of this, the Taiwan government actively engaged at least 19 government agencies or institutions and voluntarily implemented the JEE. An External Assessment Team consisting of 6 US subject matter experts conducted the external evaluation, including site visits, from June 21 to July 1, 2016. The results, published on October 18, 2016, are useful and will be translated into actions and change in the system. Based on Taiwan's experiences, early stakeholder engagement and an experts' pre-JEE pilot visit would contribute to a successful JEE process.

  20. Association of ultrafine particles with cardiopulmonary health among adult subjects in the urban areas of northern Taiwan.

    PubMed

    Liu, Jun-Yu; Hsiao, Ta-Chih; Lee, Kang-Yun; Chuang, Hsiao-Chi; Cheng, Tsun-Jen; Chuang, Kai-Jen

    2018-06-15

    The association between short-term exposure to particulate air pollution, especially fine particles, and cardiopulmonary health has been well-established in previous studies. However, previous findings regarding the effect of ultrafine particles (UFPs) on cardiopulmonary health are inconsistent. We repeatedly measured the mass concentrations of UFPs using a Micro-Orifice Uniform Deposit Impactor (MOUDI) in the apartments of 100 adult participants and collected the participants' health data from the pulmonary outpatient unit of Shuang-Ho Hospital to investigate the association between short-term exposure to UFPs and cardiopulmonary health using mixed-effects models from January 1, 2014 to August 31, 2017. We also collected ambient air pollution monitoring data from the Taiwan Environmental Protection Administration for data analysis. We observed that an interquartile range increase in the 24-hour mean UFPs (0.97 μg/m 3 ) was associated with a 6.3% [95% confidence interval (CI) = 2.9, 9.7], 5.6% (95% CI = 4.1, 7.1) and 8.5% (95% CI = 3.9, 13.1) increase in systolic blood pressure, diastolic blood pressure and high sensitivity-C-reactive protein, respectively. We also observed the association of particulate matter less than or equal to 2.5 μm in diameter and nitrogen dioxide with increased blood pressure and ozone with decreased lung function. A negative trend between UFPs and forced expiratory volume in the first second was observed. We concluded that short-term exposure to UFPs was associated with cardiovascular health in adult subjects in the urban areas of northern Taiwan. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Agency problems in hospitals participating in self-management project under global budget system in Taiwan.

    PubMed

    Yan, Yu-Hua; Hsu, Shuofen; Yang, Chen-Wei; Fang, Shih-Chieh

    2010-02-01

    The main purposes of this study are to clarify the agency problems in the hospitals participating in self-management project within the context of Global Budgeting Payment System regulated by Taiwan government, and also to provide some suggestions for hospital administrator and health policy maker in reducing the waste of healthcare resources resulting from agency problems. For the purposes above, this study examines the relationships between two agency problems (ex ante moral hazard and ex post moral hazard) aroused among the hospitals and Bureau of National Health Insurance in Taiwan's health care sector. This study empirically tested the theoretical model at organization level. The findings suggest that the hospital's ex ante moral hazards before participating the self-management project do have some influence on its ex post moral hazards after participating the self-management project. This study concludes that the goal conflict between the agents and the principal certainly exist. The principal tries hard to control the expenditure escalation and keep the financial balance, but the agents have to subsist within limited healthcare resources. Therefore, the agency cost would definitely occur due to the conflicts between both parties. According to the results of the research, some suggestions and related management concepts were proposed at the end of the paper.

  2. The East Asian age-friendly cities promotion - Taiwan's experience and the need for an oriental paradigm.

    PubMed

    Chao, Tzuyuan Stessa; Huang, Huiwen

    2016-03-01

    It is the consensus that the rapid increase of the ageing population has become a global phenomenon. In 2007, the World Health Organization (WHO) advanced a handbook called Global Age-friendly Cities: A Guide The core concept of the age-friendly cities (AFC) movement is 'active ageing'. Taiwan became one of the few Asian countries that initially responded to the WHO AFC movement in 2010. Following the guidance set by the WHO, Taiwan began its promotion at a national level, and with local authorities. However, during the advocacy process, the fundamental differences between Eastern and Western cultures in terms of family values and deep-rooted respect for the elderly have raised an awareness of the need for an oriental paradigm. This paper identifies three key elements for AFC promotion in East Asian countries based on an analysis of Taiwan's experience: during needs assessment take collectivism into consideration, during action plans at the community level community leaders' views will be more important (particularism), and when promoting AFC at the institutional level a top-down approach will be more acceptable (high power distance concept). © The Author(s) 2016.

  3. The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis

    PubMed Central

    2012-01-01

    Background Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan. Methods Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models. Results In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95). Conclusion Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides. PMID:22471759

  4. International Ranking of Infant Mortality Rates: Taiwan Compared with European Countries.

    PubMed

    Liang, Fu-Wen; Lu, Tsung-Hsueh; Wu, Mei-Hwan; Lue, Hung-Chi; Chiang, Tung-Liang; Huang, Ya-Li; Chen, Lea-Hua

    2016-08-01

    Rankings of infant mortality rates are commonly cited international comparisons to assess the health status of individual countries. We compared the infant mortality rate of Taiwan with those of European countries for 2004 according to two definitions. First, the countries were ranked on the basis of crude infant, neonatal, and postneonatal mortality rates. The countries were then ranked according to the mortality rates calculated after exclusion of live births with a known birth weight of <1000 g, which is the definition set by the World Health Organization. Taiwan was ranked 11(th), 12(th), and 15(th) among 26 high-income countries for crude infant, neonatal, and postneonatal mortality rates, respectively. The ranks were 12(th), 16(th), and 15(th), respectively, for mortality rates, excluding live births with a birth weight of <1000 g. However, in only seven, four, and 10 countries were the mortality rate ratios statistically significantly lower than Taiwan in infant, neonatal, and postneonatal mortality, respectively, according to the second definition. The ranking of Taiwan was similar (11(th) vs. 12(th)) according the two definitions. However, after consideration of the confidence interval, only six countries (Sweden, Finland, Czech Republic, Belgium, Austria, and Germany) had infant mortality rates statistically significantly lower than those of Taiwan in 2004. Copyright © 2015. Published by Elsevier B.V.

  5. Factors influencing transitional care from adolescents to young adults with cancer in Taiwan: A population-based study.

    PubMed

    Jin, Yo-Ting; Chen, Chin-Mi; Chien, Wu-Chien

    2016-08-02

    To investigate the progress of transition from paediatric to adult health care for patients with cancer in Taiwan's medical system. The data were retrieved from the Longitudinal Health Insurance Database (LHID), which contains the original inpatient and outpatient medical claims data for 1,000,000 enrollees randomly sampled from the NHIRD between 1997 and 2010. Among the 1,411 cancer patients selected for this study, 98.09 % received adult-oriented therapy before the age of 18. In addition, only 1.91 % of the patients received paediatric-oriented therapy during adolescence. The primary factors that determine whether these patients would receive paediatric-oriented therapy or adult-oriented therapy at an early age were as follows: the age of the patient at the first visit and the performance-level of the hospital (p < 0.001). Previous studies conducted in developed countries have demonstrated that the unwillingness of patients to switch from paediatric-oriented therapy to adult-oriented therapy being the major obstacle that hinders the transition process. However, this study revealed a different result: the implementation of the National Health Insurance system in Taiwan makes healthcare affordable for the adolescent patients who may not possess adequate knowledge about paediatric health care and may not appreciate paediatric-oriented therapy, thereby hindering the transition process.

  6. A Nation-Wide Cancer Registry-Based Study of Adenosquamous Carcinoma in Taiwan

    PubMed Central

    Lan, Yuan-Tzu; Huang, Kuo-Hung; Liu, Chien-An; Tai, Ling-Chen; Chen, Ming-Huang; Chao, Yee; Li, Anna Fen-Yau; Chiou, Shih-Hwa; Shyr, Yi-Ming; Wu, Chew-Wun; Fang, Wen-Liang

    2015-01-01

    Background Adenosqamous carcinoma (ASC) is a rare disease involving various organs, yet there are no large-scale population-based comparative studies on ASC among different organs. Methods The incidence and overall survival of ASC among various organs in cases diagnosed in Taiwan from January 1, 2003 to December 31, 2010 were calculated and compared using data from the Taiwan Cancer Registry (TCR). The various organs were classified and divided into three different systems: the female reproductive, respiratory, and alimentary systems. Survival analysis were also compared among 30,850 patients diagnosed as ASC, adenocarcinoma (AC) or squamous cell carcinoma (SCC) in organs with frequent ASC. Results During the study period, a total of 576 ASC cases were diagnosed in Taiwan. The most common primary system was respiratory (73.8%), followed by alimentary (16.2%) and female reproductive (10%). The overall survival were significantly higher for cases involving the female reproductive system, followed by the respiratory and alimentary systems (P = 0.016). The median overall survival were worse in males than females for cases involving the respiratory system (22.4 vs. 31.8 months, P = 0.044). Multivariate analysis showed that age≧65, more advanced T and N categories were independent unfavorable prognostic factors of overall survival in ASC. ASC histology is an independent unfavorable prognostic factor compared with AC and SCC. Conclusions ASC at an old age and more advanced T and N categories were found to be associated with a poor prognosis. PMID:26445240

  7. Electronic health records in an occupational health setting-Part II. Global deployment.

    PubMed

    Bey, Jean M; de Magalhães, Josiane S; Bojórquez, Lorena; Lin, Karen

    2013-03-01

    Electronic medical record systems are being used by more multi-national corporations. This article describes one corporation's considerations and process in successfully deploying a global electronic medical record system to international facilities in Brazil, Mexico, Singapore, and Taiwan. This article summarizes feedback from the experiences of occupational health nurse superusers in these countries. Copyright 2013, SLACK Incorporated.

  8. The sociocultural effects on orthopedic surgeries in Taiwan

    PubMed Central

    Chiu, Shin-Lin; Chu, Chiao-Lee; Lan, Shou-Jen; Chen, Chiu-Liang

    2018-01-01

    Various sociocultural factors affect healthcare-seeking behaviors. In Taiwanese society, superstitions and lunar festivals play important roles in people’s lives. We investigated the impact of “Ghost Month” (the 7th lunar month) and Chinese New Year (the 12th lunar month and the 1st lunar month of the following year) on the number of elective surgeries and emergent surgeries in Taiwan. The number of total knee replacement (TKR) surgeries and proximal femur fracture (PFF) surgeries in each lunar month from 2000 to 2011 were extracted from the Taiwan National Health Insurance Database, a computerized and population-based database. Patients were then sorted by location of residence or gender. The average number of TKR surgeries performed was significantly lower during the 1st, 7th, and 12th lunar months in urban areas, whereas in rural areas this trend was only evident in the 7th and 12th lunar months. There was however, no significant difference in the average number of PFF surgeries in each lunar month except for an increase seen in the 1st lunar month in rural patients (p<0.05). When sorted by gender, the average number of TKR surgeries was significantly decreased in the 7th and 12th lunar months in male patients, and decreased in the 1st, 7th, and 12th lunar months in female patients. In contrast, there was no difference in the average numbers of PFF surgeries in the 7th and 12th lunar months either in male or female patients. We proposed that the timing of elective surgeries such as TKR might be influenced by Ghost Month and Chinese New Year; however, emergent PFF surgeries were not significantly influenced by sociocultural beliefs and taboos in Taiwan. PMID:29596539

  9. Medical malpractice in Taiwan: injury types, compensation, and specialty risk.

    PubMed

    Chen, Kuan-Yu; Yang, Che-Ming; Tsai, Shin-Han; Chiou, Hung-Yi; Lin, Mau-Roung; Chiu, Wen-Ta

    2012-05-01

    The authors analyzed all medical malpractice claims from 2000 to 2008 using cases from the national database of the judicial system of Taiwan. The objective was to describe the factors associated with malpractice claims in Taiwan, a non-Western country that does not have a common law heritage. Emergency physicians (EPs) were the most likely to be sued and made the highest median payments. Most lawsuits involved death or permanent injury. Eighty-two percent of the cases were settled in the physician's favor. © 2012 by the Society for Academic Emergency Medicine.

  10. Impact of universal health coverage on urban–rural inequity in psychiatric service utilisation for patients with first admission for psychosis: a 10-year nationwide population-based study in Taiwan

    PubMed Central

    Chiang, Chih-Lin; Chen, Pei-Chun; Huang, Ling-Ya; Kuo, Po-Hsiu; Tung, Yu-Chi; Liu, Chen-Chung; Chen, Wei J

    2016-01-01

    Objective To examine the disparities in psychiatric service utilisation over a 10-year period for patients with first admission for psychosis in relation to urban–rural residence following the implementation of universal health coverage in Taiwan. Design Population-based retrospective cohort study. Setting Taiwan's National Health Insurance Research Database, which has a population coverage rate of over 99% and contains all medical claim records of a nationwide cohort of patients with at least one psychiatric admission between 1996 and 2007. Participants 69 690 patients aged 15–59 years with first admission between 1998 and 2007 for any psychotic disorder. Main exposure measure Patients’ urban–rural residence at first admissions. Main outcome measures Absolute and relative inequality indexes of the following quality indicators after discharge from the first admission: all-cause psychiatric readmission at 2 and 4 years, dropout of psychiatric outpatient service at 30 days, and emergency department (ED) treat-and-release encounter at 30 days. Results Between 1998 and 2007, the 4-year readmission rate decreased from 65% to 58%, the 30-day dropout rate decreased from 18% to 15%, and the 30-day ED encounter rate increased from 8% to 10%. Risk of readmission has significantly decreased in rural and urban patients, but at a slower speed for the rural patients (p=0.026). The adjusted HR of readmission in rural versus urban patients has increased from 1.00 (95% CI 0.96 to 1.04) in 1998–2000 to 1.08 (95% CI 1.03 to 1.12) in 2005–2007, indicating a mild widening of the urban–rural gap. Urban–rural differences in 30-day dropout and ED encounter rates have been stationary over time. Conclusions The universal health coverage in Taiwan did not narrow urban–rural inequity of psychiatric service utilisation in patients with psychosis. Therefore, other policy interventions on resource allocation, service delivery and quality of care are needed to improve

  11. Increasing utilization of Internet-based resources following efforts to promote evidence-based medicine: a national study in Taiwan.

    PubMed

    Weng, Yi-Hao; Kuo, Ken N; Yang, Chun-Yuh; Lo, Heng-Lien; Shih, Ya-Hui; Chen, Chiehfeng; Chiu, Ya-Wen

    2013-01-07

    Since the beginning of 2007, the National Health Research Institutes has been promoting the dissemination of evidence-based medicine (EBM). The current study examined longitudinal trends of behaviors in how hospital-based physicians and nurses have searched for medical information during the spread of EBM. Cross-sectional postal questionnaire surveys were conducted in nationally representative regional hospitals of Taiwan thrice in 2007, 2009, and 2011. Demographic data were gathered concerning gender, age, working experience, teaching appointment, academic degree, and administrative position. Linear and logistic regression models were used to examine predictors and changes over time. Data from physicians and nurses were collected in 2007 (n = 1156), 2009 (n = 2975), and 2011 (n = 3999). There were significant increases in the use of four Internet-based resources - Web portals, online databases, electronic journals, and electronic books - across the three survey years among physicians and nurses (p < 0.001). Access to textbooks and printed journals, however, did not change over the 4-year study period. In addition, there were significant relationships between the usage of Internet-based resources and users' characteristics. Age and faculty position were important predictors in relation to the usage among physicians and nurses, while academic degree served as a critical factor among nurses only. Physicians and nurses used a variety of sources to look for medical information. There was a steady increase in use of Internet-based resources during the diffusion period of EBM. The findings highlight the importance of the Internet as a prominent source of medical information for main healthcare professionals.

  12. Surgeon and hospital volume as quality indicators for CABG in Taiwan: examining hazard to mortality and accounting for unobserved heterogeneity.

    PubMed

    Hockenberry, Jason M; Lien, Hsien-Ming; Chou, Shin-Yi

    2010-10-01

    To investigate whether provider volume has an impact on the hazard of mortality for coronary artery bypass grafting (CABG) patients in Taiwan. Multiple sources of linked data from the National Health Insurance Program in Taiwan. The linked data were used to identify 27,463 patients who underwent CABG without concomitant angioplasty or valve procedures and the surgeon and hospital volumes. Generalized estimating equations and hazard models were estimated to assess the impact of volume on mortality. The hazard modeling technique used accounts for bias stemming from unobserved heterogeneity. Both surgeon and hospital volume quartiles are inversely related to the hazard of mortality after CABG. Patients whose surgeon is in the three higher volume quartiles have lower 1-, 3-, 6-, and 12-month mortality after CABG, while only those having their procedure performed at the highest quartile of volume hospitals have lower mortality outcomes. Mortality outcomes are related to provider CABG volume in Taiwan. Unobserved heterogeneity is a concern in the volume-outcome relationship; after accounting for it, surgeon volume effects on short-term mortality are large. Using models controlling for unobserved heterogeneity and examining longer term mortality may still differentiate provider quality by volume. Copyright © Health Research and Educational Trust.

  13. Brain cancer associated with environmental lead exposure: evidence from implementation of a National Petrol-Lead Phase-Out Program (PLPOP) in Taiwan between 1979 and 2007.

    PubMed

    Wu, Wei-Te; Lin, Yu-Jen; Liou, Saou-Hsing; Yang, Chun-Yuh; Cheng, Kuang-Fu; Tsai, Perng-Jy; Wu, Trong-Neng

    2012-04-01

    In 1981, a Petrol-Lead Phase-Out Program (PLPOP) was launched in Taiwan for the abatement of environmental lead emissions. The present study was intended to examine whether the high Petrol-Lead Emission Areas (PLEA) would result in an increase in the incidence rate of brain cancer based on a national data bank. The national brain cancer incidence data was obtained from the Taiwan National Cancer Registry. Age standardized incidence rates were calculated based on the 2000 WHO world standard population, and gasoline consumption data was obtained from the Bureau of Energy. The differences in the trend tests for age-standardized incidence rates of brain cancer between high, median, low, and small PLEA were analyzed. A significant increase was found from small to high PLEA in age-standardized incidence rates of brain cancer. By taking six possible confounders into account, the age-standardized incidence rates for brain cancer were highly correlated with the median and high PLEA by reference to the small PLEA. After being adjusted for a number of relevant confounders, it could be concluded that high PLEA might result in an increase in the incidence rate of brain cancer resulting from high lead exposures. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Risk factor and cost accounting analysis for dialysis patients in Taiwan.

    PubMed

    Su, Bin-Guang; Tsai, Kai-Li; Yeh, Shu-Hsing; Ho, Yi-Yi; Liu, Shin-Yi; Rivers, Patrick A

    2010-05-01

    According to the 2004 US Renal Data System's annual report, the incidence rate of chronic renal failure in Taiwan increased from 120 to 352 per million populations between 1990 and 2003. This incidence rate is the highest in the world. The prevalence rate, which ranks number two in the world (Japan ranks number one), also increased from 384 to 1630 per million populations. Based on 2005 Taiwan national statistics, there were 52,958 end-stage renal disease (ESRD) patients receiving routine dialysis treatment. This number, which comprised less than 0.2% of the total population and consumed $2.6 billion New Taiwan dollars, was more than 6.12% of the total annual spending of national health insurance during 2005. Dialysis expenditures for patients with ESRD rank the highest among all major injuries (traumas) and diseases. This article identifies and discusses the risk factors associated with consumption of medical resources during dialysis. Instead of using reimbursement data to estimate cost, as seen in previous studies, this study uses cost data within organizations and focuses on evaluating and predicting the resource consumption pattern for dialysis patients with different risk factors. Multiple regression analysis was used to identify 23 risk factors for routine dialysis patients. Of these risk factors, six were associated with the increase of dialysis cost: age (i.e. 75 years old and older), liver function disorder, hypertension, bile-duct disorder, cancer and high blood lipids. Patients with liver function disorder incurred much higher costs for injection medication and supplies. Hypertensive patients incurred higher costs for injection medication, supplies and oral medication. Patients with bile-duct disorder incurred a significant difference in check-up costs (i.e. costs were higher for those aged 75 years and older than those who were younger than 30 years of age). Cancer patients also incurred significant differences in cost of medical supplies. Patients

  15. The development and regulation of occupational exposure limits in Taiwan.

    PubMed

    Shih, Tung-Sheng; Wu, Kuen-Yuh; Chen, Hong-I; Chang, Cheng-Ping; Chang, Ho-Yuan; Huang, Yi-Shiao; Liou, Saou-Hsing

    2006-11-01

    The occupational exposure limits (OELs) in Taiwan was promulgated in 1974 and has been revised five times since then. Many of the OELs were adopted from the most recent ACGIH TLVs and US OSHA PELs. A total of 483 chemicals were listed in the current Taiwan OELs Standard. The procedures of OELs development in Taiwan include the IOSH organized a recommended exposure limits (RELs) Committee to select the target chemicals and to recommend the RELs through literature review based on the health effects in the first stage, then, the CLA put policy needs, economical and technical feasibility into consideration and set up the final OELs at the second stage. A standard operation manual of RELs Committee has been developed. Based on our experience, several issues including the participation of representatives from a comprehensive spectrum, communication/education and training/enforcement, continuous collection of the local exposure data and health hazard information, use of health risk assessment, consideration of economic, and technical feasibility, as well as the globalization and information and experience sharing are critical in developing the appropriate OELs. Three examples including benzene, crystalline silica, and 2-methoxy ethanol are given to demonstrate the operation of system.

  16. Importance-Performance Analysis of Personal Health Records in Taiwan: A Web-Based Survey

    PubMed Central

    Rau, Hsiao-Hsien; Chen, Kang-Hua

    2017-01-01

    Background Empowering personal health records (PHRs) provides basic human right, awareness, and intention for health promotion. As health care delivery changes toward patient-centered services, PHRs become an indispensable platform for consumers and providers. Recently, the government introduced “My health bank,” a Web-based electronic medical records (EMRs) repository for consumers. However, it is not yet a PHR. To date, we do not have a platform that can let patients manage their own PHR. Objective This study creates a vision of a value-added platform for personal health data analysis and manages their health record based on the contents of the "My health bank." This study aimed to examine consumer expectation regarding PHR, using the importance-performance analysis. The purpose of this study was to explore consumer perception regarding this type of a platform: it would try to identify the key success factors and important aspects by using the importance-performance analysis, and give some suggestions for future development based on it. Methods This is a cross-sectional study conducted in Taiwan. Web-based invitation to participate in this study was distributed through Facebook. Respondents were asked to watch an introductory movie regarding PHR before filling in the questionnaire. The questionnaire was focused on 2 aspects, including (1) system functions, and (2) system design and security and privacy. The questionnaire would employ 12 and 7 questions respectively. The questionnaire was designed following 5-points Likert scale ranging from 1 (“disagree strongly”) to 5 (“Agree strongly”). Afterwards, the questionnaire data was sorted using IBM SPSS Statistics 21 for descriptive statistics and the importance-performance analysis. Results This research received 350 valid questionnaires. Most respondents were female (219 of 350 participants, 62.6%), 21-30 years old (238 of 350 participants, 68.0%), with a university degree (228 of 350 participants, 65

  17. Taiwan: Background Notes Series.

    ERIC Educational Resources Information Center

    Reams, Joanne Reppert

    Concise background information on Taiwan is provided. The publication begins with a profile of Taiwan, discussing the people, geography, political establishment, and economy. A map of the country is provided. The bulk of the publication then provides more detailed information on Taiwan's people, geography, history, administration, political…

  18. Changes in the use of complementary and alternative medicine in Taiwan: a comparison study of 2007 and 2011.

    PubMed

    Chang, Mei-Ying; Liu, Chieh-Yu; Chen, Hsiao-Yu

    2014-06-01

    In this study, we explored the differences in the use of complementary and alternative medicine (CAM) based on data from 2007 and 2011 national surveys in Taiwan. Two cross-sectional, community-based epidemiological surveys were conducted in Taiwan. Participants 18 years and older were interviewed regarding their CAM use in the previous 12 months. Nationally representative random-household telephone surveys using a sampling method with a probability proportional to size were conducted in 2007 and 2011. The data were analysed to compare the results between surveys. We obtained a total of 1260 and 2266 valid responses in 2007 and 2011, respectively. The use of at least one or more CAM therapies during the previous year decreased from 48.9% in 2007 to 37.8% in 2011 (p < .001). In both surveys, the most common CAM therapies used were Chinese medicinal herbs followed by health supplement products and tuina. We observed the greatest relative increase in CAM use between 2007 and 2011 in health supplement products (12.8% vs. 16.0%) and massage (1.3% vs. 2.9%), whereas the largest relative decrease occurred for tuina (24.4-13.4%) and Chinese medicinal herbs (31.6-25.4%). Widespread CAM use reflects a more personal orientation towards maintaining health and selecting health care support services. Thus, a set of standards should be established for the safety and effectiveness of therapies, and consensus building is required to overcome the differences among practitioners from various backgrounds and traditions. Copyright © 2014. Published by Elsevier Ltd.

  19. Taiwan Space Programs

    NASA Astrophysics Data System (ADS)

    Liu, Jann-Yenq

    collection and analysis can be completed in three hours while the sounding data is updated every 90 minutes for updating weather forecast. In addition, this system can also be used as the long-term climate change research, interactive ionosphere monitoring, global space weather forecast, and earth gravity research. From 1997 to 2003, there are three launches of sounding rockets. To compliment the second phase of Taiwan's national space technology long-term development plan, the sounding rocket space exploration project was established. The timeframe of the second phase sounding rocket project is 15 years, from January 2004 to December 2018, and 10 15 sounding rockets will be launched during this time period. In this paper, the current status and results of the programs are presented in detail.

  20. Health hazards and mitigation of chronic poisoning from arsenic in drinking water: Taiwan experiences.

    PubMed

    Chen, Chien-Jen

    2014-01-01

    There are two endemic areas of long-term exposure to arsenic from drinking water in Taiwan. Residents in the southwestern and northeastern endemic areas started using high-arsenic artesian well water in the early 1910s and late 1940s, respectively. Public water supply system using surface water was implemented in southwestern and northeastern endemic areas in the 1970s and 1990s, respectively. Systemic health hazards of long-term exposure to arsenic in drinking water have been intensively investigated since the 1960s, especially after 1985 in Taiwan. Several diseases have been well documented to be associated with chronic arsenic poisoning from drinking water showing a dose-response relation. They include characteristic skin lesions like hyperpigmentation or depigmentation, hyperkeratosis in palms and soles, and Bowen disease, peripheral vascular disease (specifically blackfoot disease), ischemic heart disease, cerebral infarction, microvascular diseases, abnormal peripheral microcirculation, carotid atherosclerosis, QT prolongation and increased dispersion in electrocardiography, hypertension, goiter, diabetes mellitus, cataract (specifically posterior subcapsular lens opacity), pterygium, slow neural conduction, retarded neurobehavioral development, erectile dysfunction, and cancers of the skin, lung, urinary bladder, kidney, and liver. The method of choice to mitigate arsenic poisoning through drinking water is to use safe drinking water from uncontaminated sources.

  1. Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan.

    PubMed

    Shih, Shu-Fang; Liu, Chieh-Hsing; Liao, Li-Ling; Osborne, Richard H

    2016-03-22

    Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children. Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese. This study demonstrates strong links

  2. The impact of the cigarette market opening in Taiwan

    PubMed Central

    Wen, C; Cheng, T; Eriksen, M; Tsai, S; Hsu, C

    2005-01-01

    Objective: To assess the effect of the opening of the Taiwanese cigarette market on cigarette consumption, changes in market share, and the effects on tobacco control efforts. Methods: With the use of key word "Taiwan", the Legacy Tobacco Documents Library of the University of California, San Francisco, was searched for internal documents related to smuggling activities, promotion of light cigarettes, and market share analyses in Taiwan. Age adjusted smoking rates and cigarette and betel quid consumption before and after market opening were compared. Results: By 2000, the market share of imported cigarettes increased from less than 2% in 1986 to nearly 50%, and per capita cigarette consumption increased 15% following market opening. Because of the sharp increase in smuggling, with contraband cigarettes being as popular as legal imports, and the rapid proliferation of retail outlets, such as betel quid stalls, the market penetration by foreign tobacco companies was greater in Taiwan than among the other Super 301 Asian countries. Aggressive cigarette marketing strategies were associated with a 6% increase in adult male smoking prevalence, and with a 13% increase in the youth rate, within three years after market opening. The market opening also had an incidental effect on increasing the popularity of betel quid. Betel quid chewing has since become a major public health problem in Taiwan. Conclusion: The opening of the cigarette market in 1987 had a long lasting impact on Taiwan. It increased smoking prevalence and the market has become dominated by foreign companies. The seriousness of smuggling and its associated loss of revenue by the government, the extent of increased youth smoking and its associated future health care costs, and the increased use of betel quid and the associated doubling of oral cancer mortality rates each pose significant problems to Taiwan. However, the market opening galvanised anti-smoking sentiment and forced the government to initiate and

  3. The impact of the cigarette market opening in Taiwan.

    PubMed

    Wen, C P; Cheng, T Y; Eriksen, M P; Tsai, S P; Hsu, C C

    2005-06-01

    To assess the effect of the opening of the Taiwanese cigarette market on cigarette consumption, changes in market share, and the effects on tobacco control efforts. With the use of key word "Taiwan", the Legacy Tobacco Documents Library of the University of California, San Francisco, was searched for internal documents related to smuggling activities, promotion of light cigarettes, and market share analyses in Taiwan. Age adjusted smoking rates and cigarette and betel quid consumption before and after market opening were compared. By 2000, the market share of imported cigarettes increased from less than 2% in 1986 to nearly 50%, and per capita cigarette consumption increased 15% following market opening. Because of the sharp increase in smuggling, with contraband cigarettes being as popular as legal imports, and the rapid proliferation of retail outlets, such as betel quid stalls, the market penetration by foreign tobacco companies was greater in Taiwan than among the other Super 301 Asian countries. Aggressive cigarette marketing strategies were associated with a 6% increase in adult male smoking prevalence, and with a 13% increase in the youth rate, within three years after market opening. The market opening also had an incidental effect on increasing the popularity of betel quid. Betel quid chewing has since become a major public health problem in Taiwan. The opening of the cigarette market in 1987 had a long lasting impact on Taiwan. It increased smoking prevalence and the market has become dominated by foreign companies. The seriousness of smuggling and its associated loss of revenue by the government, the extent of increased youth smoking and its associated future health care costs, and the increased use of betel quid and the associated doubling of oral cancer mortality rates each pose significant problems to Taiwan. However, the market opening galvanised anti-smoking sentiment and forced the government to initiate and intensify a series of tobacco control

  4. Development of Activity and Participation Norms among General Adult Populations in Taiwan.

    PubMed

    Yen, Chia-Feng; Chiu, Tzu-Ying; Liou, Tsan-Hon; Chi, Wen-Chou; Liao, Hua-Fang; Liang, Chung-Chao; Escorpizo, Reuben

    2017-06-06

    Based on the International Classification of Functioning, Disability, and Health (ICF) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), The Functioning Disability Evaluation Scale-Adult version (FUNDES-Adult) began development in 2011. The FUNDES-Adult was designed to assess the difficulty level of an individual's activities and participation in daily life. There is a lack of research regarding the profile of activity and participation for the general adult population. The purposes of this study were to establish activity and participation norms for the general adult population in Taiwan and to describe, discuss, and compare the activity and participation profile with other population. A population-based survey was administered in 2013 using a computer-assisted telephone interviewing system (CATI system). Using probability proportional to size (PPS) sampling and systematic sampling with random digit dialing (RDD), 1500 adults from Taiwan's general population were selected to participate in the survey. The FUNDES-Adult with six domains and two dimensions (performance and capability) was used to obtain data on activities and participation levels. A higher domain score indicated higher participation restriction. Approximately 50% of the respondents were male, and the average age of the respondents was 45.23 years. There were no significant differences in the demographic features between the sample and the population. Among the six domains, the self-care domain score was the lowest (least restriction) and the participation domain score was the highest (most restriction). Approximately 90% of the sample scored were less than 15, and only 0.1% scored more than 80. This is the first cross-national population-based survey to assess norms of activity and participation relevant to the general population of Taiwan. As such, the results of this survey can be used as a reference for comparing the activity and participation (AP) functioning of

  5. Stockpile Model of Personal Protective Equipment in Taiwan.

    PubMed

    Chen, Yu-Ju; Chiang, Po-Jung; Cheng, Yu-Hsin; Huang, Chun-Wei; Kao, Hui-Yun; Chang, Chih-Kai; Huang, Hsun-Miao; Liu, Pei-Yin; Wang, Jen-Hsin; Chih, Yi-Chien; Chou, Shu-Mei; Yang, Chin-Hui; Chen, Chang-Hsun

    The Taiwan Centers for Disease Control (Taiwan CDC) has established a 3-tier personal protective equipment (PPE) stockpiling framework that could maintain a minimum stockpile for the surge demand of PPE in the early stage of a pandemic. However, PPE stockpiling efforts must contend with increasing storage fees and expiration problems. In 2011, the Taiwan CDC initiated a stockpile replacement model in order to optimize the PPE stockpiling efficiency, ensure a minimum stockpile, use the government's limited funds more effectively, and achieve the goal of sustainable management. This stockpile replacement model employs a first-in-first-out principle in which the oldest stock in the central government stockpile is regularly replaced and replenished with the same amount of new and qualified products, ensuring the availability and maintenance of the minimum stockpiles. In addition, a joint electronic procurement platform has been established for merchandising the replaced PPE to local health authorities and medical and other institutions for their routine or epidemic use. In this article, we describe the PPE stockpile model in Taiwan, including the 3-tier stockpiling framework, the operational model, the components of the replacement system, implementation outcomes, epidemic supports, and the challenges and prospects of this model.

  6. Space programs in Taiwan

    NASA Astrophysics Data System (ADS)

    Lee, Lou-Chuang; Chang, Guey-Shin; Ting, Nan-Hong

    2013-10-01

    Taiwan's current and future space programs are briefly introduced in this paper. The National Space Organization (NSPO) in Taiwan has successfully carried out three satellite programs (FORMOSAT-1, 2, &3) since its establishment in 1991. FORMOSAT-1 is a scientific satellite performing three scientific experiments for measuring the density, velocity and temperature of ionospheric plasmas, taking the ocean color image, and conducting Ka-band communication experiments. Equipped with a 2m ground resolution remote sensing instrument, FORMOSAT-2 operates in a sun-synchronous orbit with revisit time equal to one day. This unique feature of the daily revisit capability is significantly useful for post disaster assessment and environmental monitoring. FORMOSAT-2 also carries a scientific payload "Imager of Sprites and Upper Atmospheric Lightning (ISUAL)". ISUAL provides the world's first long-term satellite observations on the lighting phenomenon in the earth's upper atmosphere. FORMOSAT-3 is a constellation of six micro-satellites to collect atmospheric and ionospheric data for weather prediction and for climate, ionosphere, and geodesy research. FORMOSAT-3 has demonstrated the ability to significantly increase the accuracy of weather forecasting by utilizing the GPS Radio Occultation (GPS-RO) technique. Currently, NSPO is pursuing the follow-on space missions of FORMOSAT-5 and FORMOSAT-7. FORMOSAT-5 will be the first to utilize a CMOS detector on a high-resolution earth-observation camera. FORMOSAT-7 is a joint mission of Taiwan/US to deploy a 12-satellite constellation operational system to provide dense and timely GNSS RO data to the global communities for real-time weather forecast as well as space science research.

  7. Diabetes-related avoidable hospitalizations in Taiwan.

    PubMed

    Kornelius, Edy; Huang, Chien-Ning; Yang, Yi-Sun; Lu, Ying-Li; Peng, Chiung-Huei; Chiou, Jeng-Yuan

    2014-12-01

    An avoidable hospitalization (AH) is a condition that could have been prevented through effective treatment in outpatient care. Diabetes is often referred to as an ambulatory care-sensitive condition, and its associated hospitalizations are often referred to as avoidable hospitalizations. There are limited data on avoidable hospitalizations for individuals with diabetes in Taiwan. We used the National Health Interview Survey (NHIS) dataset to obtain diabetes-related avoidable hospitalizations for subjects aged above 12 years. We included data from 20,826 subjects who had completed the interview between 2004 and 2005. Data were collected from a total of 15,574 people, who had agreed to link their health information to the Taiwan National Health Insurance Research Database, including basic demographic variables, inpatient or outpatient medical events, admission date, discharge date, and diagnosis. The 1005 individuals who self-reported having diabetes or had at least 1 hospitalization or 2 physician service claims for diabetes mellitus with an ICD-9 diagnosis of 250 were included in the analysis. We divided those with diagnosis of diabetes into two groups: never hospitalized and hospitalized. The never hospitalized group served as the control group. We further identified hospitalized subjects with long-term complications due to diabetes (PQI-3) that included ICD-CM codes 250.4-250.9. The mean ages of patients with diabetes-related long-term complications in the hospitalized and never hospitalized groups were 65 years and 58 years, respectively (p-value<0.01). More than half (52%) of the patients with diabetes-related long-term complications had a body mass index (BMI) lower than 24. The hospitalized group also had lower educational status compared with that of patients in the never hospitalized group (equal to or lower than elementary school, 63% vs. 50%; junior high school, 23% vs. 14%; equal or higher than senior high school, 14% vs. 36%). Furthermore, hospitalized

  8. [The parenting practices of transnational marriage mothers in Taiwan].

    PubMed

    Chuang, Li-Yu; Shu, Bih-Ching; Huang, Chiung-Chen

    2013-02-01

    Childhood experience is a cornerstone of personality development. A child's cognitive function, self-concept, and behavioral development relate significantly to parental attitudes as well as to the way they were treated during childhood. The literature suggests a significant association between parenting practices and the mental health of the parents, temperament of the child, and socio-cultural factors. Raising children is typically central to the life of transnational marriage women living in Taiwan. They view parenting children as a life transforming experience. However, they must invest more effort than local mothers to survive in Taiwan. Thus, it is worth investigating the parenting practices of this significant subset of Taiwan's population. This paper applied parenting concepts to describe the condition and possible problems of immigrant women in parenting children. Based on study results, we summarize transnational marriage and its impact on parenting practices. The authors hope this paper provides information useful to identifying parenting difficulties faced by immigrant mothers so that healthcare professionals can provide relevant information and assistance to improve overall parenting practices and benefit the development of Taiwan's youngest generation.

  9. What Do China’s Military Reforms Mean for Taiwan

    DTIC Science & Technology

    2016-10-01

    is a Research Fellow in the Center for the Study of Chinese Military Affairs, Institute for National Strategic Studies, at the National Defense...organizations directly under the CMC, where they can be more closely scrutinized. Another strengthens auditing and discipline inspection functions...developing doctrine and conduct- ing training and operations relevant to a Taiwan contingency. The PLA is already instituting professional military

  10. Geographic Variations and Time Trends in Cancer Treatments in Taiwan.

    PubMed

    Hsu, Jason C; Chang, Sheng-Mao; Lu, Christine Y

    2017-08-02

    Targeted therapies have become important treatment options for cancer care in many countries. This study aimed to examine recent trends in utilization of antineoplastic drugs, particularly the use of targeted therapies for treatment of cancer, by geographic region in Taiwan (northern, midwestern, southern, and eastern regions and the outer islands). This was a retrospective observational study of antineoplastic agents using 2009-2012 quarterly claims data from Taiwan's National Health Insurance Research Database. Yearly market shares by prescription volume and costs for targeted therapies among total antineoplastic agents by region were estimated. We used multivariate regression model and ANOVA to examine variations in utilization of targeted therapies between geographic regions and used ARIMA models to estimate longitudinal trends. Population-adjusted use and costs of antineoplastic drugs (including targeted therapies) were highest in the southern region of Taiwan and lowest in the outer islands. We found a 4-fold difference in use of antineoplastic drugs and a 49-fold difference in use of targeted therapies between regions if the outer islands were included. There were minimal differences in use of antineoplastic drugs between other regions with about a 2-fold difference in use of targeted therapies. Without considering the outer islands, the market share by prescription volume and costs of targeted therapies increased almost 2-fold (1.84-1.90) and 1.5-fold (1.26-1.61) respectively between 2009 and 2012. Furthermore, region was not significantly associated with use of antineoplastic agents or use of targeted therapies after adjusting for confounders. Region was associated with costs of antineoplastic agents but it was not associated with costs of targeted therapies after confounding adjustments. Use of antineoplastic drugs overall and use of targeted therapies for treatment of cancer varied somewhat between regions in Taiwan; use was notably low in the outer

  11. Indigenous Wildlife Rabies in Taiwan: Ferret Badgers, a Long Term Terrestrial Reservoir.

    PubMed

    Lan, Yu-Ching; Wen, Tzai-Hung; Chang, Chao-Chin; Liu, Hsin-Fu; Lee, Pei-Fen; Huang, Chung-Yuan; Chomel, Bruno B; Chen, Yi-Ming A

    2017-01-01

    The emerging disease of rabies was confirmed in Taiwan ferret badgers (FBs) and reported to the World Organization for Animal Health (OIE) on July 17, 2013. The spread of wildlife rabies can be related to neighborhood countries in Asia. The phylogenetic analysis was conducted by maximum likelihood (ML) methods and the Bayesian coalescent approach based on the glycoprotein (G) and nucleoprotein (N) genes. The phylogeographic and spatial temporal dynamics of viral transmission were determined by using SPREAD, QGIS. Therefore, the origin and the change with time of the viruses can be identified. Results showed the rabies virus of FB strains in Taiwan is a unique clade among other strains in Asia. According to the phylogeographic coalescent tree, three major genotypes of the FB rabies virus have circulated in three different geographical areas in Taiwan. Two genotypes have distributed into central and southern Taiwan between two ecological river barriers. The third genotype has been limited in southeastern Taiwan by the natural mountain barrier. The diversity of FB rabies viruses indicates that the biological profile of FBs could vary in different geographical areas in Taiwan. An enhanced surveillance system needs to be established near the currently identified natural barriers for early warnings of the rabies virus outbreak in Taiwan.

  12. Indigenous Wildlife Rabies in Taiwan: Ferret Badgers, a Long Term Terrestrial Reservoir

    PubMed Central

    Wen, Tzai-Hung; Liu, Hsin-Fu; Lee, Pei-Fen; Chomel, Bruno B.

    2017-01-01

    The emerging disease of rabies was confirmed in Taiwan ferret badgers (FBs) and reported to the World Organization for Animal Health (OIE) on July 17, 2013. The spread of wildlife rabies can be related to neighborhood countries in Asia. The phylogenetic analysis was conducted by maximum likelihood (ML) methods and the Bayesian coalescent approach based on the glycoprotein (G) and nucleoprotein (N) genes. The phylogeographic and spatial temporal dynamics of viral transmission were determined by using SPREAD, QGIS. Therefore, the origin and the change with time of the viruses can be identified. Results showed the rabies virus of FB strains in Taiwan is a unique clade among other strains in Asia. According to the phylogeographic coalescent tree, three major genotypes of the FB rabies virus have circulated in three different geographical areas in Taiwan. Two genotypes have distributed into central and southern Taiwan between two ecological river barriers. The third genotype has been limited in southeastern Taiwan by the natural mountain barrier. The diversity of FB rabies viruses indicates that the biological profile of FBs could vary in different geographical areas in Taiwan. An enhanced surveillance system needs to be established near the currently identified natural barriers for early warnings of the rabies virus outbreak in Taiwan. PMID:28497055

  13. Learning Vietnamese as a Heritage Language in Taiwan

    ERIC Educational Resources Information Center

    Yeh, Yu-Ching; Ho, Hsiang-Ju; Chen, Ming-Chung

    2015-01-01

    In 2011, the Taiwanese Government began a campaign to encourage new immigrants to teach their native languages (heritage languages) to their children. However, these heritage languages are seldom used in cross-national families and the effectiveness of formal heritage language courses in Taiwan has yet to be explored. The present study examines…

  14. Challenges and Opportunities Facing Technology Education in Taiwan

    ERIC Educational Resources Information Center

    Lee, Lung-Sheng Steven

    2009-01-01

    The technology education in Taiwan is prescribed in the national curriculum and provided to all students in grades 1-12. However, it faces the following challenges: (1) Lack of worthy image, (2) Inadequate teachers in elementary schools, (3) Deficient teaching vitality in secondary schools, and (4) Diluted technology teacher education programs. In…

  15. Diffusion patterns of new anti-diabetic drugs into hospitals in Taiwan: the case of Thiazolidinediones for diabetes

    PubMed Central

    2011-01-01

    Background Diffusion of new drugs in the health care market affects patients' access to new treatment options and health care expenditures. We examined how a new drug class for diabetes mellitus, thiazolidinediones (TZDs), diffused in the health care market in Taiwan. Methods Assuming that monthly hospital prescriptions of TZDs could serve as a micro-market to perform drug penetration studies, we retrieved monthly TZD prescription data for 580 hospitals in Taiwan from Taiwan's National Health Insurance Research Database for the period between March 1, 2001 and December 31, 2005. Three diffusion parameters, time to adoption, speed of penetration (monthly growth on prescriptions), and peak penetration (maximum monthly prescription) were evaluated. Cox proportional hazards model and quantile regressions were estimated for analyses on the diffusion parameters. Results Prior hospital-level pharmaceutical prescription concentration significantly deterred the adoption of the new drug class (HR: 0.02, 95%CI = 0.01 to 0.04). Adoption of TZDs was slower in district hospitals (HR = 0.43, 95%CI = 0.24 to 0.75) than medical centers and faster in non-profit hospitals than public hospitals (HR = 1.79, 95%CI = 1.23 to 2.61). Quantile regression showed that penetration speed was associated with a hospital's prior anti-diabetic prescriptions (25%Q: 18.29; 50%Q: 25.57; 75%Q: 30.97). Higher peaks were found in hospitals that had adopted TZD early (25%Q: -40.33; 50%Q: -38.65; 75%Q: -32.29) and in hospitals in which the drugs penetrated more quickly (25%Q: 16.53; 50%Q: 24.91; 75%Q: 31.50). Conclusions Medical centers began to prescribe TZDs earlier, and they prescribed more TZDs at a faster pace. The TZD diffusion patterns varied among hospitals depending accreditation level, ownership type, and prescription volume of Anti-diabetic drugs. PMID:21281475

  16. A GIS-aided assessment of the health hazards of cadmium in farm soils in central Taiwan.

    PubMed

    Chiang, Po-Huang; Chan, Ta-Chien; Hsieh, Dennis P H

    2011-09-01

    A geostatistical method was developed to examine the correlation, or lack of it, between the levels of cadmium (Cd) detected in farm soils and those detected in the human specimens collected from residents around the contaminated areas in Changhua County where cadmium contamination of staple rice has been documented. We used the Taiwan EPA environment data in 2002 and human data which were generated by the National Health Research Institutes during 2003-2005. Kriging interpolation methods were used to determine soil Cd concentrations. A Zonal statistical function was performed to assess the individual exposure. Soil Cd levels and tissue Cd levels in residents were analyzed for contamination hotspots and other areas to determine correlation between the two variables. Three Cd contamination hotspots were identified, in which no correlation was found between soil Cd levels and tissue Cd levels in residents. Our results demonstrate how GIS spatial modeling technique can be used to estimate distribution of pollutants in an area using a limited number of data points. Results indicated no association between the soil contamination and the exposure of residents to Cd, suggesting that both the soils and the residents are receptors of Cd as a pollutant from as yet unidentified sources.

  17. Trends in the prevalence of periodontitis in Taiwan from 1997 to 2013

    PubMed Central

    Yu, Hui-Chieh; Su, Ni-Yu; Huang, Jing-Yang; Lee, Shiuan-Shinn; Chang, Yu-Chao

    2017-01-01

    Abstract Periodontitis is one of the most prevalent oral diseases. In this study, we probed the nationwide registered database to assess the time trends of prevalence of periodontitis in Taiwan. A retrospective study was conducted to analyze the registered database compiled by the National Health Insurance provided by the Department of Health, Taiwan, from 1997 to December 2013. We found that the prevalence of periodontitis significantly increased from 11.5% in 1997 to 19.59% in 2013 (P for trend < .0001). The mean age ± standard deviation with periodontitis from 1997 to 2013 was 54.46 ± 14.47 and 45.51 ± 16.58 years old, respectively. The proportion of individuals with periodontitis in age group >65 years old decreased markedly. The proportion of individuals with periodontitis in age groups <25 and 26 to 35 years old demonstrated an increased pattern. Compared to the reference cohort of 1953 to 1957, the recent birth cohort of 1993 to 1997 revealed the highest relative risk (RR) of periodontitis (male: RR, 67.42, 95% confidence interval [CI], 17.04–266.76; female: RR, 65.85, 95% CI, 16.70–259.70). Both male and female groups showed the similar age-effect pattern in the cross-sectional age curve from age–period–cohort model. There was an upturn with advancing age up to 40 to 50 years old and then a downward trend in both genders. Population dwelling in suburban area (RR, 0.95; 95% CI, 0.94–0.97) and rural area (RR, 0.97; 95% CI, 0.95–0.99) had the lower risk of periodontitis than those who lived in urban area. The higher income group revealed the higher risk of periodontitis compared with lower income group (RR, 1.20; 95% CI, 1.18–1.23). The prevalence of periodontitis significantly increased in Taiwan over past 17 years. The mean age with periodontitis was shown in a decreased pattern. The use of a nationwide population-based database could provide sufficient sample size, generalizability, and statistical power to assess

  18. Improving access to adequate pain management in Taiwan.

    PubMed

    Scholten, Willem

    2015-06-01

    There is a global crisis in access to pain management in the world. WHO estimates that 4.65 billion people live in countries where medical opioid consumption is near to zero. For 2010, WHO considered a per capita consumption of 216.7 mg morphine equivalents adequate, while Taiwan had a per capita consumption of 0.05 mg morphine equivalents in 2007. In Asia, the use of opioids is sensitive because of the Opium Wars in the 19th century and for this reason, the focus of controlled substances policies has been on the prevention of diversion and dependence. However, an optimal public health outcome requires that also the beneficial aspects of these substances are acknowledged. Therefore, WHO recommends a policy based on the Principle of Balance: ensuring access for medical and scientific purposes while preventing diversion, harmful use and dependence. Furthermore, international law requires that countries ensure access to opioid analgesics for medical and scientific purposes. There is evidence that opioid analgesics for chronic pain are not associated with a major risk for developing dependence. Barriers for access can be classified in the categories of overly restrictive laws and regulations; insufficient medical training on pain management and problems related to assessment of medical needs; attitudes like an excessive fear for dependence or diversion; and economic and logistical problems. The GOPI project found many examples of such barriers in Asia. Access to opioid medicines in Taiwan can be improved by analysing the national situation and drafting a plan. The WHO policy guidelines Ensuring Balance in National Policies on Controlled Substances can be helpful for achieving this purpose, as well as international guidelines for pain treatment. Copyright © 2015. Published by Elsevier B.V.

  19. Using spatial analysis to demonstrate the heterogeneity of the cardiovascular drug-prescribing pattern in Taiwan

    PubMed Central

    2011-01-01

    Background Geographic Information Systems (GIS) combined with spatial analytical methods could be helpful in examining patterns of drug use. Little attention has been paid to geographic variation of cardiovascular prescription use in Taiwan. The main objective was to use local spatial association statistics to test whether or not the cardiovascular medication-prescribing pattern is homogenous across 352 townships in Taiwan. Methods The statistical methods used were the global measures of Moran's I and Local Indicators of Spatial Association (LISA). While Moran's I provides information on the overall spatial distribution of the data, LISA provides information on types of spatial association at the local level. LISA statistics can also be used to identify influential locations in spatial association analysis. The major classes of prescription cardiovascular drugs were taken from Taiwan's National Health Insurance Research Database (NHIRD), which has a coverage rate of over 97%. The dosage of each prescription was converted into defined daily doses to measure the consumption of each class of drugs. Data were analyzed with ArcGIS and GeoDa at the township level. Results The LISA statistics showed an unusual use of cardiovascular medications in the southern townships with high local variation. Patterns of drug use also showed more low-low spatial clusters (cold spots) than high-high spatial clusters (hot spots), and those low-low associations were clustered in the rural areas. Conclusions The cardiovascular drug prescribing patterns were heterogeneous across Taiwan. In particular, a clear pattern of north-south disparity exists. Such spatial clustering helps prioritize the target areas that require better education concerning drug use. PMID:21609462

  20. National health expenditures, 1985

    PubMed Central

    Waldo, Daniel R.; Levit, Katharine R.; Lazenby, Helen

    1986-01-01

    Slower price inflation in 1985 translated into slower growth of national health expenditures, but underlying growth in the use of goods and services continued along historic trends. Coupled with somewhat sluggish growth of the gross national product, this adherence to trends pushed the share of our Nation's output accounted for by health spending to 10.7 percent. Some aspects of health spending changed: Falling use of hospital services was offset by rising hospital profits and increased use of other health care services. Other aspects remained the same: Both the public sector and the private sector continued efforts to contain costs, efforts that have affected and will continue to affect not only the providers of care but the users of care as well. PMID:10311775

  1. Establishing a Measurement Tool for a Nursing Work Environment in Taiwan.

    PubMed

    Lin, Li-Chiu; Lee, Huan-Fang; Yen, Miaofen

    2017-02-01

    The nursing work environment is a critical global health care problem. Many health care providers are concerned about the associations between the nursing work environment and the outcomes of organizations, nurses, and patients. Nursing work environment instruments have been assessed in the West but have not been considered in Asia. However, different cultures will affect the factorial structure of the tool. Using a stratified nationwide random sample, we created a measurement tool for the nursing work environment in Taiwan. The Nursing Work Environment Index-Revised Scale and the Essentials of Magnetism scale were used to examine the factorial structure. Item analysis, exploratory factor analysis, and confirmatory factor analysis were used to examine the hypothesis model and generate a new factorial structure. The Taiwan Nursing Work Environment Index (TNWEI) was established to evaluate the nursing work environment in Taiwan. The four factors were labeled "Organizational Support" (7 items), "Nurse Staffing and Resources" (4 items), "Nurse-Physician Collaboration" (4 items), and "Support for Continuing Education" (4 items). The 19 items explained 58.5% of the variance. Confirmatory factor analysis showed a good fit to the model (x2/df = 5.99; p < .05, goodness of fit index [GFI] = .90; RMSEA = .07). The TNWEI provides a comprehensive and efficient method for measuring the nurses' work environment in Taiwan.

  2. Epidemiology and patterns of facial fractures due to road traffic accidents in Taiwan: A 15-year retrospective study.

    PubMed

    Yang, Cheng-San; Chen, Solomon Chih-Cheng; Yang, Yung-Cheng; Huang, Li-Chung; Guo, How-Ran; Yang, Hsin-Yi

    2017-10-03

    The facial region is a commonly fractured site, but the etiology varies widely by country and geographic region. To date, there are no population-based studies of facial fractures in Taiwan. We conducted a retrospective study of patients diagnosed with facial fracture and registered in the National Health Insurance Research Database of Taiwan between 1997 and 2011. The epidemiological characteristics of this cohort were analyzed, including the etiology, fracture site, associated injuries, and sex and age distributions. A total of 6,013 cases were identified that involved facial fractures. Most patients were male (69.8%), aged 18-29 years (35.8%), and had fractures caused by road traffic accidents (RTAs; 55.2%), particularly motorcycle accidents (31.5%). Falls increased in frequency with advancing age, reaching 23.9% among the elderly (age > 65 years). The most common sites of involvement were the malar and maxillary bones (54.0%), but nasal bone fractures were more common among those younger than 18 years. Most facial injuries in Taiwan occur in young males and typically result from RTAs, particularly involving motorcycles. However, with increasing age, there is an increase in the proportion of facial injuries due to falls.

  3. College Access, Equity, and Student Success in the Context of Higher Education Expansion and Differentiation in Taiwan

    ERIC Educational Resources Information Center

    Yang, Cheng-Cheng

    2010-01-01

    The expansion of higher education has become a significant trend in the East Asia region, and Taiwan has proven no exception. The driving forces of higher education expansion in Taiwan include enhancing national competitiveness and human capital, responding to social and industrial needs, and reducing educational inequalities among social groups.…

  4. What is the gap in activity and participation between people with disability and the general population in Taiwan?

    PubMed

    Chiu, Tzu-Ying; Yen, Chia-Feng; Escorpizo, Reuben; Chi, Wen-Chou; Liou, Tsan-Hon; Liao, Hua-Fang; Chou, Cheng-Hsiu; Fang, Wen-Hui

    2017-08-01

    In 2010, the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was developed, based on the concept of the International Classification of Functioning, Disability and Health (ICF). The ICF provides a common language and framework for health and health-related status and attempts to integrate the biopsychosocial model as a multidimensional perspective in understanding functioning. Activities and participation (AP) is one salient component of the ICF refers to the execution of a task by an individual, and how such tasks are involved in their daily life. It is essential to examine the gap between the general adult population and adults with disabilities. This gap may be attributed to health status, personal factors, and natural and social environments, which include social and health services and policies. The purposes: (1) To develop a normative activity and participation (AP) value for the adult population and people with disabilities; and (2) to compare the gap in AP normative values between the two groups in Taiwan. We use the WHODAS 2.0 to survey and develop a normative AP value for the general adult population, and used secondary data from National Disability Eligibility Determination System (NDEDS) of Taiwan to describe the AP functioning distribution of adult with disability. There were 1100 participants, selected by stratified proportional sampling from two cities. There were also 144,850 participants who were adults with disability, selected from the secondary database in Taiwan. The AP curve for the disabled population increased rapidly at the beginning. The summary score was 13.21 in the performance at 90 percentile for the general population and 82.61 score for disabled adults that the similar gap in every domain, its means that there are significant functioning difference and health equality in general adults population and adults with disabilities. This presents a substantial challenge for both the government and the whole

  5. Historical context for the growth of medical professionalism and curriculum reform in Taiwan.

    PubMed

    Chiu, Chiung-Hsuan; Arrigo, Linda Gail; Tsai, Duujian

    2009-09-01

    Medical school curricular reform to address humanism is now a prominent issue in Taiwan. Taiwan's community of medical professionals have for the last 100 years played a leading role in the nation's modernization and democratization. With the democratic opening of 1990, they took up the cause of humanistic reform of medical education. Although the reform has not sufficiently specified the depth and breadth of professionalism to be achieved through the medical school curriculum, it points at least to the most desired professionalism goals. Collaboration with the international community, particularly with Taiwanese-American medical educators and researchers who bring their experience back to Taiwan, has been a potent force for the advancement of the humanities and professionalism in medical education. This paper presents the definition of professionalism and the history of the medical profession from the perspective of medical education in Taiwan, and discusses recent transitions.

  6. The Perpetration of School Violence in Taiwan: An Analysis of Gender, Grade Level and School Type

    ERIC Educational Resources Information Center

    Chen, Ji-Kang; Astor, Ron Avi

    2009-01-01

    Using a nationally representative sample in Taiwan, this study aims to describe the prevalence of perpetration of school violence in Taiwan. The study explores how gender, age and school type relate to students' perpetration of violence in an Asian culture context. The sample included 14,022 students from elementary to high schools in grades 4 to…

  7. Increasing utilization of Internet-based resources following efforts to promote evidence-based medicine: a national study in Taiwan

    PubMed Central

    2013-01-01

    Background Since the beginning of 2007, the National Health Research Institutes has been promoting the dissemination of evidence-based medicine (EBM). The current study examined longitudinal trends of behaviors in how hospital-based physicians and nurses have searched for medical information during the spread of EBM. Methods Cross-sectional postal questionnaire surveys were conducted in nationally representative regional hospitals of Taiwan thrice in 2007, 2009, and 2011. Demographic data were gathered concerning gender, age, working experience, teaching appointment, academic degree, and administrative position. Linear and logistic regression models were used to examine predictors and changes over time. Results Data from physicians and nurses were collected in 2007 (n = 1156), 2009 (n = 2975), and 2011 (n = 3999). There were significant increases in the use of four Internet-based resources – Web portals, online databases, electronic journals, and electronic books – across the three survey years among physicians and nurses (p < 0.001). Access to textbooks and printed journals, however, did not change over the 4-year study period. In addition, there were significant relationships between the usage of Internet-based resources and users’ characteristics. Age and faculty position were important predictors in relation to the usage among physicians and nurses, while academic degree served as a critical factor among nurses only. Conclusions Physicians and nurses used a variety of sources to look for medical information. There was a steady increase in use of Internet-based resources during the diffusion period of EBM. The findings highlight the importance of the Internet as a prominent source of medical information for main healthcare professionals. PMID:23289500

  8. Towards National eHealth Implementation--a comparative study on WHO/ITU National eHealth Strategy Toolkit in Iran.

    PubMed

    Riazi, Hossein; Jafarpour, Maryam; Bitaraf, Ehsan

    2014-01-01

    Experiences has shown that utilization of ICT in health sector requires national commitment and planned efforts to make the best use of existing capacity. Establishing the main directions as well as planning the detailed steps needed are key to achieving longer-term goals such as health sector efficiency, reform or more fundamental transformation. Collaboration between the health and ICT sectors, both public and private, is central to this effort. As the major United Nations agencies for health and telecommunications respectively, the World Health Organization (WHO) and the International Telecommunication Union (ITU) have recognized the importance of collaboration for eHealth in their global resolutions, which encourage countries to develop national eHealth strategies; the National eHealth Strategy Toolkit is the proof of these recommendations. In this study a mapping of eHealth components in WHO/ITU National eHealth Strategy Toolkit and our national eHealth vision is presented.

  9. A case study on the influences of long-range transport to Taiwan`s acid deposition using Taiwan air quality model

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ken-Hui Chang; Fu-Tien Jeng

    1996-12-31

    The long-range and transboundary transport of precursors of add deposition in East Asia became important due to the industrial development around this area. We started to develop Taiwan Air Quality Model (TAQM) system since 1992, which is based on regional Acid Deposition Model (RADM) system. A typical episode in Mei-Yu season has been selected to study. A case considering all emissions within simulated domain has been run as a reference case, and another perturbed case, not including Taiwan`s emission, has been also run for analyzing quantitatively the influence of long-range transport to Taiwan`s wet deposition during the episode are 31%more » and 24% for total sulfur compounds and total nitrogen compounds respectively; but for dry deposition, only 6% is contributed by long range transport for sulfur compounds and 29% for total nitrogen compounds. Therefore, the percentages of total acid deposition contributed by long-range transport are 27% and 25% for total sulfur compounds and total nitrogen compounds, respectively.« less

  10. Instrumental neutron activation analysis data for cloud-water particulate samples, Mount Bamboo, Taiwan

    USGS Publications Warehouse

    Lin, Neng-Huei; Sheu, Guey-Rong; Wetherbee, Gregory A.; Debey, Timothy M.

    2013-01-01

    Cloud water was sampled on Mount Bamboo in northern Taiwan during March 22-24, 2002. Cloud-water samples were filtered using 0.45-micron filters to remove particulate material from the water samples. Filtered particulates were analyzed by instrumental neutron activation analysis (INAA) at the U.S. Geological Survey National Reactor Facility in Denver, Colorado, in February 2012. INAA elemental composition data for the particulate materials are presented. These data complement analyses of the aqueous portion of the cloud-water samples, which were performed earlier by the Department of Atmospheric Sciences, National Central University, Taiwan. The data are intended for evaluation of atmospheric transport processes and air-pollution sources in Southeast Asia.

  11. Identifying Vulnerable Populations Using a Social Determinants of Health Framework: Analysis of National Survey Data across Six Asia-Pacific Countries

    PubMed Central

    Ward, Paul R.; Mamerow, Loreen; Meyer, Samantha B.

    2013-01-01

    Background In order to improve the health of the most vulnerable groups in society, the WHO called for research on the multiple and inter-linking factors shaping the social determinants of health (SDH). This paper analyses four key SDH (social cohesion, social inclusion, social empowerment and socioeconomic security) across six Asia-Pacific countries: Australia, Hong Kong, Japan, South Korea, Taiwan, and Thailand. Methods Population surveys were undertaken using a validated instrument in 2009-10, with sample sizes around 1000 in each country. The four SDH were analysed using multivariate binomial logistic regression to identify socio-demographic predictors in each country. Results Low socio-economic security was associated with low income in all six study countries and with poor subjective health in Japan, South Korea and Thailand and with being married or cohabiting in Australia and Hong Kong. Low social cohesion was associated with low income in all countries and with undertaking household duties in South Korea, Thailand and Taiwan. Low social inclusion was associated with low income in Australia, South Korea and Taiwan and with poor subjective health in Australia, Japan and South Korea. Older people had lower social inclusion in Taiwan (50-59 years) and Hong Kong (retired), younger people in Japan and South Korea (20-29 years in both countries) and younger and middle-aged people in Australia. Low social empowerment was associated with low income in Australia, Thailand and Taiwan, with being aged 60 years or over in Australia, Hong Kong and South Korea, and over 50 years in Thailand. Conclusions This paper provides baseline measures for identifying where and how policy should be altered to improve the SDH. Furthermore, these data can be used for future policy evaluation to identify whether changes in policy have indeed improved the SDH, particularly for marginalised and vulnerable populations. PMID:24349417

  12. Geological mechanism of hazardous debris flows in central Taiwan

    NASA Astrophysics Data System (ADS)

    Chen, H.; Chen, R. H.; Lin, M. L.; Su, D. Y.

    2003-04-01

    GEOLOGICAL MECHANISM OF HAZARDOUS DEBRIS FLOWS IN CENTRAL PART OF TAIWAN H. Chen (1), R. H. Chen (2), M. L. Lin (2), D.Y. Su (3) (1) Department of Geosciences, National Taiwan University, (2) Department of Civil Engineering, National Taiwan University, (3) MAA Ltd., Taiwan hche02@esc.cam.ac.uk/Fax:+44-01223-333450 This study revealed that the distribution of rock discontinuities, geomaterial characteristics and water pressure were the major hazardous factors of the triggering mechanism in the debris flows. Attention is drawn to the discontinuities pattern within the sidewalls of the gullies, which emphasized the significance of material slumping and forming the accumulated deposits in the gullies. The accumulated deposits are the main source of the debris flow once the disaster is triggered and produced large quantities of debris. A modified channel box test was used to comprehend the effect of water sources in this study. The results of this experimental test displayed that water supplied from the bottom or the top will both cause large material movement. But water supplied from the bottom tends to cause a larger and faster flow than water from the top. The visual evidence of a flushed network of discontinuities exposed after the debris flow provided in situ indications of increased pore water pressure. This rapidly increasing water pressure evidently contributed a sizable dynamic force to initiate movement of the debris flow. The heavy slurry became an effective cutting device to erode the sidewalls and move large quantities of the debris materials to the end of the gullies. Based on field investigations and laboratory tests, the precipitation could increase the water content and water pressure, and decrease the shear strength of the gullies material. It also can add confirmation to this research that debris flows are triggered by accumulated deposits from sidewalls and moved by high intensity precipitation.

  13. National Health Expenditures, 1982

    PubMed Central

    Gibson, Robert M.; Waldo, Daniel R.; Levit, Katharine R.

    1983-01-01

    Rapid growth in the share of the nation's gross national product devoted to health expenditure has heightened concern over the survival of government entitlement programs and has led to debate of the desirability of current methods of financing health care. In this article, the authors present the data at the heart of the issue, quantifying spending for various types of health care in 1982 and discussing the sources of funds for that spending. PMID:10310273

  14. Higher Education Expansion and Low-Income Students in Taiwan

    ERIC Educational Resources Information Center

    Wu, Chih-Chun

    2009-01-01

    In this paper, we report on a study of 1510 undergraduates from five national universities in Taiwan, and we show that compared to "non-prestigious" universities, a larger proportion of students at prestigious universities come from middle and high socioeconomic classes and a smaller proportion experience financial insecurity. These…

  15. Ambulance traffic accidents in Taiwan.

    PubMed

    Chiu, Po-Wei; Lin, Chih-Hao; Wu, Chen-Long; Fang, Pin-Hui; Lu, Chien-Hsin; Hsu, Hsiang-Chin; Chi, Chih-Hsien

    2018-04-01

    Ambulance traffic accidents (ATAs) are the leading cause of occupation-related fatalities among emergency medical service (EMS) personnel. We aim to use the Taiwan national surveillance system to analyze the characteristics of ATAs and to assist EMS directors in developing policies governing ambulance operations. A retrospective, cross-sectional and largely descriptive study was conducted using Taiwan national traffic accidents surveillance data from January 1, 2011 to October 31, 2016. Among the 1,627,217 traffic accidents during the study period, 715 ATAs caused 8 deaths within 24 h and 1844 injured patients. On average, there was one ATA for every 8598 ambulance runs. Compared to overall traffic accidents, ATAs were 1.7 times more likely to result in death and 1.9 times more likely to have injured patients. Among the 715 ATAs, 8 (1.1%) ATAs were fatal and 707 (98.9%) were nonfatal. All 8 fatalities were associated with motorcycles. The urban areas were significantly higher than the rural areas in the annual number of ATAs (14.2 ± 7.3 [7.0-26.7] versus 3.1 ± 1.9 [0.5-8.4], p = 0.013), the number of ATA-associated fatalities per year (0.2 ± 0.2 [0.0-0.7] versus 0.1 ± 0.1 [0.0-0.2], p = 0.022), and the annual number of injured patients (who needed urgent hospital visits) in ATAs (19.4 ± 7.3 [10.5-30.9] versus 5.2 ± 3.8 [0.9-15.3], p < 0.001). The ATA-associated fatality rate in Taiwan was high, and all fatalities were associated with motorcycles. ATAs in a highly motorcycle-populated area may require further investigation. An ambulance traffic accident reporting system should be built to provide EMS policy guidance for ATA reduction and outcome improvements. Copyright © 2018. Published by Elsevier B.V.

  16. Maternal nationality and developmental delays in young children: Analysis of the data from the national registry in Taiwan.

    PubMed

    Tseng, Yen-Cheng; Guo, How-Ran; Lai, Der-Chung

    2016-01-01

    With globalization, transnational marriages become more and more common around the world. Children born to immigrant mothers might be more likely to have developmental delays, but studies on this topic are limited and with inconsistent results. To determine whether children born to immigrant mothers are more likely to have developmental delays. We analyzed the data from the national registry of children with developmental delays from 2009 to 2013 and compared the incidence of developmental delays between children born to immigrant mothers and native mothers. We also performed stratified analyses by age, sex, and geographic area. From 2009 to 2013, 78,946 new cases of developmental delays under 6 years of age were registered, including 5619 (7.1%) born to immigrant mothers. The incidence was higher in children born to native mothers in every year with rate ratios ranging from 1.32 to 1.48, and the differences reached statistical significance even after stratification by age, sex, and geographic area. Children born to immigrant mothers had lower incidence of developmental delays in Taiwan. The result may help reduce the discrimination of foreign spouses and their children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. National Health Expenditures, 1978

    PubMed Central

    Gibson, Robert M.

    1979-01-01

    Outlays for health care in the Nation reached $192.4 billion in calendar year 1978--13 percent higher than in 1977, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $863 per person in the United States and was equal to 9.1 percent of the GNP. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. Revised estimates are presented extending back to 1965. PMID:10309049

  18. 78 FR 55751 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...

  19. A zonation technique for landslide susceptibility in southern Taiwan

    NASA Astrophysics Data System (ADS)

    Chiang, Jie-Lun; Tian, Yu-Qing; Chen, Yie-Ruey; Tsai, Kuang-Jung

    2016-04-01

    In recent years, global climate changes violently, extreme rainfall events occur frequently and also cause massive sediment related disasters in Taiwan. The disaster seriously hit the regional economic development and national infrastructures. For example, in August, 2009, the typhoon Morakot brought massive rainfall especially in the mountains in Chiayi County and Kaohsiung County in which the cumulative maximum rainfall was up to 2900 mm; meanwhile, the cumulative maximum rainfall was over 1500m.m. in Nantou County, Tainan County and Pingtung County. The typhoon caused severe damage in southern Taiwan. The study will search for the influence on the sediment hazards caused by the extreme rainfall and hydrological environmental changes focusing on southern Taiwan (including Chiayi, Tainan, Kaohsiung and Pingtung). The instability index and kriging theories are applied to analyze the factors of landslide to determine the susceptibility in southern Taiwan. We collected the landslide records during the period year, 2007~2013 and analyzed the instability factors including elevation, slope, aspect, soil, and geology. Among these factors, slope got the highest weight. The steeper the slope is, the more the landslides occur. As for the factor of aspect, the highest probability falls on the Southwest. However, this factor has the lowest weight among all the factors. Likewise, Darkish colluvial soil holds the highest probability of collapses among all the soils. Miocene middle Ruifang group and its equivalents have the highest probability of collapses among all the geologies. In this study, Kriging was used to establish the susceptibility map in southern Taiwan. The instability index above 4.21 can correspond to those landslide records. The potential landslide area in southern Taiwan, where collapses more likely occur, belongs to high level and medium-high level; the area is 5.12% and 17.81% respectively.

  20. A Major E-Learning Project to Renovate Science Learning Environment in Taiwan

    ERIC Educational Resources Information Center

    Chang, Chun-Yen; Lee, Greg

    2010-01-01

    This article summarizes a major e-Learning project recently funded by the National Science Council of Taiwan and envisions some of the future research directions in this area. This project intends to initiate the "Center for excellence in e-Learning Sciences (CeeLS): i[superscript 4] future learning environment" at the National Taiwan…

  1. The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups.

    PubMed

    Yan, Yu-Hua; Kung, Chih-Ming; Chen, Yi

    2017-11-09

    This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs) on medical resource utilization in inguinal hernia repair (IHR) in hospitals with different ownership to provide suitable reference information for hospital administrators. The 2010-2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case) was more efficient than that in the public hospital (US$902.7/case) or nonprofit proprietary hospital (US$817.1/case) surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%), while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

  2. The relationship between economic conditions and postpartum depression in Taiwan: a nationwide population-based study.

    PubMed

    Chang, Fung-Wei; Lee, Wen-Ying; Liu, Yueh-Ping; Yang, Jing-Jung; Chen, Shu-Pin; Cheng, Kuan-Chen; Lin, Yan-Cen; Ho, Te-Wei; Chiu, Feng-Hsiang; Hsu, Ren-Jun; Liu, Jui-Ming

    2016-11-01

    Understanding mothers' economic conditions and postpartum depression (PPD) is important for determining how they will take care of themselves and their infants during the postnatal period, especially for low-income families. This study examined the relationship between economic conditions and PPD to elucidate the effect of economic contraction on PPD. Our population-based nationwide study used 2000-2013 the National Health Insurance Research Database of Taiwan. A total of 1240 newly diagnosed PPD patients were recruited. We used the database of the Directorate General of Budget, Accounting, and Statistics of Executive Yuan of Taiwan for national economic indicators. The correlation between economic indicators and PPD was examined. The PPD incidence was positively correlated with yearly unemployment rate, consumer price index, and gross domestic product. During the great recession of 2008-2009, PPD was positively correlated with inflation rate. Consumer price index had a positive correlation with PPD incidence per month when comparing PPD in 2010 with the economic indicators during the great recession. As this retrospective study evaluated macroeconomic indicators, it is unclear whether the macroeconomic indicators' effect on PPD totally reflects the effect of true personal economic status on PPD. There was a significant association between PPD and economic conditions. This study shows that mothers' familial environment plays an important role in the development of PPD. The impact of the worldwide economic downturn of the great recession on women is persistent. This useful finding may give health policy planners a hint of early discovering and dealing with PPD when worldwide economic downturn. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Effects of pay-for-performance system on tuberculosis default cases control and treatment in Taiwan.

    PubMed

    Tsai, Wen-Chen; Kung, Pei-Tseng; Khan, Mahmud; Campbell, Claudia; Yang, Wen-Ta; Lee, Tsuey-Fong; Li, Ya-Hsin

    2010-09-01

    In order to make tuberculosis (TB) treatment more effective and to lower the default rate of the disease, the Bureau of National Health Insurance (BNHI) in Taiwan implemented the "pay-for-performance on Tuberculosis" program (P4P on TB) in 2004. The purpose of this study is to investigate the effectiveness of the P4P system in terms of default rate. This is a retrospective study. National Health Insurance Research Datasets in Taiwan from 2002 to 2005 has been used for the study. The study compared the differences of TB default rate before and after the implementation of P4P program, between participating and non-participating hospitals, and between P4P hospitals with and without case managers. Furthermore, logistic regression analysis was conducted to explore the related factors influencing TB patients default treatment after TB detected. The treatment default rate after "P4P on TB" was 11.37% compared with the 15.56% before "P4P on TB" implementation. The treatment default rate in P4P hospitals was 10.67% compared to 12.7% in non-P4P hospitals. In addition, the default rate was 10.4% in hospitals with case managers compared with 12.68% in hospitals without case managers. The results of the study showed that "P4P on TB" program improved the treatment default rate for TB patients. In addition, case managers improved the treatment outcome in controlling patients' default rate. Copyright 2010 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

  4. Stockpile Model of Personal Protective Equipment in Taiwan

    PubMed Central

    Chen, Yu-Ju; Cheng, Yu-Hsin; Huang, Chun-Wei; Kao, Hui-Yun; Chang, Chih-Kai; Huang, Hsun-Miao; Liu, Pei-Yin; Wang, Jen-Hsin; Chih, Yi-Chien; Chou, Shu-Mei; Yang, Chin-Hui; Chen, Chang-Hsun

    2017-01-01

    The Taiwan Centers for Disease Control (Taiwan CDC) has established a 3-tier personal protective equipment (PPE) stockpiling framework that could maintain a minimum stockpile for the surge demand of PPE in the early stage of a pandemic. However, PPE stockpiling efforts must contend with increasing storage fees and expiration problems. In 2011, the Taiwan CDC initiated a stockpile replacement model in order to optimize the PPE stockpiling efficiency, ensure a minimum stockpile, use the government's limited funds more effectively, and achieve the goal of sustainable management. This stockpile replacement model employs a first-in-first-out principle in which the oldest stock in the central government stockpile is regularly replaced and replenished with the same amount of new and qualified products, ensuring the availability and maintenance of the minimum stockpiles. In addition, a joint electronic procurement platform has been established for merchandising the replaced PPE to local health authorities and medical and other institutions for their routine or epidemic use. In this article, we describe the PPE stockpile model in Taiwan, including the 3-tier stockpiling framework, the operational model, the components of the replacement system, implementation outcomes, epidemic supports, and the challenges and prospects of this model. PMID:28418743

  5. 76 FR 71047 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on...., Chief, Extramural Project Review Branch EPRB, NIAAA, National Institutes of Health, 5365 Fishers Lane... Awards., National Institutes of Health, HHS) Dated: November 8, 2011. Jennifer S. Spaeth, Director...

  6. 78 FR 24427 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; 60-Day..., the National Human Genome Research Institute (NHGRI), National Institutes of Health (NIH), will... Genome Research Institute (NHGRI), National Institutes of Health (NIH). Need and Use of Information...

  7. Epidemiology of uveitis among the Chinese population in Taiwan: a population-based study.

    PubMed

    Hwang, De-Kuang; Chou, Yiing-Jeng; Pu, Cheng-Yun; Chou, Pesus

    2012-11-01

    This study aimed to investigate the incidence and prevalence of uveitis in Taiwan, and then analyzed the risk factors related to uveitis using multivariate regression. Population-based cohort study using medical claims data. We randomly selected 1 000 000 residents from the Taiwan National Health Insurance Research Database. All participants with correct registry data (96%) were included in the study. The study period was from 2000 to 2008. All types of uveitis were identified using the International Classification of Diseases, 9th revision, Clinical Modification diagnostic codes. The annual incidence and cumulative prevalence of uveitis were calculated. A univariate and a multivariate Poisson regression were used to determine the risk factors associated with uveitis. The first diagnosis of uveitis noted during the study period. The annual cumulative incidence rate of uveitis ranged from 102.2 to 122.0 cases per 100 000 persons over the study period, and the average incidence density was 111.3 cases per 100 000 person-years (95% confidence interval, 108.4-114.1). The cumulative prevalence was found to have increased from 318.8 cases per 100 000 persons in 2003 to 622.7 cases per 100 000 persons in 2008. Anterior uveitis was the most common location and accounted for 77.7% of all incident cases, which was followed by panuveitis, posterior uveitis, and intermediate uveitis. Multivariate regression analysis showed that males, the elderly, and individuals who lived in an urban area had higher incidence rates for uveitis. The epidemiology of uveitis in Taiwan differs from most previous studies in other countries. The incidence of uveitis in Taiwan has increased significantly recently. The elderly and individuals living in urban areas are the populations that are most commonly affected by uveitis. These findings are consistent with suggestions found in several recent studies. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights

  8. Patterns of ambulatory care utilization in Taiwan.

    PubMed

    Chen, Tzeng-Ji; Chou, Li-Fang; Hwang, Shinn-Jang

    2006-05-04

    We used the insurance claims of a representative cohort to quantify the patterns of ambulatory care visits, especially the doctor-shopping phenomenon, in Taiwan. The ambulatory visit files of the 200,000-person cohort datasets from the National Health Insurance Research Database in 2002 were analyzed. Only a visit with physician consultation would be considered. We computed the visit patterns both by visit count and by patient count. In 2002, there were 182,474 eligible people with 2,443,003 physician consultations. During the year, 87.4% of the cohort had visited physician clinics and 57.5% had visited hospital-based outpatient or emergency departments. On average, a person had 13.4 physician consultations and consulted 3.4 specialties, 5.2 physicians, and 3.9 healthcare facilities in a year. In 2002, 17.3% of the cohort had ever visited different healthcare facilities on the same day; 23.5% had ever visited physicians of the same specialty at different healthcare facilities within 7 days and the percentage of second visits was 3.8% of all visits. Besides, 7.6% of the cohort had visited two or more specialties at the same facility on the same day, and such visits make up 2.5% of all visits. The people in Taiwan did visit the physicians and outpatient departments frequently. Many patients not only consulted several physicians of different specialties and at different healthcare facilities during the year, but also switched the physicians and facilities quickly. An effective referral system with efficient data exchange between facilities might be the solution.

  9. Mammography usage with relevant factors among women with mental disabilities in Taiwan: a nationwide population-based study.

    PubMed

    Yen, Suh-May; Kung, Pei-Tseng; Tsai, Wen-Chen

    2015-02-01

    Women with mental illness are at increased risk of developing and dying from breast cancer and are thus in urgent need of breast cancer preventive care. This study examined the use of screening mammography by Taiwanese women with mental disabilities and analyzed factors affecting this use. 17,243 Taiwanese women with mental disabilities aged 50-69 years were retrospectively included as study subjects. Linked patient data were obtained from three national databases in Taiwan (the 2008 database of physically and mentally disabled persons, the Health Promotion Administration's 2007-2008 mammography screening data, and claims data from the National Health Insurance Research Database). Besides descriptive statistics and bivariate analysis, logistic regression analysis was also performed to examine factors affecting screening mammography use. The 2007-2008 mammography screening rate for Taiwanese women with mental disabilities was 8.79% (n=1515). Variables that significantly influenced screening use were income, education, presence of catastrophic illness/injury, severity of mental disability, and usage of other preventive care services. Screening was positively correlated with income and education. Those with catastrophic illness/injury were more likely to be screened (odds ratio [OR], 1.40; 95% CI=1.15-1.72). Severity of disability was negatively correlated with screening, with very severe, severe, and moderate disability being associated with 0.34-0.69 times the odds of screening as mild disability. In Taiwan, women with mental disabilities receive far less mammography screening than women in general. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Adoption of medication alert systems in hospital outpatient departments in Taiwan.

    PubMed

    Kuo, Yu-Chun; Cheng, Shou-Hsia

    2017-06-01

    The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Building the national health information infrastructure for personal health, health care services, public health, and research

    PubMed Central

    Detmer, Don E

    2003-01-01

    Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

  12. Cross-sectional and longitudinal associations of functional and health status with institutional care use: results from the Survey of Health and Living Status of the Elderly in Taiwan.

    PubMed

    Tsai, Hsin-Jen

    2013-07-01

    This study evaluated the cross-sectional and longitudinal associations of functional and health status with institutional care, and examined determinants of institutional care use over time. Data of this study were obtained from the Survey of Health and Living Status of the Elderly in Taiwan (SHLSET), which was launched in 1989 and involved a nationally representative sample of nearly-old and old Taiwanese. The baseline data in this present study were collected in 1999, and followed in 2003 and 2007. Participants with institutional care use had a higher activities of daily living (ADL) score, more self-reported diseases and poorer self-reported health status than participants without institutional care use (all P<0.05). Cross-sectional analysis showed that a higher ADL score, having heart diseases and having a stroke were positively associated with institutional care use (P<0.05); whereas the number of self-reported diseases and poor self-reported health status were not associated with institutional care use. Longitudinal analysis showed that increased ADL scores and the number of self-reported diseases over 4- and 8 years were associated with an increased likelihood of subsequent institutional care use (all P<0.05). Worsening health status over 4 years was associated with an increased likelihood of subsequent institutional care use, but this association did not exist over 8 years. Only ADL and ADL deterioration over time are cross-sectionally and longitudinally associated with increased institutional care use. Declining functional status is a major determinant of institutional care use for Taiwanese aged over 53 years. © 2012 Japan Geriatrics Society.

  13. Transfusion-acquired AIDS in Taiwan.

    PubMed

    Yao, C; Wang, W W; Chung, Y M; Su, Y L; Liu, C Y; Chen, Y M

    1996-01-01

    Human immunodeficiency virus type 1 (HIV-1) can be transmitted through blood transfusion. The first transfusion-acquired immunodeficiency syndrome (AIDS) patient in Taiwan was a 46-year-old woman who received two units of whole blood during a hysterectomy at a provincial hospital in 1985. In 1991, she experienced a herpes zoster infection. In March 1993, she had extensive herpetic gingivostomatitis and another herpes zoster attack, and was treated at the same hospital. Two months later, she had oral candidiasis and was treated at a medical center. She was not tested for HIV-1 infection until she developed Pneumocystis carinii pneumonia in June 1993. In February 1994, and developed cytomegalovirus retinitis and died 6 months later. Donor blood given to the patients during the hysterectomy was HIV-1 positive. The donor's HIV infection was discovered in 1991 and he died of AIDS in 1993. As blood centers in Taiwan did not start screening for HIV-1 until January 1988, it is urgently recommended that any individual who received a blood transfusion between 1984 and 1987 in Taiwan and who currently experiences repeated episodes of opportunistic infections have an HIV-1 blood test. The receipt of a blood transfusion between 1984 and 1987 should be listed by the Department of Health as an indication for HIV-1 screening.

  14. Risk and Outbreak Communication: Lessons from Taiwan's Experiences in the Post-SARS Era.

    PubMed

    Hsu, Yu-Chen; Chen, Yu-Ling; Wei, Han-Ning; Yang, Yu-Wen; Chen, Ying-Hwei

    In addition to the impact of a disease itself, public reaction could be considered another outbreak to be controlled during an epidemic. Taiwan's experience with SARS in 2003 highlighted the critical role played by the media during crisis communication. After the SARS outbreak, Taiwan's Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. This article describes the risk communication framework in Taiwan, which has been used to respond to the 2009-2016 influenza epidemics, Ebola in West Africa (2014-16), and MERS-CoV in South Korea (2015) during the post-SARS era. Many communication strategies, ranging from traditional media to social and new media, have been implemented to improve transparency in public communication and promote civic engagement. Taiwan CDC will continue to maintain the strengths of its risk communication systems and resolve challenges as they emerge through active evaluation and monitoring of public opinion to advance Taiwan's capacity in outbreak communication and control. Moreover, Taiwan CDC will continue to implement the IHR (2005) and to promote a global community working together to fight shared risks and to reach the goal of "One World, One Health."

  15. Risk and Outbreak Communication: Lessons from Taiwan's Experiences in the Post-SARS Era

    PubMed Central

    Chen, Yu-Ling; Wei, Han-Ning; Yang, Yu-Wen; Chen, Ying-Hwei

    2017-01-01

    In addition to the impact of a disease itself, public reaction could be considered another outbreak to be controlled during an epidemic. Taiwan's experience with SARS in 2003 highlighted the critical role played by the media during crisis communication. After the SARS outbreak, Taiwan's Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. This article describes the risk communication framework in Taiwan, which has been used to respond to the 2009-2016 influenza epidemics, Ebola in West Africa (2014-16), and MERS-CoV in South Korea (2015) during the post-SARS era. Many communication strategies, ranging from traditional media to social and new media, have been implemented to improve transparency in public communication and promote civic engagement. Taiwan CDC will continue to maintain the strengths of its risk communication systems and resolve challenges as they emerge through active evaluation and monitoring of public opinion to advance Taiwan's capacity in outbreak communication and control. Moreover, Taiwan CDC will continue to implement the IHR (2005) and to promote a global community working together to fight shared risks and to reach the goal of “One World, One Health.” PMID:28418746

  16. Development of Ocean-Bottom Seismograph in Taiwan

    NASA Astrophysics Data System (ADS)

    Chang, H.; Jang, J. P.; Chen, P.; Lin, C. R.; Kuo, B. Y.; Wang, C. C.; Kim, K. H.; Lin, P. P.

    2016-12-01

    Yardbird-20s, one type of Ocean-Bottom Seismograph (OBS), is fabricated by Taiwan Ocean Research Institute (TORI), the Institute of Earth Science of Academia Sinica and the Institute of Undersea Technology of the National Sun Yat-Sen University in Taiwan. Yardbirds can be deployed up to 5000m deep for up to 15 months. The total weight with anchor in the air is about 170Kg. The rising and sinking rate is about 0.8 m/s. We utilized ultra-low power micro control unit (MCU) and SD card to design a data logger. The sensors are three of 4.5Hz geophones that were extended the lower frequency response to 20 sec. The sensor module also includes the leveling system, which is design by dual-axis DC motor-driven module to level the vertical component to be less than 0.1 degree with respect to the gravity. Yardbirds have been successfully deployed and recovered in several research cruises in Taiwan and Korea. In this study, we'll also display the data quality and power spectral density (PSD) calculations, probability density function (PDF) plots and from the Yardbirds that deployed and recovered in the East Sea near sough-east of Korea.

  17. Interdisciplinary, interinstitutional and international collaboration of family medicine researchers in Taiwan.

    PubMed

    Lin, Yi-Hsuan; Tseng, Yen-Han; Chang, Hsiao-Ting; Lin, Ming-Hwai; Tseng, Yen-Chiang; Chen, Tzeng-Ji; Hwang, Shinn-Jang

    2015-01-01

    The family medicine researches flourished worldwide in the past decade. However, the collaborative patterns of family medicine publications had not been reported. Our study analyzed the collaborative activity of family medicine researchers in Taiwan. We focused on the types of collaboration among disciplines, institutions and countries. We searched "family medicine" AND "Taiwan" in address field from Web of Science and documented the disciplines, institutions and countries of all authors. We analyzed the collaborative patterns of family medicine researchers in Taiwan from 2010 to 2014. The journal's impact factor of each article in the same publication year was also retrieved. Among 1,217 articles from 2010 to 2014, interdisciplinary collaboration existed in 1,185 (97.3%) articles, interinstitutional in 1,012 (83.2%) and international in 142 (11.7%). Public health was the most common collaborative discipline. All international researches were also interdisciplinary and interinstitutional. The United States (75 articles), the United Kingdom (21) and the People's Republic of China (20) were the top three countries with which family medicine researchers in Taiwan had collaborated. We found a high degree of interdisciplinary and interinstitutional collaboration of family medicine researches in Taiwan. However, the collaboration of family medicine researchers in Taiwan with family medicine colleagues of other domestic or foreign institutions was insufficient. The future direction of family medicine studies could focus on the promotion of communication among family medicine researchers.

  18. Dilemma of applying telehealth for overseas organ transplantation: comparison on perspectives of health professionals and e-health information and communication technologists in Taiwan.

    PubMed

    Shih, F Jin; Shih, F Jong; Pan, Y J; Chen, H M; Wang, S-S

    2014-05-01

    Telehealth is one of the avenues of e-health; it is a voice, image, or document delivery system via the internet and aims to assist patients to prevent disease and to promote health, diagnosis, self-care, and treatment. The purpose of using telehealth for overseas organ transplantation (OOT) was debated. This study aimed to explore the dilemma in applying telehealth for OOT patients from the perspectives of health professionals and e-health information and communication technologists (eh-ICTs) in Taiwan. An exploratory qualitative method was used, with a purposive sample of OT health professionals (OTHP) and eh-ICTs in Taiwan. Qualitative data were collected by face-to-face semistructured interviews, and were analyzed by content analysis. Fifty subjects including 10 OT surgeons (OTS), 30 registered nurses (RNs), and 10 eh-ICTs participated in this study. Five dilemmas were identified: (1) medical law violation (80%, n = 40 of 50; 100% OTS [n = 10 of 10], 67% RNs [n = 20 of 30], 100% eh-ICTs [n = 10 of 10]); (2) integrating telecommunication and medical systems for OOT (74%, n = 37 of 50; 90% OTS [n = 9 of 10], 73% RNs [n = 22 of 30], 60% eh-ICTs [n = 6 of 10]); (3) the inconsistent caring protocols among medical parties (68%, n = 34 of 50; 80% OTS [n = 8 of 10], 70% RNs [n = 21 of 30], 50% eh-ICTs [n = 5 of 10]); (4) the uncertainty in quality of care in overseas medical institutes (62%, n = 31 of 50; 80% OTS [n = 8 of 10], 60% RNs [n = 18 of 30], 50% eh-ICTs [n = 5 of 10]); and (5) the uncertainty in cost-effectiveness (36%, n = 18 of 50; 60% OTS [n = 6 of 10], 17% RNs [n = 5 of 30], 70% eh-ICTs [n = 7 of 10]). The use of telehealth for OOT is in its infancy. A systematic curriculum with advanced pilots targeted to develop telehealth for OOT will be needed for mutual communication between OTHPs and eh-ICTs in the near future. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. 76 FR 40383 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Government-Owned Inventions; Availability for Licensing AGENCY: Public Health Service, National Institutes of Health, HHS. ACTION: Notice... the indicated licensing contact at the Office of Technology Transfer, National Institutes of Health...

  20. Hospital competition and inpatient services efficiency in Taiwan: a longitudinal study.

    PubMed

    Chu, Chiao-Lee; Chiang, Tung-Liang; Chang, Ray-E

    2011-10-01

    There is no consistent evidence of the relationship between market competition and hospital efficiency. Some studies indicated that more competition led to a faster patient turnover rate, higher hospital costs, and lower hospital efficiency. Since the 1980s some studies found market competition could increase the efficiency of inpatient services. However, there were few studies testing the market competition during a hospital's earlier stages on its efficiency during later stages, or the dynamic of efficiency. In this study, we examined the effect of early-stage market competition on later-stage hospital efficiency in Taiwan, and we determine the efficiency change using longitudinal study design. The data for the analysis came from the annual national hospital survey of 1996 and 2001 provided by the Department of Health. There were 102 teaching hospital be analysed. The results show that no evidence supports the proposition that higher market competition would improve the efficiency of hospitals in delivering inpatient services in Taiwan. Importantly, neither was the inefficiency score nor the Malmquist productivity index of inpatient services associated with the level of hospital market competition, regardless of the adjustment for hospital characteristics. However, the results may be related with the hospital increasing beds investment behavior. Copyright © 2010 John Wiley & Sons, Ltd.

  1. Estimating the burden of genital warts in Taiwan.

    PubMed

    Tsai, Tsen-Fang; Kothari-Talwar, Smita; Yee, Karen; Kulkarni, Amit; Lara, Nuria; Roset, Montserrat; Giuliano, Anna R; Garland, Suzanne M

    2017-11-01

    Background This study aimed to estimate the prevalence of genital warts in Taiwan among those seeking healthcare, as well as genital-warts-related healthcare resource use and costs, and self-reported genital-warts-related psychosocial impact. Genital warts prevalence estimates were extracted from a daily record of patients examined from 31 October 2011 to 4 May 2012 by 67 physicians in Taiwan. Physicians recorded the total number of patients and genital warts patients seen daily for 2 weeks. These physicians also completed a survey regarding healthcare resource use, treatment, follow-up care, and referral patterns. Patient psychosocial impact was estimated using a self-administered survey. The overall prevalence of genital warts in Taiwan was estimated at 1.1%, with a higher prevalence among men. A total of 146 genital warts case patients were included in the study (76 men, 70 women). Median costs for diagnosis and treatment were US$222 for male and US$351.8 for female patients. Male genital warts subjects reported a negative psychosocial impact on their well-being and health-related quality of life - psychosocial impact results are reported in the Supplementary Material file. Genital warts prevalence was higher among male patients; female patients incurred higher costs. Among men, genital warts had a negative psychosocial impact on well-being and health-related quality of life.

  2. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    National Consortium on Health Science and Technology Education, Okemos, MI.

    This document presents the National Health Care Skill Standards, which were developed by the National Consortium on Health Science and Technology and West Ed Regional Research Laboratory, in partnership with educators and health care employers. The document begins with an overview of the purpose and benefits of skill standards. Presented next are…

  3. National health expenditures, 1991

    PubMed Central

    Letsch, Suzanne W.; Lazenby, Helen C.; Levit, Katharine R.; Cowan, Cathy A.

    1992-01-01

    Spending for health care rose to $751.8 billion in 1991, an increase of 11.4 percent from the 1990 level. National health expenditures as a share of gross domestic product increased to 13.2 percent, up from 12.2 percent in 1990. The health care sector exhibited strong growth, despite slow growth in the overall economy. This combination resulted in the largest increase in the share of the Nation's output consumed by health care in the past three decades. In this article, the authors present estimates of health spending in the United States for 1991. The authors also examine reasons for the unusually large growth in Medicaid expenditures and highlight recent trends in the hospital sector. PMID:10127445

  4. Application of concentration ratios to analyze the phenomenon of "next-door" pharmacy in Taiwan.

    PubMed

    Ji Chen, Tzeng; Chou, Li-Fang; Hwang, Shinn Jang

    2006-08-01

    In Taiwan, a policy of separation of prescribing and dispensing practices of practitioners at Western medical and dental clinics was implemented on an incremental basis in 1997. The purpose of this policy was to promote pharmacists' autonomy and increase the transparency and safety of prescribing medications. To avoid profit loss from no longer being able to dispense prescription medications, some clinics opened pharmacies located under the same roof as the clinic ("next-door" pharmacies) or hired an on-site pharmacist. This practice might compromise pharmacists' professional autonomy and patients' benefit in pharmaceutical care. The aim of the current study was to clarify the relationship between practicing pharmacies and clinics that resulted from contracts between pharmacies and the Bureau of National Health Insurance from 1996 to 2004. The National Health Research Institutes database in Taiwan supplied the complete claims data sets of practicing pharmacies from 1997 to 2004. The prescribing source of every dispensed prescription was used to calculate the 1-firm concentration ratio (CR-1) (ie, the proportion of prescriptions issued by the largest prescribing clinic/hospital in the total number of dispensed prescriptions of a pharmacy in each year). Similar processing was applied to the clinics. We identified each clinic's largest cooperating pharmacy and compared their CR-1s. Pharmacies that dispensed >900 prescriptions/mo during the study period were considered thriving. Pharmacies with a CR-1 > or =0.99 and whose largest cooperating clinic had a CR-1 > or =0.99 were considered to have a close business relationship, possibly indicating a next-door pharmacy. The total number of prescriptions dispensed at all pharmacies in the database grew from 226,901 in 1996 to 59,785,039 in 2004, and the number of pharmacies, from 481 to 3529. An increasing number of pharmacies had a higher CR-1 after 1999. We found that most prescriptions could be dispensed at only 1

  5. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    Far West Lab. for Educational Research and Development, San Francisco, CA.

    This booklet contains draft national health care skill standards that were proposed during the National Health Care Skill Standards Project on the basis of input from more than 1,000 representatives of key constituencies of the health care field. The project objectives and structure are summarized in the introduction. Part 1 examines the need for…

  6. Risk of suicide according to the level of psychiatric contact in the older people: Analysis of national health insurance databases in Taiwan.

    PubMed

    Yeh, Shin-Ting; Ng, Yee-Yung; Wu, Shiao-Chi

    2017-04-01

    Suicide in the older people is a serious problem worldwide; however the effect of psychiatric contact on the risk of suicide has not been fully explored. The aim of this study was to investigate the relationship between psychiatric contact and suicide in the older people in Taiwan. A population-based database was used in this national case-control study. Propensity score matching was used to match older people who did and did not commit suicide from 2010 to 2012 by calendar year, gender, age, and area of residence. The level of psychiatric contact in the preceding year was classified as "no psychiatric contact," "only outpatient psychiatric contact," "psychiatric emergency room contact," or "psychiatric hospital admission". Conditional logistic regression analysis was used to assess associations between variables and the risk of suicide. A total of 2528 older people committed suicide from 2010 to 2012, with a crude suicide mortality rate of 3.37/10,000. Compared to those who had no psychiatric contact in the preceding year, the adjusted odds ratios of suicide were 10.15 (95% CI=5.8-17.7) for those who had psychiatric emergency room contact, 6.57 (95% CI=3.7-11.6) for those who had psychiatric hospital admissions, and 3.64 (95% CI=3.0-4.4) for those with only outpatient psychiatric contact. The risk of suicide was higher in those who had depression (OR=3.49, 95% CI=2.2-5.4) and bipolar disorder (OR=1.98, 95% CI=1.1-3.6). Patients with cancer were associated with suicide (OR=8.96, 95% CI=5.6-14.4). The positive association with suicide and the level of psychiatric contact in the preceding year in older people indicated that the health personnel need to do a better job in determining possible risk for older people who had psychiatric contact, especially in emergency visit or psychiatric admission. A systematic approach to quality improvement in these settings is both available and necessary. Careful discharge planning and safe transitions of care to outpatient

  7. Importance-Performance Analysis of Personal Health Records in Taiwan: A Web-Based Survey.

    PubMed

    Rau, Hsiao-Hsien; Wu, Yi-Syuan; Chu, Chi-Ming; Wang, Fu-Chung; Hsu, Min-Huei; Chang, Chi-Wen; Chen, Kang-Hua; Lee, Yen-Liang; Kao, Senyeong; Chiu, Yu-Lung; Wen, Hsyien-Chia; Fuad, Anis; Hsu, Chien-Yeh; Chiu, Hung-Wen

    2017-04-27

    Empowering personal health records (PHRs) provides basic human right, awareness, and intention for health promotion. As health care delivery changes toward patient-centered services, PHRs become an indispensable platform for consumers and providers. Recently, the government introduced "My health bank," a Web-based electronic medical records (EMRs) repository for consumers. However, it is not yet a PHR. To date, we do not have a platform that can let patients manage their own PHR. This study creates a vision of a value-added platform for personal health data analysis and manages their health record based on the contents of the "My health bank." This study aimed to examine consumer expectation regarding PHR, using the importance-performance analysis. The purpose of this study was to explore consumer perception regarding this type of a platform: it would try to identify the key success factors and important aspects by using the importance-performance analysis, and give some suggestions for future development based on it. This is a cross-sectional study conducted in Taiwan. Web-based invitation to participate in this study was distributed through Facebook. Respondents were asked to watch an introductory movie regarding PHR before filling in the questionnaire. The questionnaire was focused on 2 aspects, including (1) system functions, and (2) system design and security and privacy. The questionnaire would employ 12 and 7 questions respectively. The questionnaire was designed following 5-points Likert scale ranging from 1 ("disagree strongly") to 5 ("Agree strongly"). Afterwards, the questionnaire data was sorted using IBM SPSS Statistics 21 for descriptive statistics and the importance-performance analysis. This research received 350 valid questionnaires. Most respondents were female (219 of 350 participants, 62.6%), 21-30 years old (238 of 350 participants, 68.0%), with a university degree (228 of 350 participants, 65.1%). They were still students (195 out of 350

  8. No Aboriginal Students left Behind in Taiwan

    ERIC Educational Resources Information Center

    Wu, Sue-Jen; Hartzler-Miller, Cynthia

    2005-01-01

    The project is motivated by Taiwan's huge gap of educational levels between the aborigines and the Hans. The low achievement of aboriginal students lies in factors related to problems in finance, health, and cultural difference, which contribute to their sense of self-deprecation. The purpose of the project is to provide early intervention and…

  9. Research of Helium Isotopes in Taiwan: The Legacy of Dr. Tsanyao Frank Yang

    NASA Astrophysics Data System (ADS)

    Yang, Tsanyao Frank; Lan, Tefang; Lee, Hsiao-Fen; Fu, Ching-Chou; Chuang, Pei-Chuan; Hong, Wei-Li; Walia, Vivek; Chen, Hsuan-Wen; Wen, Hsin-Yi; Chen, Ai-Ti; Chen, Hsiao-Chi; Chiu, Chun-Ming; Cheng, Chun-Yuan; Wu, Nian-Ru; Cheng, Yu-Chen; Chuang, Jin-Lun; Kao, Li-Hsin; Chen, Cheng-Hong; Sano, Yuji

    2016-04-01

    Helium isotope systematics is a powerful proxy to distinguish fluid origins and conveys fruitful geological information. In the past several decades, this robust isotope systematics had offered pivotal knowledge on many key issues in Earth and planetary sciences. It revealed essential geological information of Taiwan as well. Taiwan is located on the junction of two subduction systems-Ryukyu Arc and Luzon Arc. The geotectonic setting is complex and intriguing. Dr. Tsanyao Frank Yang was the pioneer of gas geochemistry studies in Taiwan. He established the first gas geochemistry laboratory in National Taiwan University in 1998 and started exploring all possible research topics on and around this tectonic-active island. In the past two decades, his research covered volcanic/hydrothermal gas studies, volcanic activity monitoring, gas hydrate exploration, soil gas as a tool to locate fault traces, soil gas flux measurement, earthquake precursory, mud volcanoes, low-temperature geochronology and many more. He died of pancreas cancer in March 2015. He was a warm and enthusiastic mentor, a prolific scientist and a great friend. He will always be remembered. Here we present Dr. Yang's achievement on helium isotopes studies in Taiwan throughout his research career. We integrate all the research results from his team and summarize the observations. We will show the distribution of helium isotope ratios in Taiwan and its implications on tectonic settings.

  10. Mental health of female foreign spouses in transnational marriages in southern Taiwan.

    PubMed

    Shu, Bih-Ching; Lung, For-Wey; Chen, Ching-Hsien

    2011-01-06

    The aim of this study was to investigate the mental health status, and the risk factors associated with mild psychiatric disorders, of female foreign spouses (from Vietnam, Indonesia, and mainland China) in southern Taiwan, and to understand the mental health needs of these women. One hundred and twenty nine participants were willing to participate in this study. All participants fulfilled all questionnaires which included demographic information, the Chinese Health Questionnaire (CHQ), the Eysenck Personality Questionnaire (EPQ), and the Mental Health Care Needs Questionnaire (MHCNQ). By multiple linear regression, neuroticism characteristics (p = 0.000), the dimension of knowledge of the level of their own psychological disturbance (p = 0.001), dimension of friends assistance (p = 0.033), and dimension of religion comfort (p = 0.041) in mental health care needs could be used to predict possible mild psychiatric disorders. Furthermore, SEM model showed that Indonesian or Vietnamese spouses have more likely degree in mental health care needs (β = -0.24, p = 0.003), compared with Chinese ones. A higher level of neuroticism was associated with a greater likelihood of mild psychiatric disorder (β = 0.54, p < 0.001), and of mental health care needs (β = 0.21, p = 0.013). A higher degree of mental health care needs was related to a greater likelihood of mild psychiatric disorder (β = 0.14, p = 0.05). In conclusion, we have obtained a better understanding of the mental health status of female foreign spouses in transnational marriages, who face many difficulties. Indonesian or Vietnamese spouses tend to more likely degree in mental health care needs than Chinese spouses, and then indirectly influenced their mental health status. Some individuals with a neurotic personality are exposed to high risk and might suffer from mild psychiatric symptoms. The needs for psychological counseling and religion therapy were the first priority for these women, particularly the

  11. Mental health of female foreign spouses in transnational marriages in southern Taiwan

    PubMed Central

    2011-01-01

    Background The aim of this study was to investigate the mental health status, and the risk factors associated with mild psychiatric disorders, of female foreign spouses (from Vietnam, Indonesia, and mainland China) in southern Taiwan, and to understand the mental health needs of these women. Methods One hundred and twenty nine participants were willing to participate in this study. All participants fulfilled all questionnaires which included demographic information, the Chinese Health Questionnaire (CHQ), the Eysenck Personality Questionnaire (EPQ), and the Mental Health Care Needs Questionnaire (MHCNQ). Results By multiple linear regression, neuroticism characteristics (p = 0.000), the dimension of knowledge of the level of their own psychological disturbance (p = 0.001), dimension of friends assistance (p = 0.033), and dimension of religion comfort (p = 0.041) in mental health care needs could be used to predict possible mild psychiatric disorders. Furthermore, SEM model showed that Indonesian or Vietnamese spouses have more likely degree in mental health care needs (β = -0.24, p = 0.003), compared with Chinese ones. A higher level of neuroticism was associated with a greater likelihood of mild psychiatric disorder (β = 0.54, p < 0.001), and of mental health care needs (β = 0.21, p = 0.013). A higher degree of mental health care needs was related to a greater likelihood of mild psychiatric disorder (β = 0.14, p = 0.05). Conclusion In conclusion, we have obtained a better understanding of the mental health status of female foreign spouses in transnational marriages, who face many difficulties. Indonesian or Vietnamese spouses tend to more likely degree in mental health care needs than Chinese spouses, and then indirectly influenced their mental health status. Some individuals with a neurotic personality are exposed to high risk and might suffer from mild psychiatric symptoms. The needs for psychological counseling and religion therapy were the first priority

  12. Longitudinal trends of the healthcare-seeking prevalence and incidence of insomnia in Taiwan: an 8-year nationally representative study.

    PubMed

    Hsu, Ya-Wen; Ho, Chung-Han; Wang, Jhi-Joung; Hsieh, Kuang-Yang; Weng, Shih-Feng; Wu, Ming-Ping

    2013-09-01

    We used insurance claims of a nationally representative population-based cohort to assess the longitudinal healthcare-seeking prevalence and incidence of insomnia. Participants were identified from National Health Insurance enrollees in Taiwan during 2002 to 2009. Individuals with insomnia were identified using The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic and procedure codes of 780.52, 307.41, and 307.42. In 2009 the prevalence of insomnia was 5.4% for women and 3.0% for men; the incidence of insomnia was 1.6% for women and 1.3% for men. Patients who were women (odds ratio [OR]), 1.82; 95% confidence interval [CI], 1.79-1.86), who were older (50-64 years: OR, 23.25; 95% CI, 21.07-25.64; ≥ 65 years: OR, 24.70; 95% CI, 22.40-27.24), and who were in the middle socioeconomic status (SES) group (OR, 1.19; 95% CI, 1.16-1.21) were more likely to have insomnia. An inverse U-shaped woman-to-man ratio trend for the insomnia prevalence was found, and this ratio reached a peak around the menopausal transitional period. The persistence of healthcare-seeking behaviors with insomnia was more common in women. Our findings underscore the need to initiate treatment at an early stage as opposed to waiting for the spontaneous resolution of insomnia. Future research needs to identify causes of the persistence of insomnia and to develop proper interventions to reduce its rising prevalence. More active approaches toward preventive strategies for insomnia are needed, especially for women who are at higher risk for insomnia. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Fatal occupational injuries in Taiwan, 1994-2005.

    PubMed

    Ho, Shu-Chen; Wang, Li-Yu; Ho, Chi-Kung; Yang, Chun-Yuh

    2010-04-01

    This study examines the trends in rates of fatal occupational injuries in Taiwan by demographic group and occupation for 1994-2005. Data on deaths due to injuries at work from 1994 through 2005 were obtained from the Department of Health which is responsible for the death registration system in Taiwan. Employment data, which were used as the denominators of fatality rates in this study, were retrieved from the Directorate-General of Budget and Accounting Statistics 'Employment and Earnings' database. A Poisson regression model was used to examine the trends in rates of fatal occupational injuries in various occupations while controlling for demographic characteristics. Overall fatal occupational injury rates declined during the study period among all demographic groups and occupations. Adjusted annual changes in rates of fatal injuries ranged from a decrease of 13.6% a year in machine operators/related workers to a decrease of 35.9% in clerks. The annual decrement was faster for males than for females and for older workers compared to young workers. Despite declining rates, the number of fatal occupational injuries in Taiwan remains significant because of the growing work force. Future research should focus on the disparities in fatal injury trends.

  14. Vocational Education at the Crossroads. The Case of Taiwan.

    ERIC Educational Resources Information Center

    Chen, Gerald C.; Shih, Mingfa

    Programs and curricula in vocational education in Taiwan have traditionally been linked to the nation's priority of economic development. The current vocational education system originated in the 1950s. In the 1970s, public free education was extended from 6 years of elementary school education to include an additional 3 years of junior high…

  15. Prescription patterns of Chinese herbal products for post-surgery colon cancer patients in Taiwan.

    PubMed

    Chao, Te-Hsin; Fu, Pin-Kuei; Chang, Chiung-Hung; Chang, Shih-Ni; Chiahung Mao, Frank; Lin, Ching-Heng

    2014-08-08

    Traditional Chinese medicine (TCM) is commonly provided to cancer patients, however, the patterns of prescriptions for this type of medicine in Taiwan are unclear. This study aimed to evaluate the use of traditional Chinese medicine products in colon cancer patients post-surgery in Taiwan and to research patterns of TCM. This was a cross-sectional study of newly diagnosed colon cancer patients who received surgery between 2004 and 2008 identified from the National Health Insurance Research Database of Taiwan. The prescription patterns and reasons for the use of TCM for colon cancer were analyzed. The results showed that "symptoms, signs and ill-defined conditions" (23.3%) and diseases of the digestive system (16.9%) were the most common reasons for using Chinese herbal medicine. Xiang-sha-liu-jun-zi-tang (7.1%), Bu-zhong-yi-qi-tang (4.3%), Jia-wei-xiao-yao-san (4.1%), Shen-Ling-Bai-Zhu-San (3.7%), Ban-Xia-Xie-Xin-Tang (3.4%), Gui-pi-tang (2.4%), Ping-Wei-San (2.4%), Gan-Lu-Yin (2.0%), Bao-He-Wan (1.9%), and Zhen-Ren-Huo-Ming-Yin (1.8%) were the most commonly prescribed single Chinese herbal formulae (CHF) for colon cancer patients post-surgery. Hedyotis diffusa Willd (Bai Hua She She Cao) (5.1%) and Scutellaria barbata (Ban Zhi Lian )(4.8%) were the most commonly prescribed single Chinese herbs. This study identified patterns of TCM use in colon cancer patients post-surgery in Taiwan. The herbal ingredients were most commonly used for stimulate ghrelin secretion to increase food intake and had potential anti-tumor effect. However, further research is required to evaluate any beneficial effects which could identify leads for the development of new treatment strategies using TCM. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. 76 FR 16798 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review.... Place: National Institutes of Health, 6701 Rockledge Drive, Bethesda, MD 20892 (Telephone Conference..., National Institutes of Health, 6701 Rockledge Drive, Room 4136, MSC 7850, Bethesda, MD 20892, (301) 435...

  17. 75 FR 6044 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... individual intramural programs and projects conducted by the National Institute of Environmental Health...

  18. Progress and Prospect of Physics Research and Education in Taiwan

    NASA Astrophysics Data System (ADS)

    Raynien Kwo, J.

    2010-03-01

    Started about two decades ago, the global trend of shifting industrial manufacture power from western developed countries toward developing countries in Asia has in turn become the impetus in building up physical science and research in these areas. A very good example is the remarkable progress of physical research and education in Taiwan, in terms of quantity and quality. The continuous elevation of Taiwan's high education into graduate level plus the government's strong commitment to research and development on a level of 2.62 % GDP have led to an impressive physics program with an annual budget ˜32 million USD from National Science Council in supporting 568 PIs. The investigation scope encompasses high energy and astrophysics, nano and condensed matter, and semiconductor, optoelectronic physics, etc. The former is vigorously conducted via international collaborative efforts of LHC, KEK, ALMA, Pan-STARRS, etc. The latter is driven by vital Taiwan high tech industry mostly semiconductor IC and optoelectronics flourished during this period. The early trend of outflows of BS physics majors to western world for advanced studies has reversed dramatically. Nearly 80% of the BS students continue their MS and PhD degrees in Taiwan, attracted by lucrative job markets of high tech industry. In addition, healthy inflow of high-quality science manpower of well trained PhDs and senior scholars returning to homeland has strengthened the competitiveness. Overall, the physics community in Taiwan is thriving. The annual Physical Society meeting is expanding at a rate of 6%, reaching ˜1800 attendants and 1200 papers, and dedicated to promotions of female physicists and students. The publication quantity of Taiwan in top journals of PRs and PRL is ranked among top 20^th for all fields of physics, and ranked the 6^th in APL. Clearly Taiwan has now emerged as a strong power in applied science, not limited by its population size. Concerted efforts on scientific exchanges are being

  19. Application of three different sets of explicit criteria for assessing inappropriate prescribing in older patients: a nationwide prevalence study of ambulatory care visits in Taiwan.

    PubMed

    Chang, Chirn-Bin; Yang, Shu-Yu; Lai, Hsiu-Yun; Wu, Ru-Shu; Liu, Hsing-Cheng; Hsu, Hsiu-Ying; Hwang, Shinn-Jang; Chan, Ding-Cheng

    2015-11-06

    To investigate the national prevalence of potentially inappropriate medications (PIMs) prescribed in ambulatory care clinics in Taiwan according to three different sets of regional criteria and the correlates of PIM use. Cross-sectional study. This analysis included older patients who visited ambulatory care clinics in 2009 and represented half of the older population included on the Taiwanese National Health Insurance Research Database. We identified 1,164,701 subjects who visited ambulatory care clinics and were over 65 years old in 2009. PIM prevalence according to the 2012 Beers criteria, the PIM-Taiwan criteria and the PRISCUS criteria was estimated separately, and characteristics of PIM users were explored. Multivariate logistic regression analysis was used to determine patient factors associated with the use of at least one PIM. Leading PIMs for each set of criteria were also listed. The prevalence of having at least one PIM at the patient level was highest with the Beers criteria (86.2%), followed by the PIM-Taiwan criteria (73.3%) and the PRISCUS criteria (66.9%). Polypharmacy and younger age were associated with PIM use for all three sets of criteria. The leading PIMs detected by the PIM-Taiwan and PRISCUS criteria were all included in the 2012 Beers criteria. Non-COX-selective non-steroidal anti-inflammatory drugs in the Beers criteria and benzodiazepines in the PIM-Taiwan and PRISCUS criteria accounted for most leading PIMs. The prevalence of PIMs was high among older Taiwanese patients receiving ambulatory care visits. The prevalence of PIM and its associated factors varied according to three sets of criteria at the population level. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Psychometric testing of the short version of the world health organization quality of life (WHOQOL-BREF) questionnaire among pulmonary tuberculosis patients in Taiwan

    PubMed Central

    2012-01-01

    Background Studies on the effects of tuberculosis on a patient’s quality of life (QOL) are scant. The objective of this study was to evaluate the psychometric properties of the Taiwan short version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire using patients with tuberculosis in Taiwan and healthy referents. Methods The Taiwanese short version of the WHOQOL-BREF was administered to patients with tuberculosis undergoing treatment and healthy referents from March 2007 to July 2007. Patients with tuberculosis (n = 140) and healthy referents (n = 130), matched by age, sex, and ethnicity, agreed to an interview. All participants lived in eastern Taiwan. Reliability assessments included internal consistency, whereas validity assessments included construct validity, convergent validity, and discriminant validity. Results More than half of these patients and referents were men (70.7% and 66.2%, respectively), and their average ages were 50.1 and 47.9 years, respectively. Approximately 60% of patients and referents were aboriginal Taiwanese (60.7% and 61.1%, respectively). The proportion with low socioeconomic status was greater for these patients. The internal consistency reliability coefficients were .92 and .93 for the patients and healthy referents, respectively. Exploratory factor analysis on the healthy referents displayed a 4-domain model, which was compatible with the original WHOQOL-BREF 4-domain model. However, for the TB patient group, after deleting 3 items, both exploratory and confirmatory factor analysis revealed a 6-domain model. Conclusion Psychometric evaluation of the Taiwan short version of the WHOQOL-BREF indicates that it has adequate reliability for use in research with TB patients in Taiwan. However, the factor structure generated from this TB patient sample differed from the WHO’s original 4-factor model, which raised a validity concern to apply the Taiwan short version of the WHOQOL-BREF to Taiwanese TB

  1. National health expenditures, 1988

    PubMed Central

    1990-01-01

    Every year, analysts in the Health Care Financing Administration present figures on what our Nation spends for health. As the result of a comprehensive re-examination of the definitions, concepts, methods, and data sources used to prepare those figures, this year's report contains new estimates of national health expenditures for calendar years 1960 through 1988. Significant changes have been made to estimates of spending for professional services and to estimates of what consumers pay out of pocket for health care. In the first article, trends in use of and expenditure for various types of goods and services are discussed, as well as trends in the sources of funds used to finance health care. In a companion article, the benchmark process is described in more detail, as are the data sources and methods used to prepare annual estimates of health expenditures. PMID:10113395

  2. 76 FR 53685 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Submission for OMB Review... data collection projects, the Center for Scientific Review (CSR), National Institutes of Health (NIH... for public comment. The National Institutes of Health may not conduct or sponsor and the respondent is...

  3. Cost-effectiveness of childhood rotavirus vaccination in Taiwan.

    PubMed

    Wu, Chia-Ling; Yang, Yi-Ching; Huang, Li-Min; Chen, Kow-Tong

    2009-03-04

    Rotavirus is the most common cause of severe diarrhea in children. Two rotavirus vaccines (RotaTeq and Rotarix) have been licensed in Taiwan. We have investigated whether routine infant immunization with either vaccine could be cost-effective in Taiwan. We modeled specific disease outcomes including hospitalization, emergency department visits, hospital outpatient visits, physician office visits, and death. Cost-effectiveness was analyzed from the perspectives of the health care system and society. A decision tree was used to estimate the disease burden and costs based on data from published and unpublished sources. A routine rotavirus immunization program would prevent 146,470 (Rotarix) or 149,937 (RotaTeq) cases of rotavirus diarrhea per year, and would prevent 21,106 (Rotarix) and 23,057 (RotaTeq) serious cases (hospitalizations, emergency department visits, and death). At US$80 per dose for the Rotarix vaccine, the program would cost US$32.7 million, provided an increasing cost offset of US$19.8 million to the health care system with $135 per case averted. Threshold analysis identified a break-even price per dose of US$27 from the health care system perspective and US$41 from a societal perspective. At US$60.0 per dose of RotaTeq vaccine, the program would cost US$35.4 million and provide an increasing cost offset of US$22.5 million to the health care system, or US$150 per case averted. Threshold analysis identified a break-even price per dose of US$20.0 from the health care system perspective and $29 from the societal perspective. Greater costs of hospitalization and lower vaccine price could increase cost-effectiveness. Despite a higher burden of serious rotavirus disease than estimated previously, routine rotavirus vaccination would unlikely be cost-saving in Taiwan at present unless the price fell to US$41 (Rotarix) or US$29 (RotaTeq) per dose from societal perspective, respectively. Nonetheless, rotavirus immunization could reduce the substantial burden of

  4. International differences in the links between obesity and physiological dysregulation: the United States, England, and Taiwan.

    PubMed

    Vasunilashorn, Sarinnapha; Kim, Jung Ki; Crimmins, Eileen M

    2013-01-01

    Excess weight has generally been associated with adverse health outcomes; however, the link between overweight and health outcomes may vary with socioeconomic, cultural, and epidemiological conditions. We examine associations of weight with indicators of biological risk in three nationally representative populations: the US National Health and Nutrition Examination Survey, the English Longitudinal Study of Ageing, and the Social Environment and Biomarkers of Aging Study in Taiwan. Indicators of biological risk were compared for obese (defined using body mass index (BMI) and waist circumference) and normal weight individuals aged 54+. Generally, obesity in England was associated with elevated risk for more markers examined; obese Americans also had elevated risks except that they did not have elevated blood pressure (BP). Including waist circumference in our consideration of BMI indicated different links between obesity and waist size across countries; we found higher physiological dysregulation among those with high waist but normal BMI compared to those with normal waist and normal BMI. Americans had the highest levels of biological risk in all weight/waist groups. Cross-country variation in biological risk associated with obesity may reflect differences in health behaviors, lifestyle, medication use, and culture.

  5. International Differences in the Links between Obesity and Physiological Dysregulation: The United States, England, and Taiwan

    PubMed Central

    Vasunilashorn, Sarinnapha; Kim, Jung Ki; Crimmins, Eileen M.

    2013-01-01

    Excess weight has generally been associated with adverse health outcomes; however, the link between overweight and health outcomes may vary with socioeconomic, cultural, and epidemiological conditions. We examine associations of weight with indicators of biological risk in three nationally representative populations: the US National Health and Nutrition Examination Survey, the English Longitudinal Study of Ageing, and the Social Environment and Biomarkers of Aging Study in Taiwan. Indicators of biological risk were compared for obese (defined using body mass index (BMI) and waist circumference) and normal weight individuals aged 54+. Generally, obesity in England was associated with elevated risk for more markers examined; obese Americans also had elevated risks except that they did not have elevated blood pressure (BP). Including waist circumference in our consideration of BMI indicated different links between obesity and waist size across countries; we found higher physiological dysregulation among those with high waist but normal BMI compared to those with normal waist and normal BMI. Americans had the highest levels of biological risk in all weight/waist groups. Cross-country variation in biological risk associated with obesity may reflect differences in health behaviors, lifestyle, medication use, and culture. PMID:23781331

  6. Health Risk Assessment of Groundwater Arsenic Pollution in Southern Taiwan

    NASA Astrophysics Data System (ADS)

    Liang, Ching-Ping

    2015-04-01

    This study investigates the risk of arsenic (As) exposure to the residents in Pingtung Plain of Taiwan, where more than 50% of people extracts groundwater to meet the drinking purpose and monitoring groundwater shows that a considerable portion of groundwater has an As concentration of more than safe drinking water guideline of 10μg/L-1. Exposure and risk assessment are carried out in accordance with the provisional daily intake (PTDI) recommended by the FAO/WHO as well as hazard quotient and cancer risk standards based on the US Environmental Protection Agency. The variability of body weights and drinking water consumption scenarios are considered in exposure and risk assessment. Results shows that daily intake exceeds 2.1μg day-1 kg-1 BW for 2% of population, HQ level above unity for 20% , and can risk greater than 10-6 for 80%. These results implies that drinking water directly from groundwater will place many people at the risk of exposure and any efforts to supply safe drinking water is imperial for governing in order to protect the human health of inhabitants in Pingtung Plain.

  7. Is Fibromyalgia Risk Higher Among Male and Young Inflammatory Bowel Disease Patients? Evidence from a Taiwan Cohort of One Million.

    PubMed

    Chen, Jiunn-Horng; Chen, Hsuan-Ju; Kao, Chia-Hung; Tseng, Chun-Hung; Tsai, Chon-Haw

    2018-05-01

    Prior literatures have shown inflammatory bowel disease (IBD) could increase fibromyalgia (FM) risk. However, studies about gender and age distributions of FM risk among patients with IBD are rare. With large study samples, this study aimed to evaluate the FM risk among IBD patients with different gender and different age. We aim to estimate the FM risk among male and younger IBD patients with a large patient sample. A retrospective cohort study was arranged in this research. The data used in this research were selected from the Taiwan National Health Insurance Research Database (NHIRD). From the Taiwan NHIRD, we selected 4,510 patients with IBD and 18,040 randomly gender- and age-matched patients without a history of IBD from the beginning of 2000 to the end of 2005 to analyze the development of FM over a 12-year follow-up period (2000-2011). The Cox regression model was used to assess the effects of IBD on the risk of FM by adjusting for gender, age, and comorbidities, including hypertension, diabetes, hyperlipidemia, depression, anxiety, and sleep disorder. After adjusting suitable covariates, the IBD patients had a greater FM risk (adjusted hazard ratio [aHR] 1.70, 95% confidence interval [CI] 1.59-1.83) than the controls. Male IBD patients had a higher FM risk than female IBD patients did (aHR 2.00, 95% CI 1.79-2.23 and aHR 1.52, 95% CI 1.38-1.67, respectively). The greatest age-specific FM risk occurred in the youngest IBD subgroup (= 39 years old) (aHR 1.92, 95% CI 1.68-2.19). The information about personal behaviors was unobtainable in the Taiwan NHIRD. Other risk factors for cardiovascular disease that might augment FM cannot be excluded entirely in this study. IBD is disclosed to be correlated with an enhanced risk to develop FM, particularly in male and younger IBD patients. For preventing FM, it is necessary to pay more attention to the management of the IBD patients. Future researches are needed to further confirm the findings in this study

  8. Childlessness patterns in Taiwan.

    PubMed

    Poston Dl

    1988-06-01

    Taiwan is a newly developed and industrialized area, and along with Korea, Brazil, Argentina, and a few other countries, belongs in a special class of recently industrialized areas. Taiwan has been undergoing large-scale modernization since the 1950s when the Nationalist government 1st began to implement land reform programs and today is 1 of the showcase of newly developed areas of the world. Demographic transition theory shows that fertility is negatively associated with modernization. During the past 3 decades, fertility in Taiwan has followed this pattern in a dramatic manner. Studies of childlessness conducted in Western countries have shown also that as the modernizing influences continue, fertility declines, and childlessness increases as it becomes more and more voluntary. Subregions with the highest levels of modernization and the lowest fertility rates should therefore be characterized by the highest levels of childlessness, particularly among younger women, and vice versa. Given the levels of socioeconomic and demographic development in Taiwan and its subregions circa 1980, as well as its variability among the hsiens and major cities, the author would expect to find higher levels of childlessness in the more developed localities, and lower levels in the less developed subregions. This hypothesis is tested with data from the 1980 Census of Population and Housing: General Report, Taiwan--Fukien Area (Republic of China, 1982) and the 1980 Taiwan--Fukien Demographic Fact Book (Republic of China, 1980).

  9. Innovation within a national health care system.

    PubMed

    Young, Antony

    2017-05-01

    Tony is a practicing frontline National Health Service surgeon and director of medical innovation at Anglia Ruskin University and has founded 4 medical-technology start-ups. He has also cofounded the £500 million Anglia Ruskin MedTech Campus, which will become one of the world's largest health innovation spaces. In 2014, he was appointed as national clinical director for innovation at National Health Service England and in February 2016 became the first national clinical lead for innovation. In this role, he provides clinical leadership and support in delivering improved health outcomes in England, drives the uptake of proven innovations across the National Health Service, promotes economic growth through innovation, and helps make the National Health Service the go-to place on the planet for medical innovation. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Prevalence of Polyherbacy in Ambulatory Visits to Traditional Chinese Medicine Clinics in Taiwan

    PubMed Central

    Lin, Ming-Hwai; Chang, Hsiao-Ting; Tu, Chun-Yi; Chen, Tzeng-Ji; Hwang, Shinn-Jang

    2015-01-01

    Patients with a polyherbal prescription are more likely to receive duplicate medications and thus suffer from adverse drug reactions. We conducted a population-based retrospective study to examine the items of Chinese herbal medicine (CHM) per prescription in the ambulatory care of traditional Chinese medicine (TCM) in Taiwan. We retrieved complete TCM ambulatory visit datasets for 2010 from the National Health Insurance database in Taiwan. A total of 59,790 patients who received 313,482 CHM prescriptions were analyzed. Drug prescriptions containing more than five drugs were classified as polyherbal prescriptions; 41.6% of patients were given a polyherbal prescription. There were on average 5.2 ± 2.5 CHMs: 2.3 ± 1.1 compound herbal formula items, and 3.0 ± 2.5 single Chinese herb items in a single prescription. Approximately 4.6% of patients were prescribed 10 CHMs or more. Men had a lower odds ratio (OR) among polyherbal prescriptions (OR = 0.96, 95% confidence interval [CI] 0.92–0.99), and middle-aged patients (35–49 years) had the highest frequency of polyherbal prescription (OR = 1.19, 95% CI = 1.13–1.26). Patients with neoplasm, skin and subcutaneous tissue disease, or genitourinary system disease were more likely to have a polyherbal prescription; OR = 2.20 (1.81–2.67), 1.65 (1.50–1.80), and 1.52 (1.40–1.64), respectively. Polyherbal prescription is widespread in TCM in Taiwan. Potential herb interactions and iatrogenic risks associated with polyherbal prescriptions should be monitored. PMID:26287228

  11. Higher migraine risk in healthcare professionals than in general population: a nationwide population-based cohort study in Taiwan.

    PubMed

    Kuo, Wan-Yin; Huang, Chien-Cheng; Weng, Shih-Feng; Lin, Hung-Jung; Su, Shih-Bin; Wang, Jhi-Joung; Guo, How-Ran; Hsu, Chien-Chin

    2015-01-01

    High stress levels and shift work probably trigger migraine in healthcare professionals (HCPs). However, the migraine risk differences between HCPs and the general population is unknown. This nationwide population-based cohort study used Taiwan's National Health Insurance Research Database. Physicians (50,226), nurses (122,357), and other HCPs (pharmacists, technicians, dietitians, rehabilitation therapists, social workers, etc.) (45,736) were enrolled for the study cohort, and randomly selected non-HCPs (218,319) were enrolled for the comparison cohort. Conditional logistical regression analysis was used to compare the migraine risks. Comparisons between HCPs and between physician specialties were also done. Physicians, nurses, and other HCPs had higher migraine risks than did the general population (adjusted odds ratio [AOR]: 1.672; 95 % confidence interval [CI]: 1.468-1.905, AOR: 1.621; 95 % CI: 1.532-1.714, and AOR: 1.254; 95 % CI: 1.124-1.399, respectively) after stroke, hypertension, epilepsy, anxiety, depression, and insomnia had been adjusted for. Nurses and physicians had higher migraine risks than did other HCPs (AOR: 1.303; 95 % CI: 1.206-1.408, and AOR: 1.193; 95 % CI: 1.069-1.332, respectively). Obstetricians and gynecologists had a lower migraine risk than did other physician specialists (AOR: 0.550; 95 % CI: 0.323-0.937). HCPs in Taiwan had a higher migraine risk than did the general population. Heavy workloads, emotional stress, and rotating night shift sleep disturbances appear to be the most important risk factors. These findings should provide an important reference for promoting occupational health in HCPs in Taiwan.

  12. Characteristics and management of infectious industrial waste in Taiwan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Huang, M.-C.; Lin, Jim Juimin

    Infectious industrial waste management in Taiwan is based on the specific waste production unit. In other countries, management is based simply on whether the producer may lead to infectious disease. Thus, Taiwan has a more detailed classification of infectious waste. The advantage of this classification is that it is easy to identify the sources, while the disadvantage lies in the fact that it is not flexible and hence increases cost. This study presents an overview of current management practices for handling infectious industrial waste in Taiwan, and addresses the current waste disposal methods. The number of small clinics in Taiwanmore » increased from 18,183 to 18,877 between 2003 and 2005. Analysis of the data between 2003 and 2005 showed that the majority of medical waste was general industrial waste, which accounted for 76.9%-79.4% of total medical waste. Infectious industrial waste accounted for 19.3%-21.9% of total medical waste. After the SARS event in Taiwan, the amount of infectious waste reached 19,350 tons in 2004, an increase over the previous year of 4000 tons. Waste minimization was a common consideration for all types of waste treatment. In this study, we summarize the percentage of plastic waste in flammable infectious industrial waste generated by medical units, which, in Taiwan was about 30%. The EPA and Taiwan Department of Health have actively promoted different recycling and waste reduction measures. However, the wide adoption of disposable materials made recycling and waste reduction difficult for some hospitals. It has been suggested that enhancing the education of and promoting communication between medical units and recycling industries must be implemented to prevent recyclable waste from entering the incinerator.« less

  13. Health financing in Malawi: Evidence from National Health Accounts

    PubMed Central

    2010-01-01

    Background National health accounts provide useful information to understand the functioning of a health financing system. This article attempts to present a profile of the health system financing in Malawi using data from NHA. It specifically attempts to document the health financing situation in the country and proposes recommendations relevant for developing a comprehensive health financing policy and strategic plan. Methods Data from three rounds of national health accounts covering the Financial Years 1998/1999 to 2005/2006 was used to describe the flow of funds and their uses in the health system. Analysis was performed in line with the various NHA entities and health system financing functions. Results The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. The country had not met the Abuja of allocating at least 15% of national budget on health. The percentage of total health expenditure from households' direct out-of-pocket payments decreased from 26% in 1998/99 to 12.1% in 2005/2006. Conclusion There is a need to increase government contribution to the total health expenditure to at least the levels of the Abuja Declaration of 15% of the national budget. In addition, the country urgently needs to develop and implement a prepaid health financing system within a comprehensive health financing policy and strategy with a view to assuring universal access to essential health services for all citizens. PMID:21062503

  14. The Current Status and Future of E-Learning in Taiwan

    ERIC Educational Resources Information Center

    Tsai, Chin-Chung; Chen, Nian-Shing; Chen, Gwo-Dong

    2010-01-01

    Like any other modern, forward-looking and technologically advanced nation, Taiwan has realised the current and future importance of electronic learning--now commonly referred to as "e-learning". Bearing this in mind, some years ago, the Taiwanese government introduced a number of initiatives that were intended to promote the development…

  15. Maintaining the Status Quo in the Taiwan Strait

    DTIC Science & Technology

    2013-03-01

    of National Security and Strategy 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) U.S. Army...Count: 5,308 14. ABSTRACT In order to ensure vital U.S. interests concerning security and economic freedom in the region, the status quo in the...international/regional support of Taiwan, Taiwanese military deterrence backed by strategically ambiguous U.S. assurances of security , intertwined

  16. Integrated structural model for active arc-continental collision from southern Taiwan to central Taiwan inferred from seismogenic views

    NASA Astrophysics Data System (ADS)

    Nagai, S.; Wang, Y.; Ma, K.; Wu, Y.; Huang, H.

    2010-12-01

    The Taiwan Island is located in ongoing arc-continent collision zone between the Philippine Sea Plate and the Eurasian Plate. Numerous geophysical and geological studies have explained the tectonic processes and developed various models. There are two end-member models for Taiwan collision; Thin-skinned model [e.g. Suppe, 1987] and Lithospheric collision model [Wu et al., 1997]. One of most important issue is that collision in Taiwan involves and contributes deformation to what depth. We have presented on this point in central Taiwan through seismological views, including both observed facts and results of tomographic inversion [Nagai et al., 2010 in WPGM 2010]. We have concluded that orogenic process should involve and contribute to depth of 30 km at least in central Taiwan, and suggested ’Upper Crustal Stacking Model’. We have indicated that existence of low-velocity blocks under Central Mountain Range (CMR) is one of the most important factors to understand Taiwan arc-continental collision process. We extend this idea to southern and northern Taiwan and to connect with balanced cross-sections proposed in Ustaszewski et al. [2010]. In this talk, we focused on the structural variation from southern Taiwan to central Taiwan. We have been performing the local double-difference tomography [Zhang and Thurber, 2003] in southern and northern Taiwan using the Central Weather Bureau Seismic Network with temporary array observations. These results in seismic tomography show variation of seismic velocity under the CMR like in central Taiwan. Low-velocity anomalies are also detected. Although it should be checked carefully, velocity blocks segmented some parts and seismic activities seem to be located on their boundaries. The Jiaxian earthquake on 4th Mar, 2010 occurred on one of these segmentation boundaries. The tectonic process in Taiwan arc-continental collision consists of different-scale structures, which means finer resolution structures may be nested with the

  17. Effects of Cobalt-60 Exposure on Health of Taiwan Residents Suggest New Approach Needed in Radiation Protection

    PubMed Central

    Chen, W.L.; Luan, Y.C.; Shieh, M.C.; Chen, S.T.; Kung, H.T.; Soong, K.L; Yeh, Y.C.; Chou, T.S.; Mong, S.H.; Wu, J.T.; Sun, C.P.; Deng, W.P.; Wu, M.F.; Shen, M.L.

    2007-01-01

    The conventional approach for radiation protection is based on the ICRP's linear, no threshold (LNT) model of radiation carcinogenesis, which implies that ionizing radiation is always harmful, no matter how small the dose. But a different approach can be derived from the observed health effects of the serendipitous contamination of 1700 apartments in Taiwan with cobalt-60 (T1/2 = 5.3 y). This experience indicates that chronic exposure of the whole body to low-dose-rate radiation, even accumulated to a high annual dose, may be beneficial to human health. Approximately 10,000 people occupied these buildings and received an average radiation dose of 0.4 Sv, unknowingly, during a 9–20 year period. They did not suffer a higher incidence of cancer mortality, as the LNT theory would predict. On the contrary, the incidence of cancer deaths in this population was greatly reduced—to about 3 per cent of the incidence of spontaneous cancer death in the general Taiwan public. In addition, the incidence of congenital malformations was also reduced—to about 7 per cent of the incidence in the general public. These observations appear to be compatible with the radiation hormesis model. Information about this Taiwan experience should be communicated to the public worldwide to help allay its fear of radiation and create a positive impression about important radiation applications. Expenditures of many billions of dollars in nuclear reactor operation could be saved and expansion of nuclear electricity generation could be facilitated. In addition, this knowledge would encourage further investigation and implementation of very important applications of total-body, low-dose irradiation to treat and cure many illnesses, including cancer. The findings of this study are such a departure from expectations, based on ICRP criteria, that we believe that they ought to be carefully reviewed by other, independent organizations and that population data not available to the authors be provided

  18. Techno-politics of genomic nationalism: tracing genomics and its use in drug regulation in Japan and Taiwan.

    PubMed

    Kuo, Wen-Hua

    2011-10-01

    This paper compares the development of genomics as a form of state project in Japan and Taiwan. Broadening the concepts of genomic sovereignty and bionationalism, I argue that the establishment and use of genomic databases vary according to techno-political context. While both Japan and Taiwan hold population-based databases to be necessary for scientific advance and competitiveness, they differ in how they have attempted to transform the information produced by databases into regulatory schemes for drug approval. The effectiveness of Taiwan's biobank is severely limited by the IRB reviewing process. By contrast, while updating its regulations for drug approval, Japan, is using pharmacogenomics to deal with matters relating to ethnic identity. By analysing genomic initiatives in the political context that nurtures them, this paper seeks to capture how global science and local societies interact and offers insight into the assessment of state-sponsored science in East Asia as they become transnational. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Oseltamivir use and outcomes during the 2009 influenza A H1N1 pandemic in Taiwan

    PubMed Central

    2013-01-01

    Background The Taiwan CDC provided free oseltamivir to all patients with influenza infections confirmed by rapid testing or who had clinical warning symptoms during the 2009 H1N1 influenza pandemic in Taiwan. However, oseltamivir utilization patterns, cost, and outcomes among oseltamivir-treated patients remained unclear. Method A population-level, observational cohort study was conducted using the Taiwan National Health Insurance Database from January to December 2009 to describe the use of oseltamivir. Result Prescription trend over weeks increased after a change in government policy and responded to the influenza virus activity. The overall prescription rate was 22.33 per 1000 persons, with the highest prescription rate of 116.5 for those aged 7–12 years, followed by 69.0 for those aged 13–18 years, while the lowest rate was 1.7 for those aged ≥ 65 years. As influenza virus activity increased, the number of prescriptions for those aged ≤18 years rose significantly, whereas no substantial change was observed for those aged ≥65 years. There were also regional variations in terms of oseltamivir utilization and influenza complication rates. Conclusions Oseltamivir was widely used in the 2009 H1N1 influenza pandemic in Taiwan, particularly in those aged 7–18 years. The number of prescriptions for oseltamivir increased with a change in government policy and with increasing cases of pandemic influenza. Further study is needed to examine whether there is an over- or under-use of anti-influenza drugs in different age groups or regions and to examine the current policy of public use of anti-influenza drugs to reduce influenza-associated morbidity and mortality. PMID:23849163

  20. Health care service utilization and associated factors among heroin users in northern Taiwan.

    PubMed

    Chen, Yi-Chih; Chen, Chih-Ken; Lin, Shih-Ku; Chiang, Shu-Chuan; Su, Lien-Wen; Wang, Liang-Jen

    2013-11-01

    Due to the needs of medical care, the probability of using health care service from heroin users is high. This cross-sectional study investigated the frequency and correlates of health service utilization among heroin users. From June to September 2006, 124 heroin users (110 males and 14 females, mean age: 34.2 ± 8.3 years) who entered two psychiatric hospitals (N = 83) and a detention center (N = 41) in northern Taiwan received a face-to-face interview. Therefore, socio-demographic characteristics, patterns of drug use, psychiatric comorbidities, blood-borne infectious diseases and health service utilization were recorded. The behaviors of health service utilization were classified into the frequency of out-patient department visit and hospitalization, as well as the purchase of over-the-counter drugs. During 12 months prior to interview, 79.8% of the participants attended health care service at least once. The rate of having any event in out-patients service visit, hospitalization, and over-the-counter drugs were 66.1%, 29.8% and 25.8% respectively. The frequency of health service utilization was associated with numerous factors. Among these factors, patients who were recruited from hospital and having a mood disorder were conjoint predictors of out-patient department visit, hospitalization and purchase of over-the-counter drugs. According to the results of this study, social education and routine screening for mood disorders can help heroin users to obtain adequate health care service. The findings of this study are useful references for targeting the heroin users for whom a successful intervention represents the greatest cost benefit. © 2013 Elsevier Ltd. All rights reserved.

  1. An Analysis of English Language Education and Its Impact on Business Practice in Taiwan.

    ERIC Educational Resources Information Center

    Du-Babcock, Bertha; Babcock, Richard D.

    The state of English language instruction in Taiwan and its impact on firms doing business there are examined. The analysis draws on case studies of language training and use in four national and multinational corporations, each representing different nationalities and a different industry: Texas Instruments, Kaohsiung Monomer Company Limited,…

  2. Nitrates in drinking water and risk of death from rectal cancer in Taiwan.

    PubMed

    Kuo, Hsin-Wei; Wu, Trong-Neng; Yang, Chun-Yuh

    2007-10-01

    The relationship between nitrate levels in drinking water and rectal cancer development has been inconclusive. A matched case-control and nitrate ecology study was used to investigate the association between mortality attributed to rectal cancer and drinking-water nitrate exposure in Taiwan. All deaths due to rectal cancer of Taiwan residents from 1999 through 2003 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Data on nitrate-nitrogen (NO3-N) levels in drinking water throughout Taiwan were collected from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was assumed to be the source of the subject's nitrate exposure via drinking water. The adjusted odds ratios for rectal cancer death for those with high nitrate levels in their drinking water, as compared to the lowest tertile, were 1.22 (0.98-1.52) and 1.36 (1.08-1.70), respectively. The findings of this study warrant further investigation of the role of nitrates in drinking water in the etiology of rectal cancer in Taiwan.

  3. Value-based approaches to healthcare systems and pharmacoeconomics requirements in Asia: South Korea, Taiwan, Thailand and Japan.

    PubMed

    Kamae, Isao

    2010-01-01

    Asian healthcare systems are very diverse, representing cultures, political systems and economies from more than 30 countries with varying histories. Despite the diversity in the region, there has been enormous growth in health economics and outcomes research since the beginning of the 21st century. Whilst Japan has seen very limited use of health technology assessment (HTA), South Korea, Taiwan and Thailand have had remarkable success in establishing government agencies for HTA, employing HTA concepts from the UK National Institute for Health and Clinical Excellence (NICE). These three countries are driven by the following common factors: (i) a desire to establish universal healthcare insurance coverage in their respective nations; (ii) the need for rational allocation of scarce resources; (iii) a desire for government to provide leadership in HTA; and (iv) availability of HTA professionals and faculties through international networks. The HTA models introduced by these three countries are both similar to and different from those of HTA agencies in Europe, but might work well as examples for other countries in the region.

  4. Soil ingestion rates for children under 3 years old in Taiwan.

    PubMed

    Chien, Ling-Chu; Tsou, Ming-Chien; Hsi, Hsing-Cheng; Beamer, Paloma; Bradham, Karen; Hseu, Zeng-Yei; Jien, Shih-Hao; Jiang, Chuen-Bin; Dang, Winston; Özkaynak, Halûk

    2017-01-01

    Soil and dust ingestion rates by children are among the most critical exposure factors in determining risks to children from exposures to environmental contaminants in soil and dust. We believe this is the first published soil ingestion study for children in Taiwan using tracer element methodology. In this study, 66 children under 3 years of age were enrolled from Taiwan. Three days of fecal samples and a 24-h duplicate food sample were collected. The soil and household dust samples were also collected from children's homes. Soil ingestion rates were estimated based on silicon (Si) and titanium (Ti). The average soil ingestion rates were 9.6±19.2 mg/day based on Si as a tracer. The estimated soil ingestion rates based on Si did not have statistically significant differences by children's age and gender, although the average soil ingestion rates clearly increased as a function of children's age category. The estimated soil ingestion rates based on Si was significantly and positively correlated with the sum of indoor and outdoor hand-to-mouth frequency rates. The average soil ingestion rates based on Si were generally lower than the results from previous studies for the US children. Ti may not be a suitable tracer for estimating soil ingestion rates in Taiwan because the Ti dioxide is a common additive in food. To the best of our knowledge, this is the first study that investigated the correlations between soil ingestion rates and mouthing behaviors in Taiwan or other parts of Asia. It is also the first study that could compare available soil ingestion data from different countries and/or different cultures. The hand-to-mouth frequency and health habits are important to estimate the soil ingestion exposure for children. The results in this study are particularly important when assessing children's exposure and potential health risk from nearby contaminated soils in Taiwan.

  5. 78 FR 24760 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Prospective Grant of Start... Prevention in Humans AGENCY: National Institutes of Health, HHS. ACTION: Notice. SUMMARY: This is notice, in accordance with 35 U.S.C. 209(c)(1) and 37 CFR 404.7(a)(1)(i), that the National Institutes of Health...

  6. The prosecution of Taiwan sexuality researcher and activist Josephine Ho.

    PubMed

    Wang, Ping

    2004-05-01

    In April 2003, following a newspaper report of a hyperlink to a website on bestiality on the Sexuality Databank website of the Center for the Study of Sexualities, National Central University, Taipei, Taiwan, 14 conservative NGOs filed charges against the Center's founder, Josephine Ho, for "propagating obscenities that corrupt traditional values." Ho has been researching sexuality and supporting freedom for marginalised sexual minorities for ten years. In a public statement in response to the charges, she said that the work of scholarly research must not be dictated by prejudice and that differences in sexual values should not be arbitrated by law and should be open for public discussion. As the legal process began in January 2004, Ho's supporters in Taiwan have called for the preservation of the Taiwan Constitutional decree on integrity and autonomy of academic research and freedom of expression on the internet, for the University to resist calls to dismiss Ho from her post, and for respect for freedom of speech and expression and the right to create spaces to educate people about non-normative sexualities.

  7. Taiwan: growing, growing, gone.

    PubMed

    Hanson, R

    1979-10-01

    Accommodation between Taiwan and the People's Republic of China may not be inconceivable as trade contacts (though officially disallowed) grow. Because of Taiwan's well-established success and the pressing need in China to industrialize, it appears, however, that such an accommodation will occur only after China becomes more like Taiwan. Taiwan owes its success, first, to land reform and then, in the 1960s, to steady industrialization. Besides broad controls over money supply and capital designed to ward off inflationary pressures when needed, and the grand outlines for development, another factor in the island's economic success is that the government has interfered little with private enterprise. The economy has an underpinning of small to medium size businesses. There are more than 10,000 trading companies. This diverse foundation has given the economy as a whole a flexible buffer on which more sophisticated industires can be formed.

  8. Antihypertensive medication prescription patterns and time trends for newly-diagnosed uncomplicated hypertension patients in Taiwan.

    PubMed

    Liu, Pang-Hsiang; Wang, Jung-Der

    2008-06-18

    Knowledge of existing prescription patterns in the treatment of newly-diagnosed hypertension can provide useful information for improving clinical practice in this field. The aims of this study are to determine the prescription patterns and time trends for antihypertensive medication in newly-diagnosed cases of uncomplicated hypertension in Taiwan and to compare these with current clinical guidelines. A total of 6,536 newly-diagnosed patients with uncomplicated hypertension, aged >/=30 years, were identified from the representative 200,000-person sample in the computerized reimbursement database of the National Health Insurance in Taiwan. These patients were followed from 1998 to 2004 with all diagnoses, prescription data and medication charges being retrieved for subsequent analysis. Prescription patterns varied by age, gender and clinical facilities, with mono-therapies being found to be dominant in the first year, albeit declining over time. Calcium channel blockers and beta-blockers were the most frequently prescribed antihypertensive drugs, either alone or in combinations. Although least expensive, the prescription rates of diuretics were low, at 8.3% for mono-therapies and 19.9% overall. The prescription rate for angiotensin receptor blockers (ARBs) was elevated considerably over time. After controlling for other related factors by multiple logistic regression analysis, ARBs were found to be prescribed mainly by medical centers or regional hospitals. These findings indicate the existence of a gap between current clinical practice and the desired goal of cost-effectiveness in antihypertensive treatment in Taiwan, which should be corrected.

  9. Risk of cancer in patients with genital warts: A nationwide, population-based cohort study in Taiwan

    PubMed Central

    Cho, Ching-Yi; Lo, Yu-Cheng; Hung, Miao-Chiu; Lai, Chou-Cheng; Chen, Chun-Jen

    2017-01-01

    Background Condyloma acuminata currently affects around 1% of sexually active adults, and its incidence is increasing. The coexistence of genital warts (GW) and certain cancers and an association between human papillomavirus (HPV) and various malignancies have been reported. Therefore, we conducted this large national study to analyze the risk of malignancies among men and women with GW in Taiwan. Methods and findings Between January 2000 and December 2013, approximately 3 million patients were reported to the National Health Insurance Research Database of Taiwan. Of these patients, 21,763 were diagnosed with GW. In the same time period, a total of 213,541 cancer cases were reported to the registry, of which 1002 were recorded among patients with GW. The age-specific incidence rates of GW and standardized incidence ratios (SIRs) of malignancies compared to the general population were calculated. Women acquired GW earlier than men, with a mean age at diagnosis of 32.63±12.78 years. The highest incidence rate for both genders peaked at 20–29 years. Of the 1002 patients with GW and malignancies, the SIR was 1.95 (95%CI 1.83–2.07). The most markedly increased risk was found for HPV-related cancers, with a SIR of 9.74 (95%CI 3.70–15.77). Significantly elevated risks were also noted for smoking-related cancers, anogenital cancers, cervix in situ, colon, rectum, lung, kidney, and prostate cancers. Most cancers developed within 10 years after the diagnosis of GW. Conclusions Patients with GW have an increased risk of HPV-related cancers, especially anogenital malignancies in Taiwan. The elevated risk of other cancers highlights differences in exposure and risk factors among patients with GW compared to the general population. Cancer screening and HPV vaccination programs should be emphasized for at-risk patients. PMID:28806741

  10. Severe Dengue Fever Outbreak in Taiwan

    PubMed Central

    Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur

    2016-01-01

    Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005–2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. PMID:26572871

  11. Severe Dengue Fever Outbreak in Taiwan.

    PubMed

    Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur

    2016-01-01

    Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005-2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. © The American Society of Tropical Medicine and Hygiene.

  12. Performance assessment methodology and preliminary results for low-level radioactive waste disposal in Taiwan.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Arnold, Bill Walter; Chang, Fu-lin; Mattie, Patrick D.

    2006-02-01

    Sandia National Laboratories (SNL) and Taiwan's Institute for Nuclear Energy Research (INER) have teamed together to evaluate several candidate sites for Low-Level Radioactive Waste (LLW) disposal in Taiwan. Taiwan currently has three nuclear power plants, with another under construction. Taiwan also has a research reactor, as well as medical and industrial wastes to contend with. Eventually the reactors will be decomissioned. Operational and decommissioning wastes will need to be disposed in a licensed disposal facility starting in 2014. Taiwan has adopted regulations similar to the US Nuclear Regulatory Commission's (NRC's) low-level radioactive waste rules (10 CFR 61) to govern themore » disposal of LLW. Taiwan has proposed several potential sites for the final disposal of LLW that is now in temporary storage on Lanyu Island and on-site at operating nuclear power plants, and for waste generated in the future through 2045. The planned final disposal facility will have a capacity of approximately 966,000 55-gallon drums. Taiwan is in the process of evaluating the best candidate site to pursue for licensing. Among these proposed sites there are basically two disposal concepts: shallow land burial and cavern disposal. A representative potential site for shallow land burial is located on a small island in the Taiwan Strait with basalt bedrock and interbedded sedimentary rocks. An engineered cover system would be constructed to limit infiltration for shallow land burial. A representative potential site for cavern disposal is located along the southeastern coast of Taiwan in a tunnel system that would be about 500 to 800 m below the surface. Bedrock at this site consists of argillite and meta-sedimentary rocks. Performance assessment analyses will be performed to evaluate future performance of the facility and the potential dose/risk to exposed populations. Preliminary performance assessment analyses will be used in the site-selection process and to aid in design of

  13. Antimicrobial usage in ambulatory patients with respiratory infections in Taiwan, 2001.

    PubMed

    Ho, Monto; Hsiung, Chao Agnes; Yu, Hui-Tzu; Chi, Cheng-Liang; Yin, Hsiao-Chuan; Chang, Hong-Jen

    2004-02-01

    Excess use of antimicrobials by ambulatory patients is a determinant of antimicrobial resistance. This study investigated the types of illnesses for which antimicrobials were prescribed and the amounts prescribed with special emphasis on respiratory infections for the year in which the Bureau of National Health Insurance (BNHI) enforced a policy to restrict antimicrobials for upper respiratory infections. The number of ambulatory patients seen and the types of ambulatory facilities in Taiwan were also described. Raw data were obtained from the BNHI database on every 500 th visit in 2001. Medical diagnoses were categorized according to the ICD-9-CM system. Antimicrobial consumption was expressed in defined daily doses per 1000 population per day (DDD/1000/day). Among the population of 22.3 million in Taiwan, there were 285.8 million ambulatory patient visits (12.8 per person), including 108.9 million visits (4.9 per person) for respiratory infections, of which 62.7 million (2.8 per person) were for upper respiratory infections (URI). Antimicrobial consumption was 19.83 DDD/1000/day [standard error (SE), 0.00055], of which 9.97 DDD/1000/day (SE, 0.00047) were for respiratory infections and 4.03 DDD/1000/day (0.00055) were for URI. 23.6% of visits for URI entailed a prescription for antimicrobials. About two-thirds (66.5%) of ambulatory patients were seen in clinics, mostly private ones, and 67.6% of all antimicrobials were received there. Aminopenicillins and cephalosporins constituted 35.2% and 19.5%, respectively, of antimicrobials prescribed. Despite the new BNHI rule restricting antimicrobial usage for URI, Taiwan still has an excessive number of ambulatory patient visits, especially for respiratory infections and URI. The majority of antimicrobials used were for URI. They were mostly prescribed in private clinics rather than hospital outpatient departments.

  14. Low accuracy of the national reporting system of acute hepatitis C infection in Taiwan, 1995-2004.

    PubMed

    Kee, Kwong-Ming; Hung, Chi-Ming; Wang, Jing-Houng; Hung, Chao-Hung; Chen, Pao-Fei; Lin, Kuo-Sin; Lu, Sheng-Nan

    2010-07-01

    This study attempted to clarify accuracy of acute hepatitis C (AHC) and its clinical characteristics. We reviewed 632 reported cases from national surveillance data of the Taiwan Center for Disease Control between 1995 and 2004, and reclassified diagnoses. A definite case was defined as alanine aminotransferase (ALT) > 10 x the upper limit of normal (ULN) with seroconversion of anti-hepatitis C virus antibody (anti-HCV). A probable case was defined as (i) seroconversion of anti-HCV and/or elevated ALT levels; or (ii) anti-HCV(+) but titers increased (from < 40 S/CO to >or= 40 S/CO) and ALT > 10 x the ULN. A suspected case was defined as initial anti-HCV(+) and ALT level > 10 x the ULN and/or jaundice. Excluded cases were defined as ALT levels less than 10 x ULN with initial positive anti-HCV Ab. A total of 310 (49%) cases were confirmed as AHC; these included 95 (15%) definite and 215 (34%) probable cases. Higher incidence rates and accuracy of AHC were demonstrated in the southern area significantly if compared with northern, eastern and central areas, respectively (all P < 0.05). On comparison between blood centers and hospitals, more AHC cases were found in Southern Taiwan than in other areas (157/73 vs 24/40, P < 0.001), younger mean age (33.3 +/- 11.1 vs 49.3 +/- 16.4, P < 0.001), lower ALT levels (263.1 +/- 200.9 vs 1264.2 +/- 706.8, P < 0.001) and male predominance (191/39 vs 46/18, P = 0.046). This study showed our reporting system over-estimated the AHC diagnosis, which is also a common issue worldwide. Greater efforts are needed to establish appropriate reporting systems, as well as more supplemental methods to distinguish between prevalent and incident cases.

  15. A climate-based spatiotemporal prediction for dengue fever epidemics: a case study in southern Taiwan

    NASA Astrophysics Data System (ADS)

    Yu, H.-L.; Yang, S.-J.; Lin, Y.-C.

    2012-04-01

    Dengue Fever (DF) has been identified by the World Health organization (WHO) as one of the most serious vector-borne infectious diseases in tropical and sub-tropical areas. DF has been one of the most important epidemics in Taiwan which occur annually especially in southern Taiwan during summer and autumn. Most DF studies have focused mainly on temporal DF patterns and its close association with climatic covariates, whereas few studies have investigated the spatial DF patterns (spatial dependence and clustering) and composite space-time effects of the DF epidemics. The present study proposes a spatio-temporal DF prediction approach based on stochastic Bayesian Maximum Entropy (BME) analysis. Core and site-specific knowledge bases are considered, including climate and health datasets under conditions of uncertainty, space-time dependence functions, and a Poisson regression model of climatic variables contributing to DF occurrences in southern Taiwan during 2007, when the highest number of DF cases was recorded in the history of Taiwan epidemics (over 2000). The obtained results show that the DF outbreaks in the study area are highly influenced by climatic conditions. Furthermore, the analysis can provide the required "one-week-ahead" outbreak warnings based on spatio-temporal predictions of DF distributions. Therefore, the proposed analysis can provide the Taiwan Disease Control Agency with a valuable tool to timely identify, control, and even efficiently prevent DF spreading across space-time.

  16. The NCU Lu-Lin Observatory Survived the Taiwan 921 Earthquake

    NASA Astrophysics Data System (ADS)

    Tsay, W. S.; Chang, K. H.; Li, H. H.

    1999-12-01

    The NCU (National Central University) Lu-Lin Observatory is located at Mt. Front Lu-Lin, 120o 52' 25" E and 23o 28' 07" N, a 2862-m peak in the Yu-Shan National Park. The construction of Lu-Lin Observatory was finished in January 1999. Fortunately the Lu-Lin Observatory survived the Taiwan 921 Earthquake that was 7.3 on the Ritcher scale. We are proud of the design of Lu-Lin Observatory adopted H-beam and steel wall even the center of earthquake was only 40 km away. The initial study of Lu-Lin site was started since late 1989. Later on, a three-year project was founded by the National Science Council , which supported the development of a modern seeing monitor for this site survey study from 1990 through 1993. The average seeing of Lu-Lin site is about 1.39 arc-second with average 200 clear nights annually. The sky background of this site is 20.72 mag/arcsec2 in V band and 21.22 mag/arcsec2 in B band. The Lu-Lin observatory is developed for both research and education activity. A homemade 76-cm Super Light Telescope (SLT) and three TAOS's 50-cm robotic telescopes will be the two major research facilities. This work is supported by the National Science Council of Taiwan.

  17. 78 FR 42967 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee... Resources Research, National Institutes of Health, HHS) Dated: July 12, 2013. Michelle Trout, Program...

  18. Comparison of national mental health quality assessment programs across the globe.

    PubMed

    Parameswaran, Sharat; Spaeth-Rublee, Brigitta; Huynh, Phuong Trang; Pincus, Harold Alan

    2012-10-01

    This study by the International Initiative for Mental Health Leadership Clinical Leaders Project sought to describe ongoing or soon-to-be-established national-level mental health quality measurement programs in 12 participating countries, in order to understand the nature and structure of these programs. A survey was distributed to representatives from the participating countries (Australia, Canada, England, Germany, Ireland, Japan, the Netherlands, New Zealand, Norway, Scotland, Taiwan, and the United States). Data included descriptions of qualifying programs and the organizations responsible for them, quality indicators used, entities assessed, sources and means of the programs' data collection, the level at which data are reported, and how the data are used. Participants were asked to identify which quality domains and subdomains were represented by indicators in each program. Results were analyzed with descriptive statistics. Thirty-eight programs were identified. Most programs were administered by governmental organizations, focused on hospital care, and used encounter or utilization databases as sources of information. Programs used different methods to identify indicators. Program data were used for various purposes. A wide range of domains of quality were represented in the programs reported, although most commonality was seen in domains associated with high-acuity care, with fewer programs assessing recovery-related domains. This study found wide variation among established quality assessment programs, which may reflect a focus on local priorities. The goal of this project is to work toward establishing an international framework for mental health quality assessment and thus a means to compare key measures of performance across countries.

  19. Redistribution of Streptococcus pneumoniae Serotypes After Nationwide 13-valent Pneumococcal Conjugate Vaccine Program in Children in Northern Taiwan.

    PubMed

    Cho, Ying-Chun; Chiu, Nan-Chang; Lu, Chun-Yi; Huang, Daniel Tsung-Ning; Huang, Fu-Yuan; Chang, Luan-Yin; Huang, Li-Min; Chi, Hsin

    2017-12-01

    After the introduction of 13-valent pneumococcal conjugate vaccine (PCV13) against Streptococcus pneumoniae, public health officials in Taiwan monitored a decline in circulating vaccine serotypes and the emergence of nonvaccine serotypes in children with invasive pneumococcal disease. A gradually expanded PCV13 national immunization program was launched in 2013 in Taiwan. Here, we evaluate the changes in the distribution of pneumococcal serotypes and antimicrobial nonsusceptibility in children during the evolution of vaccination policy. S. pneumoniae isolates from children with pneumococcal disease were collected and serotyped from 2010 to 2015 in northern Taiwan. PCVs were administered at the recipients' expense between 2010 and 2012, and then PCV13 was partially reimbursed by the government beginning in 2013. The distribution and diversity of serotypes were analyzed along with their antimicrobial susceptibilities. Among a total of 498 isolates, the proportion of invasive pneumococcal disease isolates declined (47.1%-10.6%) during the study period, and serotype diversity increased after 2011. Between 2010 and 2012, the dominant serotypes were 19A, 19F, 3, 6B and 14, and serotype 19A rose from 44.1% to 57.5%. Serotypes 19A, 15A, 19F and 15B were more prevalent from 2013 to 2015, and serotype 19A decreased from 42.1% to 4.5%. Serotypes 19F and 15A became the most commonly detected serotypes in 2015. Overall, PCV13 additional serotypes were reduced by 80% (P < 0.0001) but nonvaccine serotypes increased from 8.8% to 51.5% (P < 0.0001). The step-by-step PCV13 national immunization program is effective against pneumococcal disease in Taiwanese children, mainly by reducing PCV13 additional serotypes.

  20. Lifetime costs for peritoneal dialysis and hemodialysis in patients in Taiwan.

    PubMed

    Kao, Tze-Wah; Chang, Yu-Yin; Chen, Pau-Chung; Hsu, Chih-Cheng; Chang, Yu-Kang; Chang, Yu-Hung; Lee, Lukas Jyuhn-Hsiarn; Wu, Kwan-Dun; Tsai, Tun-Jun; Wang, Jung-Der

    2013-01-01

    This study compared the lifetime costs for peritoneal dialysis (PD) and hemodialysis (HD) patients in Taiwan. Using the National Health Insurance (NHI) database of all end-stage renal disease patients on maintenance dialysis registered from July 1997 to December 2005, we matched eligible PD patients with eligible HD patients on age, sex, and diabetes status. The matched patients were followed until 31 December 2006. Patients were excluded if they were less than 18 years of age, had been diagnosed with cancer before dialysis, or had been dialyzed at centers or clinics other than hospitals. Outcomes-including life expectancy, total lifetime costs, and costs per life-year paid by the NHI-were estimated and compared. The 3136 pairs of matched PD and HD patients had a mean age of 53.2 ± 15.4 years. The total lifetime cost for PD patients (US$139 360 ± US$8 336) was significantly lower than that for HD patients (US$185 235 ± US$9 623, p < 0.001). Except for patients with diabetes (who had a short life expectancy), the total lifetime cost was significantly lower for PD patients than for HD patients regardless of sex and age (p < 0.01). In Taiwan, the total lifetime costs paid by the NHI were lower for PD than for HD patients.

  1. 75 FR 71134 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U....398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of Health, HHS) Dated...

  2. Determinants of Prescription Drug Use by Adolescents with Intellectual Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Yen, Chia-Feng; Lin, Jin-Ding; Loh, Ching-Hui; Shi, Leiyu; Hsu, Shang-Wei

    2009-01-01

    Direct family caregivers of population-based adolescents with intellectual disabilities in Taiwan were surveyed regarding their perceptions of the use of prescribed medication and its relationship with health-related behaviors, medical care and preventive health utilization of people with intellectual disabilities. Cross-sectional data on 1419…

  3. Mind the information gap: fertility rate and use of cesarean delivery and tocolytic hospitalizations in Taiwan

    PubMed Central

    2011-01-01

    Background Physician-induced demand (PID) is an important theory to test given the longstanding controversy surrounding it. Empirical health economists have been challenged to find natural experiments to test the theory because PID is tantamount to strong income effects. The data requirements are both a strong exogenous change in income and two types of treatment that are substitutes but have different net revenues. The theory implies that an exogenous fall in income would lead physicians to recoup their income by substituting a more expensive treatment for a less expensive treatment. This study takes advantages of the dramatic decline in the Taiwanese fertility rate to examine whether an exogenous and negative income shock to obstetricians and gynecologists (ob/gyns) affected the use of c-sections, which has a higher reimbursement rate than vaginal delivery under Taiwan's National Health Insurance system during the study period, and tocolytic hospitalizations. Methods The primary data were obtained from the 1996 to 2004 National Health Insurance Research Database in Taiwan. We hypothesized that a negative income shock to ob/gyns would cause them to provide more c-sections and tocolytic hospitalizations to less medically-informed pregnant women. Multinomial probit and probit models were estimated and the marginal effects of the interaction term were conducted to estimate the impacts of ob/gyn to birth ratio and the information gap. Results Our results showed that a decline in fertility did not lead ob/gyns to supply more c-sections to less medically-informed pregnant women, and that during fertility decline ob/gyns may supply more tocolytic hospitalizations to compensate their income loss, regardless of pregnant women's access to health information. Conclusion The exogenous decline in the Taiwanese fertility rate and the use of detailed medical information and demographic attributes of pregnant women allowed us to avoid the endogeneity problem that threatened the

  4. Mind the information gap: fertility rate and use of cesarean delivery and tocolytic hospitalizations in Taiwan.

    PubMed

    Ma, Ke-Zong M; Norton, Edward C; Lee, Shoou-Yih D

    2011-12-12

    Physician-induced demand (PID) is an important theory to test given the longstanding controversy surrounding it. Empirical health economists have been challenged to find natural experiments to test the theory because PID is tantamount to strong income effects. The data requirements are both a strong exogenous change in income and two types of treatment that are substitutes but have different net revenues. The theory implies that an exogenous fall in income would lead physicians to recoup their income by substituting a more expensive treatment for a less expensive treatment. This study takes advantages of the dramatic decline in the Taiwanese fertility rate to examine whether an exogenous and negative income shock to obstetricians and gynecologists (ob/gyns) affected the use of c-sections, which has a higher reimbursement rate than vaginal delivery under Taiwan's National Health Insurance system during the study period, and tocolytic hospitalizations. The primary data were obtained from the 1996 to 2004 National Health Insurance Research Database in Taiwan. We hypothesized that a negative income shock to ob/gyns would cause them to provide more c-sections and tocolytic hospitalizations to less medically-informed pregnant women. Multinomial probit and probit models were estimated and the marginal effects of the interaction term were conducted to estimate the impacts of ob/gyn to birth ratio and the information gap. Our results showed that a decline in fertility did not lead ob/gyns to supply more c-sections to less medically-informed pregnant women, and that during fertility decline ob/gyns may supply more tocolytic hospitalizations to compensate their income loss, regardless of pregnant women's access to health information. The exogenous decline in the Taiwanese fertility rate and the use of detailed medical information and demographic attributes of pregnant women allowed us to avoid the endogeneity problem that threatened the validity of prior research. They also

  5. Structural Features of the Western Taiwan Foreland Basin in the Eastern Taiwan Strait since Late Miocene

    NASA Astrophysics Data System (ADS)

    WANG, J. H.; Liu, C. S.; Chang, J. H.; Yang, E. Y.

    2017-12-01

    The western Taiwan Foreland Basin lies on the eastern part of Taiwan Strait. The structures in this region are dominated by crustal stretch and a series of flexural normal faults have been developed since Late Miocene owing to the flexural of Eurasia Plate. Through deciphering multi-channel seismic data and drilling data, these flexural features are observed in the offshore Changhua coastal area. The flexure normal faults are important features to realize structural activity in the western Taiwan Foreland Basin. Yang et al. (2016) mention that the reactivated normal faults are found north of the Zhushuixi estuary. It should be a significant issue to decipher whether these faults are still active. In this study, we have analyzed all the available seismic reflections profiles in the central part of the Taiwan Strait, and have observed many pre-Pliocene normal faults that are mainly distributed in the middle of the Taiwan Strait to Changyun Rise, and we tentatively suggest that the formation of these faults may be associated with the formation of the foreland basal unconformity. Furthermore, we will map the distribution of these normal faults and examine whether the reactivated normal faults have extended to south of the Zhushuixi estuary. Finally, we discuss the relation between the reactivated normal faults in the Taiwan Strait and those faults onshore. Key words: Multichannel seismic reflection profile, Taiwan Strait, Foreland basin, normal fault.

  6. Quality Assurance at a Distance: International Accreditation in Taiwan Higher Education

    ERIC Educational Resources Information Center

    Hou, Angela Yung-Chi

    2011-01-01

    In response to the global competitiveness in higher education, the government, in recent years, has encouraged Taiwan colleges and universities to seek international accreditation, which raises several questions, such as jurisdiction over national accreditation, a single set of standards for local and global quality assurance, demand for the…

  7. Urban-Rural Disparity in Geographical and Temporal Availability of Pediatric Clinics: A Nationwide Survey in Taiwan.

    PubMed

    Leu, Hsin-I; Chang, Wei-Ting; Lin, Ming-Hwai; Chen, Tzeng-Ji; Hwang, Shinn-Jang; Chou, Li-Fang; Jeng, Mei-Jy

    2017-08-01

    The shortage and maldistribution of pediatricians affected after-hours pediatric services, especially in rural areas. Our study aimed to examine the urban-rural disparity in geographical and temporal availability of the pediatrician workforce in Taiwan by analyzing opening time schedules of all pediatric clinics throughout the country. The opening time schedules of nonhospital pediatric clinics were downloaded from the website of the National Health Insurance Administration in Taiwan for analysis. The geographical and temporal availability of pediatric clinics was calculated and stratified by urbanization level and opening time, which was divided into daytime and evening sessions over 1 week. Each of 368 towns in Taiwan was also regarded as a unit of measurement to estimate the local availability of at least one pediatric clinic open in after-hours sessions. Among 1483 nonhospital pediatric clinics in Taiwan, the overwhelming majority were situated in urban (65.8%) and suburban (30.6%) areas. On average, a pediatric clinic provided 16.3 (standard deviation=3.04) sessions of services per week. One-third (34.7%, n=50) of 144 suburban towns and over three-fourths (77.4%, n=120) of 155 rural towns had no pediatric clinic. Most pediatric clinics remained open on weekday evenings (91.1%) and during Saturday daytime (91.8%). The percentage of open clinics gradually decreased over the weekend: Saturday evening (58.1%), Sunday daytime (33.4%), and Sunday evening (19.4%). Rural pediatric clinics remained closed mostly on weekends. On Sunday evenings, pediatric clinics were open only in 5.2% of rural towns, with a decline of 77.1%, whereas they were open in 78.3% of urban towns, with a decline of 18.2%. Pediatric clinics in Taiwan were unevenly distributed between urban and rural areas. The disparity of pediatric services became more obvious at weekends. The consequences of undersupplied rural pediatric care deserve further investigation. Copyright © 2017. Published by

  8. National Health Interview Survey (NHIS)

    EPA Pesticide Factsheets

    The NHIS collects data on a broad range of health topics through personal household interviews. The results of NHIS provide data to track health status, health care access, and progress toward achieving national health objectives.

  9. Indoor Air Quality in the Metro System in North Taiwan.

    PubMed

    Chen, Ying-Yi; Sung, Fung-Chang; Chen, Mei-Lien; Mao, I-Fang; Lu, Chung-Yen

    2016-12-02

    Indoor air pollution is an increasing health concern, especially in enclosed environments such as underground subway stations because of increased global usage by urban populations. This study measured the indoor air quality of underground platforms at 10 metro stations of the Taipei Rapid Transit system (TRTS) in Taiwan, including humidity, temperature, carbon monoxide (CO), carbon dioxide (CO₂), formaldehyde (HCHO), total volatile organic compounds (TVOCs), ozone (O₃), airborne particulate matter (PM 10 and PM 2.5 ), bacteria and fungi. Results showed that the CO₂, CO and HCHO levels met the stipulated standards as regulated by Taiwan's Indoor Air Quality Management Act (TIAQMA). However, elevated PM 10 and PM 2.5 levels were measured at most stations. TVOCs and bacterial concentrations at some stations measured in summer were higher than the regulated standards stipulated by Taiwan's Environmental Protection Administration. Further studies should be conducted to reduce particulate matters, TVOCs and bacteria in the air of subway stations.

  10. Arsenic speciation in rice and risk assessment of inorganic arsenic in Taiwan population.

    PubMed

    Chen, Hsiu-Ling; Lee, Ching-Chang; Huang, Winn-Jung; Huang, Han-Ting; Wu, Yi-Chen; Hsu, Ya-Chen; Kao, Yi-Ting

    2016-03-01

    This study assessed the total arsenic content and arsenic speciation in rice to determine the health risks associated with rice consumption in various age-gender subgroups in Taiwan. The average total arsenic levels in white rice and brown rice were 116.6 ± 39.2 and 215.5 ± 63.5 ng/g weight (n = 51 and 13), respectively. The cumulative cancer risk among males was 10.4/100,000. The highest fraction of inorganic/total arsenic content in white rice ranged from 76.9 to 88.2 % and from 81.0 to 96.5 % in brown rice. The current study found different arsenic speciation of rice in southern Taiwan, where the famous blackfoot disease has been reported compared with arsenic speciation from other Taiwan areas. Therefore, rice and other grains should be further monitored in southern Taiwan to evaluate whether arsenic contamination is well controlled in this area.

  11. Occupational Neurotoxic Diseases in Taiwan

    PubMed Central

    Liu, Chi-Hung; Huang, Chu-Yun

    2012-01-01

    Occupational neurotoxic diseases have become increasingly common in Taiwan due to industrialization. Over the past 40 years, Taiwan has transformed from an agricultural society to an industrial society. The most common neurotoxic diseases also changed from organophosphate poisoning to heavy metal intoxication, and then to organic solvent and semiconductor agent poisoning. The nervous system is particularly vulnerable to toxic agents because of its high metabolic rate. Neurological manifestations may be transient or permanent, and may range from cognitive dysfunction, cerebellar ataxia, Parkinsonism, sensorimotor neuropathy and autonomic dysfunction to neuromuscular junction disorders. This study attempts to provide a review of the major outbreaks of occupational neurotoxins from 1968 to 2012. A total of 16 occupational neurotoxins, including organophosphates, toxic gases, heavy metals, organic solvents, and other toxic chemicals, were reviewed. Peer-reviewed articles related to the electrophysiology, neuroimaging, treatment and long-term follow up of these neurotoxic diseases were also obtained. The heavy metals involved consisted of lead, manganese, organic tin, mercury, arsenic, and thallium. The organic solvents included n-hexane, toluene, mixed solvents and carbon disulfide. Toxic gases such as carbon monoxide, and hydrogen sulfide were also included, along with toxic chemicals including polychlorinated biphenyls, tetramethylammonium hydroxide, organophosphates, and dimethylamine borane. In addition we attempted to correlate these events to the timeline of industrial development in Taiwan. By researching this topic, the hope is that it may help other developing countries to improve industrial hygiene and promote occupational safety and health care during the process of industrialization. PMID:23251841

  12. Time series clustering analysis of health-promoting behavior

    NASA Astrophysics Data System (ADS)

    Yang, Chi-Ta; Hung, Yu-Shiang; Deng, Guang-Feng

    2013-10-01

    Health promotion must be emphasized to achieve the World Health Organization goal of health for all. Since the global population is aging rapidly, ComCare elder health-promoting service was developed by the Taiwan Institute for Information Industry in 2011. Based on the Pender health promotion model, ComCare service offers five categories of health-promoting functions to address the everyday needs of seniors: nutrition management, social support, exercise management, health responsibility, stress management. To assess the overall ComCare service and to improve understanding of the health-promoting behavior of elders, this study analyzed health-promoting behavioral data automatically collected by the ComCare monitoring system. In the 30638 session records collected for 249 elders from January, 2012 to March, 2013, behavior patterns were identified by fuzzy c-mean time series clustering algorithm combined with autocorrelation-based representation schemes. The analysis showed that time series data for elder health-promoting behavior can be classified into four different clusters. Each type reveals different health-promoting needs, frequencies, function numbers and behaviors. The data analysis result can assist policymakers, health-care providers, and experts in medicine, public health, nursing and psychology and has been provided to Taiwan National Health Insurance Administration to assess the elder health-promoting behavior.

  13. April Spotlight: National Minority Health Month

    Cancer.gov

    Each April, we recognize National Minority Health Month and National Minority Cancer Awareness Week. Dr. Peter Ogunbiyi shares how CRCHD’s work is related to the 2017 theme: Bridging Health Equity Across Communities.

  14. Use of celecoxib correlates with increased relative risk of acute pancreatitis: a case-control study in Taiwan.

    PubMed

    Hung, Shih-Chang; Hung, Shih-Rong; Lin, Cheng-Li; Lai, Shih-Wei; Hung, Hung-Chang

    2015-10-01

    This study evaluated whether there is an association between the use of celecoxib and acute pancreatitis in Taiwan. We conducted a case-control study using the database of the Taiwan National Health Insurance Program. The participants comprised 5,095 subjects, aged 20-84 years, with a first admission episode of acute pancreatitis from 2000 to 2011 as the cases and 20,380 randomly selected sex-matched and age-matched subjects without acute pancreatitis as the controls. The absence of celecoxib prescription was defined as "never used." Current use of celecoxib was defined as subjects who had received at least one prescription for celecoxib within 3 days before diagnosis with acute pancreatitis. A multivariate unconditional logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for acute pancreatitis associated with the use of celecoxib. Compared with subjects who never used celecoxib, the adjusted OR of acute pancreatitis was 5.62 in subjects with current use of celecoxib (95% CI=3.33-9.46). The current use of celecoxib is associated with an increased risk of acute pancreatitis.

  15. Job autonomy, its predispositions and its relation to work outcomes in community health centers in Taiwan.

    PubMed

    Lin, Blossom Yen-Ju; Lin, Yung-Kai; Lin, Cheng-Chieh; Lin, Tien-Tse

    2013-06-01

    It has been debated that employees in a government or public ownership agency may perceive less need for growth opportunities or high-powered incentives than is the case for employees in private organizations. This study examined employees' job autonomy in government-run community health centers, its predispositions and its relation to their work outcomes. A cross-sectional study was conducted in Taiwan. From 230 responding community health centers, 1380 staff members responded to the self-completed, structured questionnaire. Structural equation modeling revealed that employees' job autonomy has positive work outcomes: greater work satisfaction, and less intent to transfer and intentions to leave. In addition, job autonomy was related to employees' higher education levels, medical profession, permanent employment and serving smaller populations. Moreover, employees' age, educational levels, medical profession and employment status were found to be related to their work satisfaction, intent to transfer and intent to leave.

  16. Women scientists in Taiwan: an update.

    PubMed

    Wang, Hsiu-Yun; Stocker, Joel Floyd

    2010-06-01

    This paper reflects upon issues of gender and science in Taiwan. Its starting point is the first academic paper on the subject published in Taiwan in 1996 by Fu and Wang, and then it draws upon the biographical accounts of 20 women scientists. We emphasize the importance of focusing on the specific contexts of the history of science and women in Taiwan. Partly as a result of Taiwan's colonial past and women's limited access to education, women scientists did not emerge in Taiwan until the second half of the 20(th) century when higher education became available to women. The gender issues with which women scientists in Taiwan have had to cope include the ways in which women have been excluded or included, their marital and career status, the local and global politics of scientific knowledge, and negotiating social networks. These issues have remained largely the same since the Fu and Wang study, but they have certainly gained wider attention and understanding, and greater articulation, both within academia and society. 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

  17. Australia's national men's health policy: masculinity matters.

    PubMed

    Saunders, Margo; Peerson, Anita

    2009-08-01

    The development of Australia's first national men's health policy provides an important opportunity for informed discussions of health and gender. It is therefore a concern that the stated policy appears to deliberately exclude hegemonic masculinity and other masculinities, despite evidence of their major influence on men's health-related values, beliefs, perspectives, attitudes, motivations and behaviour. We provide an evidence-based critique of the proposed approach to a national men's health policy which raises important questions about whether the new policy can achieve its aims if it fails to acknowledge 'masculinity' as a key factor in Australian men's health. The national men's health policy should be a means to encourage gender analysis in health. This will require recognition of the influence of hegemonic masculinity, and other masculinities, on men's health. Recognising the influence of 'masculinity' on men's health is not about 'blaming' men for 'behaving badly', but is crucial to the development of a robust, meaningful and comprehensive national men's health policy.

  18. Surgeon and Hospital Volume as Quality Indicators for CABG in Taiwan: Examining Hazard to Mortality and Accounting for Unobserved Heterogeneity

    PubMed Central

    Hockenberry, Jason M; Lien, Hsien-Ming; Chou, Shin-Yi

    2010-01-01

    Objective To investigate whether provider volume has an impact on the hazard of mortality for coronary artery bypass grafting (CABG) patients in Taiwan. Data Sources/Study Setting Multiple sources of linked data from the National Health Insurance Program in Taiwan. Study Design The linked data were used to identify 27,463 patients who underwent CABG without concomitant angioplasty or valve procedures and the surgeon and hospital volumes. Generalized estimating equations and hazard models were estimated to assess the impact of volume on mortality. The hazard modeling technique used accounts for bias stemming from unobserved heterogeneity. Principal Findings Both surgeon and hospital volume quartiles are inversely related to the hazard of mortality after CABG. Patients whose surgeon is in the three higher volume quartiles have lower 1-, 3-, 6-, and 12-month mortality after CABG, while only those having their procedure performed at the highest quartile of volume hospitals have lower mortality outcomes. Conclusions Mortality outcomes are related to provider CABG volume in Taiwan. Unobserved heterogeneity is a concern in the volume–outcome relationship; after accounting for it, surgeon volume effects on short-term mortality are large. Using models controlling for unobserved heterogeneity and examining longer term mortality may still differentiate provider quality by volume. PMID:20662948

  19. Attitudes toward Web-based distance learning among public health nurses in Taiwan: a questionnaire survey.

    PubMed

    Yu, Shu; Yang, Kuei-Feng

    2006-08-01

    Public health nurses (PHNs) often cannot receive in-service education due to limitations of time and space. Learning through the Internet has been a widely used technique in many professional and clinical nursing fields. The learner's attitude is the most important indicator that promotes learning. The purpose of this study was to investigate PHNs' attitude toward web-based learning and its determinants. This study conducted a cross-sectional research design. 369 health centers in Taiwan. The population involved this study was 2398 PHNs, and we used random sampling from this population. Finally, 329 PHNs completed the questionnaire, with a response rate of 84.0%. Data were collected by mailing the questionnaire. Most PHNs revealed a positive attitude toward web-based learning (mean+/-SD=55.02+/-6.39). PHNs who worked at village health centers, a service population less than 10,000, PHNs who had access to computer facility and on-line hardware in health centers and with better computer competence revealed more positive attitudes (p<0.01). Web-based learning is an important new way of in-service education; however, its success and hindering factors require further investigation. Individual computer competence is the main target for improvement, and educators should also consider how to establish a user-friendly learning environment on the Internet.

  20. Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008

    PubMed Central

    Chen, Brian K.; Yang, Chun-Yuh

    2014-01-01

    The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result. PMID:24503974