Socioeconomic inequality in one-year mortality of elderly people with hip fracture in Taiwan

研究成果: Article

1 引文 (Scopus)

摘要

Hip fracture commonly results in considerable consequences in terms of disability, mortality, long-term institutional care and cost. Taiwan launched its universal health insurance coverage in 1995, which largely removes financial barriers to health care. This study aims to investigate whether socioeconomic inequality in one-year mortality exists among Taiwanese elderly people. This population-based cohort study included 193,158 elderly patients (≥65 years) admitted for hip fracture between 2000 and 2012. With over a one-year follow-up, 10.52% of the participants died from all causes. The mortality rate was low in the northern part of Taiwan and in urban and high-family-income areas. Multiple Poisson regression models further suggested that the level of >Q1–Q3 and >Q3–Max showed significantly reduced odds ratio of one-year mortality at 0.90 (95% confidence interval (CI), 0.87–0.93) and 0.77 (95% CI, 0.74–0.81), respectively, compared with that of the lowest family income level (i.e., Min.–Q1). Despite a monotonic decline in overall one-year mortality during the study period, socioeconomic inequality in one-year mortality rate remained evident. The annual percentage change in one-year mortality was higher (−2.86) in elderly people from families with high income (>Q3–Max.) than that for elderly patients from family with low income (Min.–Q1, −1.94). Accessibility, rather than affordability, to health care for hip fracture is probably responsible for the observed socioeconomic inequality.

原文English
文章編號352
期刊International journal of environmental research and public health
15
發行號2
DOIs
出版狀態Published - 2018 二月 16

指紋

Hip Fractures
Taiwan
Mortality
Confidence Intervals
Delivery of Health Care
Insurance Coverage
Long-Term Care
Health Insurance
Cohort Studies
Odds Ratio
Costs and Cost Analysis
Population

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

引用此文

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title = "Socioeconomic inequality in one-year mortality of elderly people with hip fracture in Taiwan",
abstract = "Hip fracture commonly results in considerable consequences in terms of disability, mortality, long-term institutional care and cost. Taiwan launched its universal health insurance coverage in 1995, which largely removes financial barriers to health care. This study aims to investigate whether socioeconomic inequality in one-year mortality exists among Taiwanese elderly people. This population-based cohort study included 193,158 elderly patients (≥65 years) admitted for hip fracture between 2000 and 2012. With over a one-year follow-up, 10.52{\%} of the participants died from all causes. The mortality rate was low in the northern part of Taiwan and in urban and high-family-income areas. Multiple Poisson regression models further suggested that the level of >Q1–Q3 and >Q3–Max showed significantly reduced odds ratio of one-year mortality at 0.90 (95{\%} confidence interval (CI), 0.87–0.93) and 0.77 (95{\%} CI, 0.74–0.81), respectively, compared with that of the lowest family income level (i.e., Min.–Q1). Despite a monotonic decline in overall one-year mortality during the study period, socioeconomic inequality in one-year mortality rate remained evident. The annual percentage change in one-year mortality was higher (−2.86) in elderly people from families with high income (>Q3–Max.) than that for elderly patients from family with low income (Min.–Q1, −1.94). Accessibility, rather than affordability, to health care for hip fracture is probably responsible for the observed socioeconomic inequality.",
author = "I-Lin Hsu and Chia-Ming Chang and Deng-Chi Yang and Chang, {Ya Hui} and Li, {Chia Chun} and Hu, {Susan C} and Chung-Yi Li",
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T1 - Socioeconomic inequality in one-year mortality of elderly people with hip fracture in Taiwan

AU - Hsu, I-Lin

AU - Chang, Chia-Ming

AU - Yang, Deng-Chi

AU - Chang, Ya Hui

AU - Li, Chia Chun

AU - Hu, Susan C

AU - Li, Chung-Yi

PY - 2018/2/16

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N2 - Hip fracture commonly results in considerable consequences in terms of disability, mortality, long-term institutional care and cost. Taiwan launched its universal health insurance coverage in 1995, which largely removes financial barriers to health care. This study aims to investigate whether socioeconomic inequality in one-year mortality exists among Taiwanese elderly people. This population-based cohort study included 193,158 elderly patients (≥65 years) admitted for hip fracture between 2000 and 2012. With over a one-year follow-up, 10.52% of the participants died from all causes. The mortality rate was low in the northern part of Taiwan and in urban and high-family-income areas. Multiple Poisson regression models further suggested that the level of >Q1–Q3 and >Q3–Max showed significantly reduced odds ratio of one-year mortality at 0.90 (95% confidence interval (CI), 0.87–0.93) and 0.77 (95% CI, 0.74–0.81), respectively, compared with that of the lowest family income level (i.e., Min.–Q1). Despite a monotonic decline in overall one-year mortality during the study period, socioeconomic inequality in one-year mortality rate remained evident. The annual percentage change in one-year mortality was higher (−2.86) in elderly people from families with high income (>Q3–Max.) than that for elderly patients from family with low income (Min.–Q1, −1.94). Accessibility, rather than affordability, to health care for hip fracture is probably responsible for the observed socioeconomic inequality.

AB - Hip fracture commonly results in considerable consequences in terms of disability, mortality, long-term institutional care and cost. Taiwan launched its universal health insurance coverage in 1995, which largely removes financial barriers to health care. This study aims to investigate whether socioeconomic inequality in one-year mortality exists among Taiwanese elderly people. This population-based cohort study included 193,158 elderly patients (≥65 years) admitted for hip fracture between 2000 and 2012. With over a one-year follow-up, 10.52% of the participants died from all causes. The mortality rate was low in the northern part of Taiwan and in urban and high-family-income areas. Multiple Poisson regression models further suggested that the level of >Q1–Q3 and >Q3–Max showed significantly reduced odds ratio of one-year mortality at 0.90 (95% confidence interval (CI), 0.87–0.93) and 0.77 (95% CI, 0.74–0.81), respectively, compared with that of the lowest family income level (i.e., Min.–Q1). Despite a monotonic decline in overall one-year mortality during the study period, socioeconomic inequality in one-year mortality rate remained evident. The annual percentage change in one-year mortality was higher (−2.86) in elderly people from families with high income (>Q3–Max.) than that for elderly patients from family with low income (Min.–Q1, −1.94). Accessibility, rather than affordability, to health care for hip fracture is probably responsible for the observed socioeconomic inequality.

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