Abstract
Various sociocultural factors affect healthcare-seeking behaviors. In Taiwanese society, superstitions and lunar festivals play important roles in people’s lives. We investigated the impact of “Ghost Month” (the 7th lunar month) and Chinese New Year (the 12th lunar month and the 1st lunar month of the following year) on the number of elective surgeries and emergent surgeries in Taiwan. The number of total knee replacement (TKR) surgeries and proximal femur fracture (PFF) surgeries in each lunar month from 2000 to 2011 were extracted from the Taiwan National Health Insurance Database, a computerized and population-based database. Patients were then sorted by location of residence or gender. The average number of TKR surgeries performed was significantly lower during the 1st, 7th, and 12th lunar months in urban areas, whereas in rural areas this trend was only evident in the 7th and 12th lunar months. There was however, no significant difference in the average number of PFF surgeries in each lunar month except for an increase seen in the 1st lunar month in rural patients (p<0.05). When sorted by gender, the average number of TKR surgeries was significantly decreased in the 7th and 12th lunar months in male patients, and decreased in the 1st, 7th, and 12th lunar months in female patients. In contrast, there was no difference in the average numbers of PFF surgeries in the 7th and 12th lunar months either in male or female patients. We proposed that the timing of elective surgeries such as TKR might be influenced by Ghost Month and Chinese New Year; however, emergent PFF surgeries were not significantly influenced by sociocultural beliefs and taboos in Taiwan.
Highlights
Different sociocultural factors have shown potential influence on health-seeking behaviors [1,2,3]
The Dragon Boat Festival falls on the 5th day of the 5th lunar month
The celebration of the Chinese New Year usually starts from the 16th day of the 12th lunar month to the 15th day of the 1st lunar month of the following year, with only five national holidays in this time period
Summary
Different sociocultural factors have shown potential influence on health-seeking behaviors [1,2,3]. Many cultures believe in the existence of ghosts [4,5,6]; superstitious beliefs affect social and health-seeking behaviors in many countries [7, 8]. In Taiwanese culture, there are four main lunar events including the Chinese New Year, the Dragon Boat Festival, the Ghost Month, and the Moon festival. Most Taiwanese avoid elective surgeries during the Chinese New Year festival. The Ghost Month is deemed a dangerous time period of the year, filled with mishaps. Because of this belief, people avoid potentially dangerous activities such as participating in watersports, mountain climbing, undergoing surgery, etc. We further investigated the impact of urban and rural locality and gender differences on these surgeries
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