Background The World Health Organization has recognized that people with disability are among the most marginalized in the world. This study’s objective was to investigate the differences in the probability of colorectal cancer (CRC) screening with faecal immunochemical testing (FIT) between people with disability and without disability in Taiwan. Methods The study participants included people with and without disability from the Disability Registration Database (2012) and the National Health Insurance Research Database (2009–2012). The study included 50- to 69-year-olds with and without disability who were screened from 2011 to 2012 and were alive in 2012. There were 16 categories of disability. After propensity score matching (PSM) between the two groups, conditional logistic regression analysis with control variables was used to investigate the odds ratio (OR) that people with or without disability would undergo CRC screening. Results The percentage of people with disability receiving CRC screening was 21.84%, and the highest rate of those receiving CRC screening (38.72%) was found in people with intractable epilepsy, whose OR was 1.47 times that of people with moving functional limitation (95% confidence interval (CI) = 1.17–1.85). The results showed that the probability of CRC screening in people with disability was lower than that in people without disability (OR = 0.88, 95%CI = 0.87–0.89). The probability of receiving CRC screening differed between people with different categories of disability. Conclusions Although the probability of CRC screening in the four categories of disability was higher than that in the general population, overall, people with disability were less likely than people without disability to undergo CRC screening. Health inequalities still exist under National Health Insurance in Taiwan.
Background The increasing trend in the prevalence of multiple sclerosis (MS) cannot be neglected. Long-term epidemiological investigations of MS patients who have been registered in Taiwan are very scarce. Objective The aim of this study was to investigate the epidemiology of MS and medical utilisation among MS patients in Taiwan. Methods The National Health Insurance Research Database was used as the source of the research population; the time period investigated was 2001–2015. A descriptive statistical analysis of the number of MS patients was conducted. For newly diagnosed MS patients, the frequencies of emergency visits and hospitalisations and changes in their temporal distributions were calculated. Results The standardised incidence of MS peaked at 0.50/100,000 in 2003, and the highest standardised prevalence was 7.14/100,000 in 2015. The highest standardised mortality was 0.11/100,000 in 2015, with an overall mortality rate of 13.34/1000 person-years. The number of annual emergency visits for MS patients peaked at 0.9 ± 3.5 in 2011, and the longest annual length of hospital stays was 19.2 ± 40.1 days in 2001, which decreased to 5.6 ± 23.5 days in 2015. Conclusion The standardised prevalence of MS steadily increased, and its incidence slightly decreased from 2001 to 2015.
The literature describing the effectiveness of multidisciplinary team (MDT) for the care of colorectal cancer remains unclear. We investigated the effects of MDT care on the quality of colorectal cancer treatment, and the emergency department visit number was used as an indicator. In total, 45,418 patients newly diagnosed with colorectal cancer from the Taiwan National Health Insurance Research Database (2005–2009) were included. Propensity score matching with a ratio of 1:3 was adopted to reduce differences in characteristics between MDT care participants and non-MDT care participants. After matching, 3039 participation MDT care groups and 9117 nonparticipation groups were included and analyzed with χ2 and t tests, determine the distribution was similar. Without the control of variables, the percentage difference between participation and nonparticipation MDT care groups in utilization of emergency care was 0.03% (P > .05). The logistic regression model involving controlled variables demonstrated that odds ratio (OR) by probability of emergency care used for participation MDT care groups within a year of cancer diagnosis was less than that for nonparticipation (OR = 0.87, 95% confidence interval: 0.78–0.96). Large amount data were used and confirmed significant benefits of MDT in colorectal cancer care.
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