Routine Versus Risk-Based HIV Testing and Mortality of Patients With HIV Under National Health Insurance: A Population-Based Cohort Study

2020 ◽  
Author(s):  
Yi-Hsuan Chen ◽  
Chi-Tai Fang ◽  
Ming-Chieh Shih ◽  
Kuan-Yin Lin ◽  
Shu-Sen Chang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Hiv Testing ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Versus Risk

scholarly journals Thiazide diuretics and the risk of hip fracture after stroke: a population-based propensity-matched cohort study using Taiwan’s National Health Insurance Research Database

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016992 ◽  
Author(s):  
Shu-Man Lin ◽  
Shih-Hsien Yang ◽  
Hung-Yu Cheng ◽  
Chung-Chao Liang ◽  
Huei-Kai Huang
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Hip Fracture ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Research Database ◽  
Matched Cohort ◽  
Matched Cohort Study

ObjectivesThis study aimed to investigate the association between thiazide use and the risk of hip fracture after stroke.SettingA population-based, propensity-matched cohort study was conducted on the basis of Taiwan’s National Health Insurance Research Database.ParticipantsPatients with newly diagnosed ischaemic stroke between 2000 and 2011 were included. After propensity score matching, 7470 patients were included, of whom 3735 received thiazides and 3735 did not.Outcome measuresHRs for developing hip fractures within 2 years after stroke were calculated using Cox proportional hazards regression model with adjustments for sociodemographic and coexisting medical conditions.ResultsOverall, patients using thiazides after stroke had a lower risk of hip fracture than those not using thiazides (8.5 vs 13.9 per 1000 person-years, adjusted HR=0.64, 95% CI 0.46 to 0.89, p=0.007). Further sensitivity analysis based on the duration of thiazide use revealed that the risk of hip fracture tended to decrease as the duration of exposure of thiazides increased. However, the effect was significant only in patients with long-term use of thiazides (using thiazides for >365 days within 2 years after stroke), with a 59% reduction in the risk of hip fracture when compared with patients not using thiazide (adjusted HR=0.41, 95% CI 0.22 to 0.79, p=0.008).ConclusionsThe long-term use of thiazides is associated with a decreased risk of hip fracture after stroke.

Methylphenidate and mortality in children with attention-deficit hyperactivity disorder: population-based cohort study

2020 ◽  
pp. 1-9
Author(s):  
Vincent Chin-Hung Chen ◽  
Hsiang-Lin Chan ◽  
Shu-I Wu ◽  
Mong-Liang Lu ◽  
Michael E. Dewey ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cohort Study ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Attention Deficit ◽  
Population Based ◽  
Research Database ◽  
Adhd Diagnosis ◽  
Hyperactivity Disorder

Background Little is known about methylphenidate (MPH) use and mortality outcomes. Aims To investigate the association between MPH use and mortality among children with an attention-deficit hyperactivity disorder (ADHD) diagnosis. Method This population-based cohort study analysed data from Taiwan's National Health Insurance Research Database (NHIRD). A total of 68 096 children and adolescents aged 4–17 years with an ADHD diagnosis and prescribed MPH between 2000 and 2010 were compared with 68 096 without an MPH prescription, matched on age, gender and year of first ADHD diagnosis. All participants were followed to death, migration, withdrawal from the National Health Insurance programme or 31 December 2013. MPH prescriptions were measured on a yearly basis during the study period, and the association between MPH use and mortality was analysed using a repeated-measures time-dependent Cox regression model. The outcome measures included all-cause, unnatural-cause (including suicide, accident and homicide) and natural-cause mortality, obtained from linkage to the National Mortality Register in Taiwan. Results The MPH group had lower unadjusted all-cause, natural-, unnatural- and accident-cause mortality than the comparison group. After controlling for potential confounders, MPH use was associated with a significantly lower all-cause mortality (adjusted hazard ratio AHR = 0.81, 95% CI 0.67–0.98, P = 0.027), delayed use of MPH was associated with higher mortality (AHR = 1.05, 95% CI 1.01–1.09) and longer MPH use was associated with lower mortality (AHR = 0.83, 95% CI 0.70–0.98). Conclusions MPH use is associated with a reduced overall mortality in children with ADHD in this cohort study, but unmeasured confounding cannot be excluded absolutely.

scholarly journals Risk of dementia after Parkinson’s disease in Taiwan: a population-based retrospective cohort study using National Health Insurance claims

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025274 ◽  
Author(s):  
Chih-Ching Liu ◽  
Yu Sun ◽  
Pei-Chen Lee ◽  
Chung-Yi Li ◽  
Susan C Hu
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Control Groups ◽  
And Control ◽  
Dementia Onset ◽  
Incidence Of Dementia ◽  
First Diagnosis

ObjectivesA nationwide cohort study on the risk of dementia onset after first diagnosis of Parkinson’s disease (PD) is lacking. This study aims to assess 11 years of incidence and the HRs for developing dementia in patients with PD compared with matched controls.DesignA population-based cohort study.SettingNational Health Insurance database in Taiwan.ParticipantsA total of 5932 patients with PD were identified, and 29 645 age-matched, sex-matched and index year-matched PD-free individuals were randomly selected.Outcome measuresAll subjects were linked to the claim data to identify the first diagnosis of dementia. The Poisson assumption was used to estimate the incidence rate. Cause-specific hazards models with a partitioning of time at 1 year to account for proportionality were used to estimate the risk of dementia onset.ResultsThe median duration from the first diagnosis of PD to the development of dementia was 9.02 years. In the first partition (≦ 1 year), the incidence of dementia in the PD and control groups was 114.49 and 9.76 per 1000 person-years, respectively, with an adjusted HR of 6.43 (95% CI 5.46 to 7.57). In the second partition (>1 year), the incidence of dementia in the PD and control groups was 30.99 and 10.83 per 1000 person-years, with an adjusted HR of 2.42 (95% CI 2.23 to 2.61). Notably, in the second partition, both men and women aged <70 years had the highest HR (3.82, 95% CI 2.79 to 5.22 and 4.27, 95% CI 3.25 to 5.63, respectively).ConclusionsThis study noted an increased risk of dementia after a diagnosis of PD. The magnitude of effect estimation was higher in men in the first partition but was similar in both genders in the second partition. PD patients aged <70 years have the highest risk of dementia in any given partition time.

scholarly journals Association between de Quervain syndrome and herpes zoster: a population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e046891
Author(s):  
Chao-Yu Hsu ◽  
Der-Shin Ke ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Herpes Zoster ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Control Group ◽  
Research Database ◽  
Increased Risk ◽  
De Quervain

ObjectiveBoth physical diseases such as infection and chronic pain and psychological disorders such as depression have been associated with herpes zoster (HZ) reactivation. However, the relationship between de Quervain syndrome (DQS), a painful tenosynovitis and HZ remains unclear. We investigated whether DQS increases the risk of HZ reactivation.DesignA retrospective population-based cohort study.SettingTaiwan.ParticipantsWe used a subset of Taiwan’s National Health Insurance Research Database, the Longitudinal Health Insurance Database which contains the registration files and original claims data of 1 million randomly selected individuals from the National Health Insurance programme. The case group in this study comprised patients newly diagnosed with DQS between 2000 and 2012. Individuals without DQS comprised the control group. Cases and controls were 1:1 matched by age, sex and index year (defined as the year of DQS diagnosis).ResultsApproximately 55% of the participants were ≤49 years. Most participants were women (77%). The incidence rate of HZ in the DQS group was 8.39 per 1000 person years. After adjustments for age, sex and comorbidities, patients with DQS had a 1.30 times higher risk of HZ reactivation than the control group. Stratification analysis revealed taht DQS increases the HZ risk in individuals ≤64 years, women, and patients without comorbidities.ConclusionDQS is associated with an increased risk of HZ. Clinicians should be aware of this risk when dealing with patients with DQS, particularly in young adults.

scholarly journals Smoking and risk of incident end-stage kidney disease in general population: A Nationwide Population-based Cohort Study from Korea

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Hong Sang Choi ◽  
Kyung-Do Han ◽  
Tae Ryom Oh ◽  
Chang Seong Kim ◽  
Eun Hui Bae ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Kidney Disease ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
End Stage Kidney Disease ◽  
Smoking Duration ◽  
Korean National Health Insurance ◽  
End Stage

AbstractWe analyzed data from the Korean National Health Insurance Service (NHIS) to investigate whether smoking increases the risk of end-stage kidney disease (ESKD). This retrospective nationwide population-based cohort study included the data of 23,232,091 participants who underwent at least one health examination between 2009 and 2012. Smoking status was recorded at baseline. The incidence of ESKD was identified via ICD-10 codes and special medical aid codes from the Korean National Health Insurance Service database till December 2016. A Cox proportional-hazards model with multivariable adjustment was used to evaluate the association between smoking and ESKD incidence. Overall, 24.6% of participants were current smokers; 13.5% and 61.9%, were ex- and non-smokers, respectively. Overall, 45,143 cases of ESKD developed during the follow-up period. Current smokers (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.35–1.43) and ex-smokers (HR, 1.09; 95% CI, 1.06–1.12) demonstrated a significant increase in the adjusted risk of ESKD compared to non-smokers. The risk of ESKD was directly proportional to the smoking duration, number of cigarettes smoked daily, and pack-years. In conclusion, smoking is associated with a greater risk of ESKD in the general Korean population; the risk increases with an increase in the smoking duration, number of cigarettes smoked daily, and pack-years.

scholarly journals Chronic periodontitis and community-acquired pneumonia: a population-based cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Seon-Jip Kim ◽  
Kyuwoong Kim ◽  
Seulggie Choi ◽  
Jooyoung Chang ◽  
Sung Min Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Chronic Periodontitis ◽  
Proportional Hazards ◽  
Population Based ◽  
Incidence Rates ◽  
Community Acquired Pneumonia ◽  
Cox Proportional Hazards

Abstract Background This study aimed to determine the association between chronic periodontitis (CP) and community-acquired pneumonia (CAP) according to CP severity in the Korean population based on the National Health Insurance Service database. Methods Data from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS), conducted from 2002 to 2013, were analyzed. A total of 363,541 participants were enrolled in this retrospective cohort study. Data on socio-demographic characteristics and CAP-related variables were collected. Participants were divided into 4 groups according to CP severity. Cox proportional hazards regression was performed after adjusting for sociodemographic and related covariates. Results A total of 363,541 participants were included in the analysis. The number of CAP cases in the index period was 14,838 (4.1%). Among the 4 groups, the mean age was significantly higher in the severe CP group. The incidence rates of severe and non-severe CP were 5.68 and 4.99, respectively (per 103 person-years). The hazard ratio for CAP was not significant in any of the models regardless of the presence or absence of CP. On stratification analysis by sex, smoking and Charlson comorbidity index, there were no significant differences between CAP and CP in any of the models. Conclusion The results of this study show that CP may not be a potential risk factor for CAP.

Iatrogenic Vocal Fold Paralysis: A Population-Based Cohort Study in Taiwan

2021 ◽  
pp. 000348942110412
Author(s):  
Ying-Ta Lai ◽  
Pin-Zhir Chao ◽  
Yu-Kang Chang ◽  
Yu-Chun Yen ◽  
Yu-Ting Shen ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cervical Spine ◽  
National Health Insurance ◽  
National Health ◽  
Vocal Fold ◽  
Population Based ◽  
Vocal Fold Paralysis ◽  
Research Database ◽  
Bilateral Vocal Fold Paralysis ◽  
Co Morbidity

Objective: Iatrogenic vocal fold paralysis is an important issue in laryngology, yet there are few population-based studies regarding the epidemiology. This study used a nationwide population-based claims database (the National Health Insurance Research Database) to investigate the epidemiology of iatrogenic unilateral and bilateral vocal fold paralysis (UVFP/BVFP) among the general adult population in Taiwan. Method: This study analyzed patients (20-90 years old) who underwent thyroid, parathyroid, thoracic, cardiac, or anterior cervical spine operations with vocal fold paralysis among adults in Taiwan from January 1, 2007 to December 31, 2013. The codes for vocal fold paralysis were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Claims data in the Taiwan National Health Insurance Research Database were used. Results: The most commonly performed operations which were related to vocal fold paralysis in Taiwan were, in descending order of frequency, thyroid, cervical spine, cardiac, thoracic (esophagectomy), and parathyroid operations. The operations that put laryngeal nerves at risk (ONRs) most commonly associated with a diagnosis of UVFP were, in descending order of frequency, thoracic, thyroid, parathyroid, cardiac, and cervical spine. For both UVFP and BVFP, the most commonly associated age group was 51 to 60. For both UVFP and BVFP, the more commonly associated sex was women. Increased length of stay was associated with a higher incidence of UVFP and BVFP. Charlson medical co-morbidity index (CCI) was not associated with UVFP but BVFP was associated with higher Charlson medical co-morbidity scores. Conclusions: Thyroid operations, age 51 to 60, longer hospital stays are associated with vocal fold paralysis. Overall women are more surgically affected than men. This is the first population-based study of iatrogenic vocal fold paralysis.

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