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    標題: Medical Attendance for Lower Urinary Tract Symptoms Is Associated with Subsequent Increased Risk of Outpatient Visits and Hospitalizations Based on a Nationwide Population-Based Database
    作者: Wu, Ming-Ping
    Weng, Shih-Feng
    Hsu, Ya-Wen
    Wang, Jhi-Joung
    Kuo, Hann-Chorng
    貢獻者: 醫務管理系
    關鍵字: Benign Prostatic Hyperplasia
    Quality-Of-Life
    Overactive Bladder
    Cardiovascular Risk
    Incontinence
    Prevalence
    Men
    Impact
    Bother
    Women
    日期: 2013-05
    上傳時間: 2014-05-26 10:47:40 (UTC+8)
    出版者: Public Library Science
    摘要: Introduction: Lower urinary tract symptoms (LUTS), which encompass storage, voiding, and postmicturition symptoms, are highly prevalent and recognized globally. Based on a nationwide population-based database, this study tests the hypothesis that medical attendance for LUTS is associated with a subsequent increase in the number of outpatient visits and hospitalizations, with differences among medical specialties and age groups.Methods: Participants were selected from a random population sample of approximately one million people as a representative cohort of National Health Insurance (NHI) enrollees in Taiwan. Participants had at least three outpatient service claims with a coding of LUTS during the recruitment period 2001-2004. Both the LUTS group and non-LUTS control group were monitored for subsequent outpatient visits and hospitalizations, excluding LUTS-related healthcare services, for 2 years following the index date. The results were categorized based on medical specialty and age group.Results: The outpatient visit rates (no. per person-year) and adjusted incidence rate ratios (IRRs) (95% confidence interval (CI) were significantly higher in urology (4.51, 95% CI 4.15-4.91) and gynecology (1.82, 95% CI 1.76-1.89) for the LUTS group. They were also significantly high in other departments, including internal medicine (1.25), general practice (1.13), Chinese medicine (1.77), family medicine (1.19), surgery (1.38), and psychiatry (1.98). Similarly, the hospitalization rate (no. per 1000 person-year) and adjusted IRRs (95% CI) were significantly higher in urology (5.50, 95% CI = 4.60-6.50) and gynecology (1.60, 95% CI = 1.35-1.90), as well as in internal medicine (1.55) and surgery (1.56), but not in psychiatry (1.12). Furthermore, the IRRs differed among 3 age groups.Conclusions: A significantly higher number of outpatient visits and hospitalizations were observed for individuals with LUTS, compared to the control group, and the effects differed with the advancement of age. This study broadens understanding of LUTS by viewing their impact on healthcare services with multiple and overlapping systems, rather than considering them exclusively as symptoms of traditional diseases of the bladder and urethra.
    關聯: Plos One, v.8 n.3, e57825
    顯示於類別:[醫務管理系(所)] 期刊論文

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