Clipping Board » Medical Affairs and Administration ─ Medical system, pharmaceuticals, and medical community-related reports
2008-08-26 07:15:02 By Zhang Cuifen / Taipei Report
What has caused Taiwan's incidence and prevalence of dialysis to rank first in the world? The answer is surprisingly "the implementation of universal health insurance"! Yang Wuchang, director of the Nephrology Department at Taipei Veterans General Hospital, analyzed the current situation of dialysis in Taiwan and found that after the implementation of universal health insurance in 1995, the number of patients with end-stage renal disease increased rapidly. According to the latest statistics this year, the dialysis population has reached more than 56,000, a 3.5-fold increase compared to the year before the implementation of health insurance.
The health insurance system has changed the epidemiological trend of end-stage renal disease. This unique "Taiwan experience" was recently published in the most authoritative official medical journal in Europe, "Nephrology, Dialysis, Transplantation" (Nephrol Dial Transplant), attracting international attention.
Yang Wuchang, former chairman of the Taiwan Society of Nephrology, and Huang Shangzhi, a nephrologist at Kaohsiung Medical University, collected data from Taiwan's health insurance dialysis registry. They retrospectively analyzed the trends in incidence, prevalence, and mortality of end-stage renal failure in Taiwan from 1990 to 2001, and examined the impact of dialysis, dubbed "Taiwan's new national disease," on the national health insurance.
Yang Wuchang stated that the incidence and prevalence of dialysis patients due to end-stage renal disease in Taiwan have shown a rapid increase after the implementation of universal health insurance in 1995. In 1990, there were 8,051 dialysis patients, and by 1994, the year before health insurance was implemented, the number had risen to 16,650. In 1995, when health insurance was introduced, the number quickly grew to 19,978, and by 2001, it had reached 31,876. The incidence rate increased by 2.6 times, and the prevalence rate increased by 3.5 times.
He further analyzed and found that after the implementation of health insurance, the average age of dialysis patients increased from 53.8 years to 61 years, a rise of 7.2 years. The increase was most significant among elderly patients and those with diabetic nephropathy, with the most noticeable growth occurring in 1995, the first year of universal health insurance. The first-year mortality rate of patients also increased significantly, from 7.8 per thousand patients in 1994 to more than double, reaching 18 deaths per thousand patients by 2001.
The study also analyzed the cumulative survival rate of elderly patients over 65 years old, with surprising results. The cumulative survival rate of elderly dialysis patients in the 1990-1994 group (before health insurance) was actually better than that of the 1995-1999 group (after health insurance). This indicates that universal health insurance has seriously affected patient flow and mortality rates.
Yang Wuchang stated that universal health insurance is indeed a "welfare," and the inclusion of dialysis in health insurance benefits has helped many patients. However, the increase is mostly among elderly, diabetic, and critically ill patients. In the past, critically ill patients often gave up treatment because they had to pay for dialysis themselves. With health insurance, even though families know the patient's condition is not optimistic, they still request dialysis to buy more time. Some patients may live a few more weeks or months, which also contributes to the rise in first-year mortality rates among dialysis patients.
Yang Wuchang said that the advancement of dialysis technology in Taiwan and the high prevalence rate, which ranks first in the world, are actually due to the increased cumulative survival rate of patients. Patients live longer, and the cumulative number naturally increases. He emphasized that Taiwan should strengthen the prevention and treatment of chronic kidney disease, reduce the number of dialysis patients, and further alleviate the burden on health insurance.Prevention is better than dialysis to alleviate the burden on health insurance.
Zhu Zemin, the general manager of the Central Health Insurance Bureau, admitted that the care provided by health insurance for dialysis patients is akin to "doing good deeds." According to statistics from the Health Insurance Bureau, there are approximately 56,000 dialysis patients in Taiwan each year. Out of the total annual medical expenses of 440 billion NTD, more than 33 billion NTD is spent on dialysis, averaging about 600,000 NTD per patient annually, which is 30 times that of the average person. In recent years, the growth rate of new dialysis patients and the overall number of dialysis patients has slowed down. However, in the long run, dialysis still represents a significant expenditure for health insurance.
Source: http:/ / news. pchome. com. tw/ li……ex- 12197061039736524009. html
Taiwan's Dialysis Rate Soars to World's Highest after Health Insurance Implementation
What has caused Taiwan's incidence and prevalence of dialysis to rank first in the world? The answer is surprisingly "the implementation of universal health insurance"! Yang Wuchang, director of the Nephrology Department at Taipei Veterans General Hospital, analyzed the current situation of dialysis in Taiwan and found that after the implementation of universal health insurance in 1995, the number of patients with end-stage renal disease increased rapidly. According to the latest statistics this year, the dialysis population has reached more than 56,000, a 3.5-fold increase compared to the year before the implementation of health insurance.
The health insurance system has changed the epidemiological trend of end-stage renal disease. This unique "Taiwan experience" was recently published in the most authoritative official medical journal in Europe, "Nephrology, Dialysis, Transplantation" (Nephrol Dial Transplant), attracting international attention.
Yang Wuchang, former chairman of the Taiwan Society of Nephrology, and Huang Shangzhi, a nephrologist at Kaohsiung Medical University, collected data from Taiwan's health insurance dialysis registry. They retrospectively analyzed the trends in incidence, prevalence, and mortality of end-stage renal failure in Taiwan from 1990 to 2001, and examined the impact of dialysis, dubbed "Taiwan's new national disease," on the national health insurance.
Yang Wuchang stated that the incidence and prevalence of dialysis patients due to end-stage renal disease in Taiwan have shown a rapid increase after the implementation of universal health insurance in 1995. In 1990, there were 8,051 dialysis patients, and by 1994, the year before health insurance was implemented, the number had risen to 16,650. In 1995, when health insurance was introduced, the number quickly grew to 19,978, and by 2001, it had reached 31,876. The incidence rate increased by 2.6 times, and the prevalence rate increased by 3.5 times.
He further analyzed and found that after the implementation of health insurance, the average age of dialysis patients increased from 53.8 years to 61 years, a rise of 7.2 years. The increase was most significant among elderly patients and those with diabetic nephropathy, with the most noticeable growth occurring in 1995, the first year of universal health insurance. The first-year mortality rate of patients also increased significantly, from 7.8 per thousand patients in 1994 to more than double, reaching 18 deaths per thousand patients by 2001.
The study also analyzed the cumulative survival rate of elderly patients over 65 years old, with surprising results. The cumulative survival rate of elderly dialysis patients in the 1990-1994 group (before health insurance) was actually better than that of the 1995-1999 group (after health insurance). This indicates that universal health insurance has seriously affected patient flow and mortality rates.
Yang Wuchang stated that universal health insurance is indeed a "welfare," and the inclusion of dialysis in health insurance benefits has helped many patients. However, the increase is mostly among elderly, diabetic, and critically ill patients. In the past, critically ill patients often gave up treatment because they had to pay for dialysis themselves. With health insurance, even though families know the patient's condition is not optimistic, they still request dialysis to buy more time. Some patients may live a few more weeks or months, which also contributes to the rise in first-year mortality rates among dialysis patients.
Yang Wuchang said that the advancement of dialysis technology in Taiwan and the high prevalence rate, which ranks first in the world, are actually due to the increased cumulative survival rate of patients. Patients live longer, and the cumulative number naturally increases. He emphasized that Taiwan should strengthen the prevention and treatment of chronic kidney disease, reduce the number of dialysis patients, and further alleviate the burden on health insurance.Prevention is better than dialysis to alleviate the burden on health insurance.
Zhu Zemin, the general manager of the Central Health Insurance Bureau, admitted that the care provided by health insurance for dialysis patients is akin to "doing good deeds." According to statistics from the Health Insurance Bureau, there are approximately 56,000 dialysis patients in Taiwan each year. Out of the total annual medical expenses of 440 billion NTD, more than 33 billion NTD is spent on dialysis, averaging about 600,000 NTD per patient annually, which is 30 times that of the average person. In recent years, the growth rate of new dialysis patients and the overall number of dialysis patients has slowed down. However, in the long run, dialysis still represents a significant expenditure for health insurance.
Source: http:/ / news. pchome. com. tw/ li……ex- 12197061039736524009. html