Nantou, Taiwan
Nantou, Taiwan

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Yen S.-M.,China Medical University at Taichung | Yen S.-M.,Nantou Hospital | Kung P.-T.,Asia University, Taiwan | Tsai W.-C.,China Medical University at Taichung
BMC Health Services Research | Year: 2014

Background: This study examines the Pap smear usage conditions and relevant influential factors for 18,204 women aged 30 years and above with intellectual disabilities, using nationwide data from 2008. Methods. The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of Pap smear testing by women with intellectual disabilities. Chi-square test was used to assess the correlation between Pap smear test usage and several variables. Logistic regression analysis was employed to explore the factors that influence Pap smear test usage. Results: The results show that 4.83% (n =880) of women with intellectual disabilities underwent Pap smear tests. Pap smear test usage rates exhibit a declining trend with increases in age. Factors that significantly influence Pap smear test use include age, urbanization level of resident area, monthly salary, aboriginal status, marital status, existence of DM, severity of disability. Conclusions: The women with intellectual disabilities had a low use rate of Pap smear test, which is significantly less than the 28.8% usage rate for the general population of women aged 30 years and above. © 2014 Yen et al.; licensee BioMed Central Ltd.


Yen S.-M.,China Medical University at Taichung | Yen S.-M.,Nantou Hospital | Kung P.-T.,Asia University, Taiwan | Chiu L.-T.,China Medical University at Taichung | Tsai W.-C.,China Medical University at Taichung
BMC Health Services Research | Year: 2014

Background: This study aimed to investigate the utilization of preventive health services in the adults with intellectual disabilities from the nationwide database. Methods. The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of preventive health services by intellectual disabled adults. Chi-square test was used to determine the relationship between the utilization of preventive health services and these variables. Multivariate logistic regression analysis was used to explore the factors that affect intellectual disabled adults' use of preventive health services. Results: Our findings indicated 16.65% of people with intellectual disabilities aged over 40 years used the preventive health services. Females were more frequent users than males (18.27% vs. 15.21%, p <0.001). The utilization rate decreased with increasing severity of intellectual disabilities. The utilization was lowest (13.83%) for those with very severe disability, whereas that was the highest (19.38%) for those with mild severity. The factors significantly influencing utilization of the services included gender, age, and marital status, urbanization of resident areas, monthly payroll, low-income household status, catastrophic illnesses status and relevant chronic diseases and severity of disability. Conclusions: Although Taiwan's Health Promotion Administration (HPA) has provided free preventive health services for more than 15 years, people with intellectual disabilities using preventive health care tend to be low. Demographics, economic conditions, health status, relevant chronic diseases, environmental factor, and severity of disability are the main factors influencing the use of preventive healthcare. According to the present findings, it is recommended that the government should increase the reimbursement of the medical staff performing health examinations for the persons with intellectual disabilities. It is also suggested to conduct media publicity and education to the public and the nursing facilities for the utilization of adult preventive health services. © 2014Yen et al.; licensee BioMed Central Ltd.


PubMed | Central Taiwan University of Science and Technology, China Medical University at Taichung, Nantou Hospital and Second Corps
Type: | Journal: Emergency medicine journal : EMJ | Year: 2016

Maintaining the standard two-handed chest compression is difficult in high-speed ambulances in rural areas.A retrospective, video-based, observational study was conducted from June to September 2013 in Nantou, a rural county of central Taiwan, to evaluate the chest compression fraction in an ambulance carriage during the travel from the scene to the hospital. The chest compression fraction was calculated as the chest compression time period divided by the ambulance travelling time period; the one-handed and two-handed chest compression fractions were also calculated.During the 4-month study period, a total of 102 videos that were recorded in an ambulance carriage were reviewed, including 97 cases of manual chest compressions. When there was only one emergency medical technician (EMT) in the carriage, the combined chest compression fraction was 50.620.7%; when there were two EMTs, the fraction was 58.316.0% and the fraction was 58.321.0% in a three-EMT scenario (p=0.221). Moreover, in the carriage, EMTs usually performed one-handed chest compressions.The chest compression fraction was low for patients with out-of-hospital cardiac arrest in a moving ambulance, irrespective of the number of providers. Reasons for this observation, as well as the effectiveness of the one-handed chest compression require further evaluation.


PubMed | China Medical University at Taichung, Asia University, Taiwan and Nantou Hospital
Type: | Journal: International journal for equity in health | Year: 2016

The oral condition of people with disabilities has considerable influence on their physical and mental health. However, nationwide surveys regarding this group have not been conducted. For this study, we used the National Health Insurance Research Database to explore the tooth filling utilization among people with disabilities.Using the database of the Ministry of the Interior in 2008 which included people with disabilities registered, we merged with the medical claims database in 2008 of the Bureau of National Health Insurance to calculate the tooth filling utilization and to analyze relative factors. We recruited 993,487 people with disabilities as the research sample.The tooth filling utilization was 17.53 %. The multiple logistic regression result showed that the utilization rate of men was lower than that of women (OR=0.78, 95 % CI=0.77-0.79) and older people had lower utilization rates (aged over 75, OR=0.22, 95 % CI=0.22-0.23) compared to those under the age of 20. Other factors that significantly influenced the low tooth filling utilization included a low education level, living in less urbanized areas, low economic capacity, dementia, and severe disability.We identified the factors that influence and decrease the tooth-filling service utilization rate: male sex, old age, low education level, being married, indigenous ethnicity, residing in a low urbanization area, low income, chronic circulatory system diseases, dementia, and severe disabilities. We suggest establishing proper medical care environments for high-risk groups to maintain their quality of life.


Hung S.-C.,Nantou Hospital | Hung S.-C.,China Medical University at Taichung | Lai S.-W.,China Medical University at Taichung | Tsai P.-Y.,China Medical University at Taichung | And 6 more authors.
British Journal of Cancer | Year: 2013

Background: The incidence of prostate cancer is much lower in Asian men than in Western men. This study investigated whether prostate cancer is associated with prostatitis, benign prostatic hyperplasia (BPH), and other medical conditions in the low-incidence population. Methods: From the claims data obtained from the universal National Health Insurance of Taiwan, we identified 1184 patients with prostate cancer diagnosed from 1997 to 2008. Controls comprised 4736 men randomly selected from a cancer-free population. Both groups were 50 years of age or above. Medical histories between the two groups were compared. Results: Multivariate logistic regression analysis showed that prostatitis and BPH had stronger association with prostate cancer than the other medical conditions tested. Compared with men without prostatitis and BPH, a higher odds ratio (OR) for prostate cancer was associated with BPH (26.2, 95% confidence interval (CI) 20.8-33.0) than with prostatitis (10.5, 95% CI=3.36-32.7). Men with both conditions had an OR of 49.2 (95% CI=34.7-69.9). Conclusion: Men with prostate cancer have strong association with prostatitis and/or BPH. Prostatitis interacts with BPH, resulting in higher estimated relative risk of prostate cancer in men suffering from both conditions. © 2013 Cancer Research UK. All rights reserved.


Hung S.-C.,Nantou Hospital
American Journal of Gastroenterology | Year: 2015

Objectives:This study evaluated whether there is an association between the use of celecoxib and acute pancreatitis in Taiwan.Methods:We conducted a case–control study using the database of the Taiwan National Health Insurance Program. The participants comprised 5,095 subjects, aged 20–84 years, with a first admission episode of acute pancreatitis from 2000 to 2011 as the cases and 20,380 randomly selected sex-matched and age-matched subjects without acute pancreatitis as the controls. The absence of celecoxib prescription was defined as “never used.” Current use of celecoxib was defined as subjects who had received at least one prescription for celecoxib within 3 days before diagnosis with acute pancreatitis. A multivariate unconditional logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for acute pancreatitis associated with the use of celecoxib.Results:Compared with subjects who never used celecoxib, the adjusted OR of acute pancreatitis was 5.62 in subjects with current use of celecoxib (95% CI=3.33–9.46).Conclusions:The current use of celecoxib is associated with an increased risk of acute pancreatitis.Am J Gastroenterol advance online publication, 1 September 2015; doi:10.1038/ajg.2015.259. © 2015 American College of Gastroenterology


Hung S.-C.,Nantou Hospital | Hung S.-C.,China Medical University at Taichung | Liao K.-F.,Taichung Tzu Chi General Hospital | Liao K.-F.,Tzu Chi University | And 3 more authors.
BMC Gastroenterology | Year: 2011

Background: Cholelithiasis has become a major health problem in Taiwan. The predominant type of gallstone found in Asian populations differs from that in the West, indicating possible differences in the etiology and risk factors for cholelithiasis. The aim of this study is to investigate the risk factors for cholelithiasis using data representative of the general population.Methods: We performed a population-based, case-control study in which we analyzed medical data for 3725 patients newly diagnosed with cholelithiasis and 11175 gender- and age-matched controls with no history of cholelithiasis, using information obtained from the 2005 Registry for Beneficiaries of the National Health Insurance Research Database. Coexisting medical conditions were included in the analysis. Relative risks were estimated by adjusted odds ratio (OR) and 95% confidence interval (CI) using a multivariate logistic regression analysis.Results: After controlling for the other covariates, multivariate logistic regression analysis identified the following as risk factors for cholelithiasis (in descending order of contribution): Among all patients - hepatitis C (OR = 2.78), cirrhosis (OR = 2.47), hepatitis B (OR = 2.00), obesity (OR = 1.89), and hyperlipidemia (OR = 1.54); Among women - hepatitis C (OR = 3.05), cirrhosis (OR = 1.92), obesity (OR = 1.91), menopause (OR = 1.61), hepatitis B (OR = 1.54), and hyperlipidemia (OR = 1.49). Diabetes mellitus appeared to have a marked influence on the development of cholelithiasis but was not identified as a significant independent risk factor for cholelithiasis.Conclusions: The risk factors for cholelithiasis were obesity, hyperlipidemia, hepatitis B infection, hepatitis C infection, and cirrhosis in both genders, and menopause in females. Despite differences in the predominate type of gallstone in Asian versus Western populations, we identified no unique risk factors among the population of Taiwan. © 2011 Hung et al; licensee BioMed Central Ltd.


Ku C.-Y.,National Chung Cheng University | Sung P.-C.,National Chung Cheng University | Hsieh W.-H.,National Chung Cheng University | Hsieh W.-H.,Nantou Hospital
Telematics and Informatics | Year: 2014

Although the policy of the separation of dispensing from the medical practice (SDMP) has been promoted by the Department of Health (DOH) in Taiwan for many years, it has never been significantly successful. Instead of transferring prescriptions to the insurance-contracted pharmacy (ICP) in the community, most of the patients still fill their prescriptions in the hospital or clinic. This is because the policy lacks the necessary supporting measures and incentives. Therefore, we propose a prescription-release information system (PRIS) that makes the prescription release more convenient under the governmental healthcare policy. This test-run system is integrated into the hospital information system (HIS) of Sinying Hospital, which allows the outpatient to choose a preferable pharmacy and transfer prescriptions there via the virtual private network (VPN) in a self-guided way. We posit that this PRIS is a major factor in the successful promotion of the SDMP policy. Therefore, a research model is built, and the corresponding survey is administered to validate our hypotheses. The results indicate that most of the respondents are satisfied with the PRIS and the SDMP and that the PRIS concretely supports the prevalence of the SDMP policy. © 2013 Elsevier Ltd. All rights reserved.


Hsieh S.-E.,Central Taiwan University of Science and Technology | Lo H.-H.,Central Taiwan University of Science and Technology | Chen S.-T.,Nantou Hospital | Lee M.-C.,Central Taiwan University of Science and Technology | Tseng Y.-H.,Tzu Chi University
Applied and Environmental Microbiology | Year: 2011

In searching for an alternative antibacterial agent against multidrug-resistant Staphylococcus aureus, we have isolated and characterized a lytic staphylophage, Stau2. It possesses a double-stranded DNA genome estimated to be about 134.5 kb and a morphology resembling that of members of the family Myoviridae. With an estimated latency period of 25 min and a burst size of 100 PFU/infected cell, propagation of Stau2 in liquid culture gave a lysate of ca. 6 × 1010 PFU/ml. It was stable at pH 5 to 13 in normal saline at room temperature for at least 4 weeks and at -85°C for more than 2 years, while 1 × 109 out of 2 × 1012 PFU/ml retained infectivity after 36 months at 4°C. Stau2 could lyse 80% of the S. aureus isolates (164/205) obtained from hospitals in Taiwan, with complete lysis of most of the isolates tested within 3 h; however, it was an S. aureus-specific phage because no lytic infection could be found in the coagulase-negative staphylococci tested. Its host range among S. aureus isolates was wider than that of polyvalent phage K (47%), which can also lyse many other staphylococcal species. Experiments with mice demonstrated that Stau2 could provide 100% protection from lethal infection when a multiplicity of infection of 10 was administered immediately after a challenge with S. aureus S23. Considering these results, Stau2 could be considered at least as a candidate for topical phage therapy or an additive in the food industry. Copyright © 2011, American Society for Microbiology. All Rights Reserved.


PubMed | Central Taiwan University of Science and Technology, China Medical University at Taichung and Nantou Hospital
Type: Journal Article | Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] | Year: 2016

It remains unknown whether nabumetone increases or decreases acute pancreatitis risk. To investigate this, we conducted a population-based case-control study using the database from the Taiwan National Health Insurance Program.We analysed 5384 cases aged 20-84 years who had their first attack of acute pancreatitis during 1998-2011 and 21,536 controls without acute pancreatitis, and matched them according to sex, age and year in which acute pancreatitis was diagnosed. Never use of nabumetone was defined as subjects who had never received a nabumetone prescription; active use as subjects receiving a minimum of one prescription for nabumetone within 7 days before acute pancreatitis diagnosis and non-active use of nabumetone as subjects who did not receive a prescription for nabumetone within 7 days before but received at least one prescription for nabumetone 8 days before. The odds ratio and 95% confidence interval (CI) were estimated to investigate the risk of acute pancreatitis associated with nabumetone use, using the multivariable unconditional logistic regression model.The adjusted odds ratio of acute pancreatitis was 3.69 (95%CI 1.69, 8.05) for subjects with active use of nabumetone compared with those with never use. The odds ratios decreased to 1.0 (95%CI 0.88, 1.12) for subjects with non-active use.Active use of nabumetone may increase the risk of acute pancreatitis.

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