A structured interview survey was conducted in a major city in Taiwan to explore and compare older and younger family primary caregivers' well being and their future caregiving plans for these adults with intellectual disability. The sample size was 315 caregivers who were 55 years or older and who cared for adults with intellectual disability and 472 similar caregivers who were under 55 years of age. The results indicated that the older caregivers compared with younger ones reported a lower quality of life, less family support, a more negative perception of having a family member with intellectual disability, and greater worries about the future care arrangements of the adult with intellectual disability. Statistical analysis showed that predisposing, enabling, and need factors influenced the caregivers' future caregiving options.

This is the first study to examine the dual use of e-cigarettes and traditional cigarettes among adolescents in Taiwan. This study identified the risk factors of using traditional cigarettes only, using e-cigarettes only, and the dual use of e-cigarettes and traditional cigarettes, with nonsmokers used as a reference group. This study examined the relationship between exposure to cigarette promotions and the use of various tobacco products including the dual use of e-cigarettes and traditional cigarettes, both of which have been disregarded in previous studies.

Soonman Kwon, naoKi iKEgami and yuE-chunE lEE Japan, the Republic of Korea and Taiwan, China are neighbouring high-income countries with some similarities in health systems policy. All three have historically organized publicly financed health coverage around the labour market, with the government paying for some or all of the costs of self-employed, retired or poorer people, but Japan has a much higher share of public spending on health and a much lower share of out-of-pocket payments than the other two. All three rely heavily on the private sector to deliver health services. And in all three, private health insurance plays a supplementary role, offering subscribers daily cash benefits in case of hospitalization or lump sum payments in case of severe illness such as cancer. Although private health insurance markets in these countries are marginal in terms of spending on health, they cover relatively large shares of the population.This chapter reviews the origins and development of private health insurance in the three countries and considers why the market is not larger in terms of health spending, especially given the relatively high share of out-of-pocket payments in the Republic of Korea and Taiwan, China and the widespread use of cost sharing for publicly financed health services in all three countries.

Background: The goal of this study was to examine the effect of hospital emergency department (ED) regionalization policy and the categorization of hospital emergency care policy (categorization policy) on patient appropriate ED use.Methods: We conducted an observational study of the effect of emergency care policy intervention on patients' visits. Seven years of data from the Taiwan National Health Insurance Research Database (NHIRD) were examined. Taiwan implemented a nationwide three-tiered hospital ED regionalization and categorization policies in 2007 and 2009, respectively. There were 1,835,860 ED visits found among one million random samples from the NHIRD between 2005 and 2011. ED visits were categorized by the modified New York University ED algorithm. A time series analysis was performed to examine the change in the rate of appropriate ED use after the policy took effect.Results: Total ED visits increased by 10.7% from 2005 to 2011. Average appropriate ED visit rate was 66.9% during the policy intervention. The trend in the appropriate ED visit rate showed no significant policy effect.Conclusions: Provider side of regionalization and categorization policies did increase emergency care accessibility. However, regionalization and categorization policies no significant effect on patient appropriate ED use.

Background: Developmental delay (DD) indicates a failure to meet the developmental milestones of most children of the same age. Studies based solely on the ICD coding manual may underestimate the prevalence of DD. Real-world use of rehabilitation data may be useful in the identification of more DD children previously undiagnosed with DD. Aim: The aim of this study is to estimate the prevalence of DD among children aged 0-6 by age and sex in Taiwan based on modified ICD codes. Methods: A list of ICD codes specific to DD (including delays and disabilities requiring early intervention) was generated from the existing ICD codebook and modified based on National Health Insurance (NHI) claims data pertaining to developmental rehabilitation of children aged 0-6. The validity of the codes was subsequently assessed by DD experts in various fields using the consensus development technique. The resulting list was used to estimate the prevalence of DD among children in Taiwan from 2000 to 2015 based on analysis of longitudinal NHI data.Result: Between 2000 and 2015, the prevalence of DD among children aged 0 to 6 years increased from 2.0% to 5.7%, and the sex ratio was 181-197 males per 100 females. The prevalence estimate obtained in this study (5.6%) was 229% higher than existing government statistics (1.6%) published in 2014. Conclusions:The codes developed using claims data in this study can be used to estimate the prevalence of DD among children and evaluate the effectiveness of intervention programmes. Consistent increases in the prevalence of DD indicate that efforts to promote early intervention have been effective. Nonetheless, the low prevalence rate among 0-2 years children with developmental delay and low prevalence rate of female CWDD means that the policy should notice the lack of access to healthcare services for infants and female children and produce a more equitable or fair distribution of healthcare resources.