This study is one of the largest pioneer studies to date to survey sedatives-hypnotics use among community-dwelling elderly. One in five community-dwelling older adults reported sedative-hypnotic drugs use in Taiwan, and about 5% of sedative and/or hypnotics usage was without a doctor's prescription. Findings could be helpful for drug-use safety interventions to identify target geriatric patients who are in general at higher risk of downstream harm associated with sedative-hypnotic use in geriatric patients.

China has built a social medical insurance system that covers the entire population so as to reduce the impact of diseases on individuals and families. Although the decline in the incidence of catastrophic health expenditures (CHEs) in China is encouraging, this issue remains important. On the basis of considering selectivity bias and heterogeneity, we applied propensity score matching (PSM) to analyze the 2018 data from the China Family Panel Studies. We assigned CHE households and non-CHE households to the treatment group and the control group, respectively, and used non-random data to simulate a randomized trial to investigate the impact of CHE on household consumption in China. The results of this study indicate that, when the threshold is set at 40%, the consumption of households experiencing CHEs (CHE household) is significantly lower than that of households not experiencing CHEs (non-CHE households) and that CHEs have a significant negative impact on other household consumption and a significant impact on the household property and debt. This effect still exists when the threshold is set lower, with household essential consumption most affected. The occurrence of CHEs leads to a reduction in household consumption and a significantly worsening financial situation for the CHE households, impacting the basic quality of life of the families. Therefore, it is necessary to further reform the medical and health system to reduce the high medical expenses.

The purpose of this study was to report our results of totally implantable access ports (TIAP) approached via the femoral vein. Patients and Methods: Seven patients were enrolled. The mean age was 62 years. Four patients were male, and 3 patients were female. Six patients received TIAP via the right femoral vein and 1 patient via the left femoral vein. All patients underwent local anesthesia. The reason for femoral vein TIAP placement, mean operative time, follow-up time and complications were recorded. Results: The mean operative time was 37 ± 12 min, the mean follow-up time 13.5 ± 12.0 months. The causes for repeat TIAP or conversion to femoral vein access are as follows: In 2 cases repeat TIAP was associated with thrombus formation in the subclavian vein, 2 cases developed a superior vena cava syndrome (one was accompanied by chest wall invasion), 2 cases showed repeat catheter obstruction, and in 1 case infection and catheter obstruction was found. Five of the 7 patients had 2 TIAP before, 2 patients only 1 TIAP. All interventions remained free of complications. Conclusion: TIAP via conventional central venous access such as jugular, subclavian or brachial veins are simple. However, not all cases are suitable for these methods. We present an alternative method of central vein access: the approach via the femoral vein. This method is safe and simple, but the port site should be placed far away from the groin region to avoid infections.

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 prognostic role of the interval between disease onset and hospital admission (O-A interval) was undetermined in patients with the coronavirus disease 2019 (COVID-19). Methods: A total of 205 laboratory-confirmed inpatients admitted to Hankou hospital of Wuhan from January 11 to March 8, 2020 were consecutively included in this retrospective observational study. Demographic data, medical history, laboratory testing results were collected from medical records. Univariate and multivariate logistic regression models were used to evaluate the prognostic effect of the O-A interval (≤7 versus >7 days) on disease progression in mild-to-moderate patients. For severe-to-critical patients, the in-hospital mortality and the length of hospital stay were compared between the O-A interval subgroups using log-rank test and Mann-Whitney U test, respectively. Results: Mild-to-moderate patients with a short O-A interval (≤7 days) are more likely to deteriorate to severe-to-critical stage compared to those with a long O-A interval (>7 days) [unadjusted odds ratio =2.93, 95% confidence interval (CI), 1.32-6.55; adjusted odds ratio =3.44, 95% CI, 1.20-9.83]. No association was identified between the O-A interval and the mortality or the length of hospital stay of severe-to-critical patients. Conclusions: The O-A interval has predictive values for the disease progression in mild-to-moderate COVID-19 patients. Under circumstances of the specific health system in Wuhan, China, the spontaneous healthcare-seeking behavior is usually determined by patients' own heath conditions. Hence, the O-A interval can be reflective of the natural course of COVID-19 to some extent. However, our findings should be validated further in other cohorts and in other health systems.