Huang Shi-Hao, Hsing Shih-Chun, Sun Chien-An, Chung Chi-Hsiang, Tsao Chang-Huei, Chung Ren-Jei, Wang Bing-Long, Huang Yao-Ching, Chien Wu-Chien
Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan.
Center for Healthcare Quality Management, Cheng Hsin General Hospital, Taipei 11220, Taiwan.
Healthcare (Basel). 2021 Mar 18;9(3):349. doi: 10.3390/healthcare9030349.
Is income still an obstacle that influences health in Taiwan, the National Health Insurance system was instituted in 1995? After collecting injured inpatient data from the health insurance information of nearly the whole population, we categorized the cases as either low-income or nonlow-income and tried to determine the correlation between poverty and injury. Chi-square tests, Fisher's exact tests, an independent-samples t-test, and percentages were used to identify differences in demographics, causes for hospitalization, and other hospital care variables. Between 1998 and 2015, there were 74,337 inpatients with low-income injuries, which represented 1.6% of all inpatients with injury events. The hospitalization mortality rate for the low-income group was 1.9 times higher than that of the nonlow-income group. Furthermore, the average length of hospital stay (9.9 days), average medical expenses (1681 USD), and mortality rate (3.6%) values for the low-income inpatients were higher than those of the nonlow-income group (7.6 days, 1573 USD, and 2.1%, respectively). Among the injury causes, the percentages of "fall," "suicide," and "homicide" incidences were higher for the low-income group than for the nonlow-income group. These findings support our hypothesis that there is a correlation between poverty and injury level, which results in health inequality. Achieving healthcare equality may require collaboration between the government and private and nonprofit organizations to increase the awareness of this phenomenon.
在台湾，自1995年实施全民健康保险制度后，收入是否仍是影响健康的障碍？在收集了几乎全体人口的健康保险信息中的受伤住院患者数据后，我们将病例分为低收入和非低收入两类，并试图确定贫困与受伤之间的相关性。使用卡方检验、费舍尔精确检验、独立样本t检验和百分比来确定人口统计学、住院原因及其他医院护理变量方面的差异。1998年至2015年期间，有74337名低收入受伤住院患者，占所有受伤事件住院患者的1.6%。低收入组的住院死亡率比非低收入组高1.9倍。此外，低收入住院患者的平均住院天数（9.9天）、平均医疗费用（1681美元）和死亡率（3.6%）均高于非低收入组（分别为7.6天、1573美元和2.1%）。在受伤原因中，低收入组“跌倒”“自杀”和“他杀”发生率的百分比高于非低收入组。这些发现支持了我们的假设，即贫困与受伤程度之间存在相关性，这导致了健康不平等。实现医疗保健平等可能需要政府与私营和非营利组织合作，以提高对这一现象的认识。
