Abstract
BackgroundThis study searches the National Health Insurance Research Database (NHIRD) used in a previous project, aiming for reconstructing possible cerebrovascular disease-related groups (DRG),and estimating the costs between cerebrovascular disease and related diseases.Methods and MaterialsWe conducted a nationwide retrospective cohort study in stroke inpatients, we examined the overall costs in 3 municipalities in Taiwan, by evaluating the possible costs of the expecting diagnosis related group (DRG) by using the international classification of diseases version-9 (ICD-9) system, and the overall analysis of the re-admission population that received traditional Chinese medicine (TCM) treatment and those who did not.ResultsThe trend demonstrated that the non-participant costs were consistent with the ICD-9 categories (430 to 437) because similarities existed between years 2006 to 2007. Among the TCM patients, a wide variation and additional costs were found compared to non-TCM patients during these 2 years. The average re-admission duration was significantly shorter for TCM patients, especially those initially diagnosed with ICD 434 during the first admission. In addition, TCM patients demonstrated more severe general symptoms, which incurred high conventional treatment costs, and could result in re-admission for numerous reasons. However, in Disease 7 of ICD-9 category, representing the circulatory system was most prevalent in non-TCM inpatients, which was the leading cause of re-admission.ConclusionWe concluded that favorable circulatory system outcomes were in adjuvant TCM treatment inpatients, there were less re-admission for circulatory system events and a two-third reduction of re-admission within ICD-9 code 430 to 437, compared to non-TCM ones. However, there were shorter re-admission duration other than circulatory system events by means of unfavorable baseline condition.
Highlights
Cerebrovascular diseases pose a critical threat to human health
We conducted a nationwide retrospective cohort analysis in stroke inpatients, aiming for reconstructing possible cerebrovascular disease-related groups (DRG),and estimating the costs between cerebrovascular disease and related diseases. we examined the overall costs in three municipals in Taiwan, and estimated the possible costs for the expecting diagnosis related group (DRG) using the international classification of diseases version-9 (ICD-9) system, and an overall analysis of the readmission population
In 2006, the inpatients’ first ICD-9 code between 430–437 as the primary analysis population, random-control group matched for sex, age by propensity score matching procedures. (Table 1) The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of post-stroke complications and mortality associated with adjuvant Traditional Chinese Medicine (TCM) treatments were calculated again in ICD-9 codes
Summary
The prevalence of cerebrovascular diseases in the study population older than 45 years old was 17.5/1000 (95% confidence interval 17.0–18.0) [1]. Cerebrovascular diseases, such as hemorrhage, thrombosis and necrosis, are malignant and can cause death or disability, which has a detrimental effect on individuals, families, and society [2,3]. According to World Health Organization (WHO) reports, cerebrovascular diseases in high income countries were among the world’s top 10 leading causes of death in 2005, and were the second highest cause of death overall. The health burden of cerebrovascular diseases was measured at an annual population prevalence of 11.7/1000 (95% confidence interval of 11.3 to 12.1), and it is estimated that up to 67% of cerebrovascular disease survivors are unable to be self-supporting [1], and 10% of survivors require long-term care in paramedical institutions [5]. This study searches the National Health Insurance Research Database (NHIRD) used in a previous project, aiming for reconstructing possible cerebrovascular disease-related groups (DRG),and estimating the costs between cerebrovascular disease and related diseases
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