Epidemiological investigation of multiple sclerosis and related medical utilisation in Taiwan

Abstract

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.

Survival and Its Correlates in Multiple Sclerosis Patients under a Universal Health Insurance Program in Taiwan: An 18-Year Nationwide Cohort Study

“…On the other hand, patient demographic characteristics, socioeconomic status, environmental factors, comorbidity severity, and related medical variables did not show statistically significant HRs. Our findings are consistent with the results of an epidemiological report in Taiwan, which revealed a sharp increase in mortality with age over a 15-year period [22]. Similarly, studies conducted in other countries have shown that age is a significant predictor of mortality in MS patients [12,14].…”

“…Epidemiological reports of MS in Taiwan and worldwide have indicated a decline in standard incidence and fatality rates in recent years [1,22]. Firstly, we observed that the district hospital group had a higher risk of death than the medical center group.…”

“…We also learned from previous research reports that during the 15-year observation period, MS patients had an overall mortality rate of 1334 people per 100,000 person-years. In comparison, the standardized population mortality rate in 2015 was 431.5 people per 100,000 population in Taiwan, indicating a mortality ratio of approximately three times higher in MS patients [22]. A previous study in Taiwan identified monthly salary and interferon drug treatment as significant factors affecting mortality [18].…”

“…Three MS disease reports based on Taiwan's national data after 2000 as a sample do not mention any analysis of the risk of death in MS patients [19][20][21]. An MS epidemiology report in Taiwan showed a slight decrease in the fatality rate of MS from 2001 to 2015 [22]. The Global Burden of Disease (GBD) meta-analysis also revealed that Taiwan's standardized mortality rate for MS decreased by 23.9% from 1990 to 2016, which was greater than the global decline [1].…”