Exploration of Preventable Hospitalizations for Colorectal Cancer with the National Cancer Control Program in Taiwan.

Yu-Han Hung,Pi-Yueh Lee,Yu-Chieh Chung,Hao-Yun Kao

doi:10.3390/ijerph18179327

Abstract

Background: Causing more than 40,000 deaths each year, cancer is one of the leading causes of mortality and preventable hospitalizations (PH) in Taiwan. To reduce the incidence and severity of cancer, the National Cancer Control Program (NCCP) includes screening for various types of cancer. A cohort study was conducted to explore the long-term trends in PH/person-years following NCCP intervention from 1997 to 2013. Methods: Trend analysis was carried out for long-term hospitalization. The Poisson regression model was used to compare PH/person-years before (1997–2004) and after intervention (2005–2013), and to explore the impact of policy intervention. Results: The policy response reduced 26% for the risk of hospitalization; in terms of comorbidity, each additional point increased the risk of hospitalization by 2.15 times. The risk of hospitalization doubled for each 10-year increase but was not statistically significant. Trend analysis validates changes in the number of hospitalizations/person-years in 2005. Conclusions: PH is adopted as an indicator for monitoring primary care quality, providing governments with a useful reference for which to gauge the adequacy, accessibility, and quality of health care. Differences in PH rates between rural and urban areas can also be used as a reference for achieving equitable distribution of medical resources.

Highlights

IntroductionCausing more than 40,000 deaths each year, cancer is one of the leading causes of mortality in Taiwan, resulting in great suffering and expense to families and the national health care system
Clinical disease identification codes vary among national health care systems; the recorded disease code may not match the actual diagnosis
Previous studies have generally found that socio-economic conditions, marital status, education, and residency all affect preventable hospitalizations (PH), but the present study was not able to directly measure socio-economic status

Summary

Introduction

Causing more than 40,000 deaths each year, cancer is one of the leading causes of mortality in Taiwan, resulting in great suffering and expense to families and the national health care system. In the 1980s, the United States (US) national healthcare policy adopted improvements to access primary care as an important indicator for the overall effectiveness of the health care system. One measure towards this was the introduction of “ambulatory care sensitive conditions (ACSC)” [7,8,9], a concept in which some diseases may be prevented through appropriate and immediate primary care, minimizing PH through immediate and effective outpatient care.

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Discussion

Conclusion