Critical care medicine in Taiwan from 1997 to 2013 under National Health Insurance

doi:10.21037/jtd.2018.07.131

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Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/32156

Title:	Critical care medicine in Taiwan from 1997 to 2013 under National Health Insurance
Authors:	Lai, Chih-Cheng Ho, Chung-Han Chang, Chia-Li Chen, Chin-Ming Chiang, Shyh-Ren Chao, Chien-Ming Wang, Jhi-Joung Cheng, Kuo-Chen
Contributors:	Chi Mei Med Ctr, Dept Intens Care Med Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Chi Mei Med Ctr, Dept Intens Care Med Chia Nan Univ Pharm & Sci Chi Mei Med Ctr, Dept Internal Med Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm Engn
Keywords:	Critical care intensive care unit (ICU) mortality utilization
Date:	2018-08
Issue Date:	2019-11-15 15:43:05 (UTC+8)
Publisher:	AME PUBL CO
Abstract:	Background: Monitoring of trends in the use of the intensive care unit (ICU) and the outcomes of ICU patients is essential for the assessment of the effective use of ICU. This study aims to investigate the incidence and outcome of critical care admissions in Taiwan from 1997 to 2013. Methods: Patients >18 years who had ICU admission between January 1997 and December 2013 were identified from the National Health Insurance Research Database in Taiwan. The main outcomes including ICU mortality and ICU length of stay (LOS) were measured. Results: A total of 3,451,157 patients with ICU admission were identified during the study period. The mean ICU LOS was 5.9 +/- 9.0 days and the overall ICU-mortality rate was 19.8%. The mean age of the patients was 65.4 years old, 58.0% were elderly (>= 65 years old), 61.1% were male. Annual incidence of ICU admissions increased from 115,754 in 1997 (age-adjusted incidence: 1,130/100,000 population) to 244,820 in 2013 (incidence: 1,483/100,000 population) (P<0.0001). The admission rate was highest for patients 75-104 years old (8,074 per 100,000 population), and lowest for those 18-44 years old (298 per 100,000 population). Among ICU admission patients, the percentage of patients >= 75 years old significantly increased from 25.2% in 1997 to 38.3% in 2013 (P<0.0001). ICU LOS remained stable during the study period, but the annual mortality rate significantly decreased from 23.0% in 1997 to 16.3% in 2013. Conclusions: ICU admissions significantly increased from 1997 to 2013, especially for elderly patients, in contrast, the mortality rate of ICU patients significantly declined with time. In addition, the ICU LOS did not change during the study period.
???metadata.dc.relation.uri???:	http://dx.doi.org/10.21037/jtd.2018.07.131
Relation:	Gland Surgery, v.10, n.8, pp.4957–4965
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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