Hospice utilization during the SARS outbreak in Taiwan
Identifieur interne : 001119 ( Pmc/Checkpoint ); précédent : 001118; suivant : 001120Hospice utilization during the SARS outbreak in Taiwan
Auteurs : Tzeng-Ji Chen [Taïwan] ; Ming-Hwai Lin [Taïwan] ; Li-Fang Chou [Taïwan] ; Shinn-Jang Hwang [Taïwan]Source :
- BMC Health Services Research [ 1472-6963 ] ; 2006.
Abstract
The severe acute respiratory syndrome (SARS) epidemic threw the world into turmoil during the first half of 2003. Many subsequent papers have addressed its impact on health service utilization, but few have considered palliative (hospice) care. The aim of the present study was to describe changes in hospice inpatient utilization during and after the SARS epidemic in 2003 in Taiwan.
The data sources were the complete datasets of inpatient admissions during 2002 and 2003 from the National Health Insurance Research Database. Before-and-after comparisons of daily and monthly utilizations were made. Hospice analyses were limited to those wards that offered inpatient services throughout these two years. The comparisons were extended to total hospital bed utilization and to patients who were still admitted to hospice wards during the peak period of the SARS epidemic.
Only 15 hospice wards operated throughout the whole of 2002 and 2003. In 2003, hospice utilization began to decrease in the middle of April, reached a minimum on 25 May, and gradually recovered to the level of the previous November. Hospices showed a more marked reduction in utilization than all hospital beds (
Hospice inpatient utilization in Taiwan was indeed more sensitive to the emerging epidemic than general inpatient utilization. A well-balanced network with seamless continuity of care should be ensured.
The online version of this article (doi:10.1186/1472-6963-6-94) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/1472-6963-6-94
PubMed: 16889656
PubMed Central: 1559606
Affiliations:
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wicri:step="Checkpoint">001119</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Hospice utilization during the SARS outbreak in Taiwan</title><author><name sortKey="Chen, Tzeng Ji" sort="Chen, Tzeng Ji" uniqKey="Chen T" first="Tzeng-Ji" last="Chen">Tzeng-Ji Chen</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.278247.c</institution-id><institution-id institution-id-type="ISNI">0000000406045314</institution-id><institution>Department of Family Medicine,</institution><institution>Taipei Veterans General Hospital,</institution></institution-wrap>Shih-Pai Road, Section 2, No 201, Taipei, 11217 Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Shih-Pai Road, Section 2, No 201, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.260770.4</institution-id><institution-id institution-id-type="ISNI">0000000104255914</institution-id><institution>National Yang-Ming University School of Medicine,</institution></institution-wrap>Taipei, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Taipei</wicri:regionArea></affiliation></author><author><name sortKey="Lin, Ming Hwai" sort="Lin, Ming Hwai" uniqKey="Lin M" first="Ming-Hwai" last="Lin">Ming-Hwai Lin</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.278247.c</institution-id><institution-id institution-id-type="ISNI">0000000406045314</institution-id><institution>Department of Family Medicine,</institution><institution>Taipei Veterans General Hospital,</institution></institution-wrap>Shih-Pai Road, Section 2, No 201, Taipei, 11217 Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Shih-Pai Road, Section 2, No 201, 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Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Taipei</wicri:regionArea></affiliation></author><author><name sortKey="Hwang, Shinn Jang" sort="Hwang, Shinn Jang" uniqKey="Hwang S" first="Shinn-Jang" last="Hwang">Shinn-Jang Hwang</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.278247.c</institution-id><institution-id institution-id-type="ISNI">0000000406045314</institution-id><institution>Department of Family Medicine,</institution><institution>Taipei Veterans General Hospital,</institution></institution-wrap>Shih-Pai Road, Section 2, No 201, Taipei, 11217 Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Shih-Pai Road, Section 2, No 201, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.260770.4</institution-id><institution-id institution-id-type="ISNI">0000000104255914</institution-id><institution>National Yang-Ming University School of Medicine,</institution></institution-wrap>Taipei, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Taipei</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Health Services Research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The severe acute respiratory syndrome (SARS) epidemic threw the world into turmoil during the first half of 2003. Many subsequent papers have addressed its impact on health service utilization, but few have considered palliative (hospice) care. The aim of the present study was to describe changes in hospice inpatient utilization during and after the SARS epidemic in 2003 in Taiwan.</p></sec><sec><title>Methods</title><p>The data sources were the complete datasets of inpatient admissions during 2002 and 2003 from the National Health Insurance Research Database. Before-and-after comparisons of daily and monthly utilizations were made. Hospice analyses were limited to those wards that offered inpatient services throughout these two years. The comparisons were extended to total hospital bed utilization and to patients who were still admitted to hospice wards during the peak period of the SARS epidemic.</p></sec><sec><title>Results</title><p>Only 15 hospice wards operated throughout the whole of 2002 and 2003. In 2003, hospice utilization began to decrease in the middle of April, reached a minimum on 25 May, and gradually recovered to the level of the previous November. Hospices showed a more marked reduction in utilization than all hospital beds (<italic>e.g</italic>. -52.5% <italic>vs</italic>. -19.9% in May 2003) and a slower recovery with a three-month lag. In total, 566 patients were admitted to hospice wards in May/June 2003, in contrast to 818 in May/June 2002. Gender, age and diagnosis distributions did not differ.</p></sec><sec><title>Conclusion</title><p>Hospice inpatient utilization in Taiwan was indeed more sensitive to the emerging epidemic than general inpatient utilization. A well-balanced network with seamless continuity of care should be ensured.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/1472-6963-6-94) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Christian, Md" uniqKey="Christian M">MD Christian</name></author><author><name sortKey="Poutanen, Sm" uniqKey="Poutanen S">SM Poutanen</name></author><author><name sortKey="Loutfy, Mr" uniqKey="Loutfy M">MR Loutfy</name></author><author><name sortKey="Muller, Mp" uniqKey="Muller M">MP Muller</name></author><author><name sortKey="Low, De" uniqKey="Low D">DE Low</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Leung, Gm" uniqKey="Leung G">GM Leung</name></author><author><name sortKey="Hedley, Aj" uniqKey="Hedley A">AJ Hedley</name></author><author><name sortKey="Ho, Lm" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Health Serv Res</journal-id><journal-id journal-id-type="iso-abbrev">BMC Health Serv Res</journal-id><journal-title-group><journal-title>BMC Health Services Research</journal-title></journal-title-group><issn pub-type="epub">1472-6963</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">16889656</article-id><article-id pub-id-type="pmc">1559606</article-id><article-id pub-id-type="publisher-id">271</article-id><article-id pub-id-type="doi">10.1186/1472-6963-6-94</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Hospice utilization during the SARS outbreak in Taiwan</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Chen</surname><given-names>Tzeng-Ji</given-names></name><address><email>tjchen@vghtpe.gov.tw</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Lin</surname><given-names>Ming-Hwai</given-names></name><address><email>mhlin@vghtpe.gov.tw</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Chou</surname><given-names>Li-Fang</given-names></name><address><email>lifang@nccu.edu.tw</email></address><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Hwang</surname><given-names>Shinn-Jang</given-names></name><address><email>sjhwang@vghtpe.gov.tw</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="GRID">grid.278247.c</institution-id><institution-id institution-id-type="ISNI">0000000406045314</institution-id><institution>Department of Family Medicine,</institution><institution>Taipei Veterans General Hospital,</institution></institution-wrap>Shih-Pai Road, Section 2, No 201, Taipei, 11217 Taiwan</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="GRID">grid.260770.4</institution-id><institution-id institution-id-type="ISNI">0000000104255914</institution-id><institution>National Yang-Ming University School of Medicine,</institution></institution-wrap>Taipei, Taiwan</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="GRID">grid.412042.1</institution-id><institution-id institution-id-type="ISNI">0000000121066277</institution-id><institution>Department of Public Finance,</institution><institution>National Chengchi University,</institution></institution-wrap>Taipei, Taiwan</aff></contrib-group><pub-date pub-type="epub"><day>04</day><month>8</month><year>2006</year></pub-date><pub-date pub-type="pmc-release"><day>04</day><month>8</month><year>2006</year></pub-date><pub-date pub-type="collection"><year>2006</year></pub-date><volume>6</volume><elocation-id>94</elocation-id><history><date date-type="received"><day>28</day><month>4</month><year>2006</year></date><date date-type="accepted"><day>04</day><month>8</month><year>2006</year></date></history><permissions><copyright-statement>© Chen et al; licensee BioMed Central Ltd. 2006</copyright-statement><license license-type="OpenAccess"><license-p>This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>The severe acute respiratory syndrome (SARS) epidemic threw the world into turmoil during the first half of 2003. Many subsequent papers have addressed its impact on health service utilization, but few have considered palliative (hospice) care. The aim of the present study was to describe changes in hospice inpatient utilization during and after the SARS epidemic in 2003 in Taiwan.</p></sec><sec><title>Methods</title><p>The data sources were the complete datasets of inpatient admissions during 2002 and 2003 from the National Health Insurance Research Database. Before-and-after comparisons of daily and monthly utilizations were made. Hospice analyses were limited to those wards that offered inpatient services throughout these two years. The comparisons were extended to total hospital bed utilization and to patients who were still admitted to hospice wards during the peak period of the SARS epidemic.</p></sec><sec><title>Results</title><p>Only 15 hospice wards operated throughout the whole of 2002 and 2003. In 2003, hospice utilization began to decrease in the middle of April, reached a minimum on 25 May, and gradually recovered to the level of the previous November. Hospices showed a more marked reduction in utilization than all hospital beds (<italic>e.g</italic>. -52.5% <italic>vs</italic>. -19.9% in May 2003) and a slower recovery with a three-month lag. In total, 566 patients were admitted to hospice wards in May/June 2003, in contrast to 818 in May/June 2002. Gender, age and diagnosis distributions did not differ.</p></sec><sec><title>Conclusion</title><p>Hospice inpatient utilization in Taiwan was indeed more sensitive to the emerging epidemic than general inpatient utilization. A well-balanced network with seamless continuity of care should be ensured.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/1472-6963-6-94) contains supplementary material, which is available to authorized users.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Severe Acute Respiratory Syndrome</kwd><kwd>Severe Acute Respiratory Syndrome</kwd><kwd>Hospice Care</kwd><kwd>National Health Insurance Research Database</kwd><kwd>Severe Acute Respiratory Syndrome Patient</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2006</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Taïwan</li></country></list><tree><country name="Taïwan"><noRegion><name sortKey="Chen, Tzeng Ji" sort="Chen, Tzeng Ji" uniqKey="Chen T" first="Tzeng-Ji" last="Chen">Tzeng-Ji Chen</name></noRegion><name sortKey="Chen, Tzeng Ji" sort="Chen, Tzeng Ji" uniqKey="Chen T" first="Tzeng-Ji" last="Chen">Tzeng-Ji Chen</name><name sortKey="Chou, Li Fang" sort="Chou, Li Fang" uniqKey="Chou L" first="Li-Fang" last="Chou">Li-Fang Chou</name><name sortKey="Hwang, Shinn Jang" sort="Hwang, Shinn Jang" uniqKey="Hwang S" first="Shinn-Jang" last="Hwang">Shinn-Jang Hwang</name><name sortKey="Hwang, Shinn Jang" sort="Hwang, Shinn Jang" uniqKey="Hwang S" first="Shinn-Jang" last="Hwang">Shinn-Jang Hwang</name><name sortKey="Lin, Ming Hwai" sort="Lin, Ming Hwai" uniqKey="Lin M" first="Ming-Hwai" last="Lin">Ming-Hwai Lin</name><name sortKey="Lin, Ming Hwai" sort="Lin, Ming Hwai" uniqKey="Lin M" first="Ming-Hwai" last="Lin">Ming-Hwai Lin</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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