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Invasively-treated incidence of lower extremity peripheral arterial disease and associated factors in Taiwan: 2000-2011 nationwide hospitalized data analysis.

Chang NT, Chan CL, Lu YT, Hsu JC, Hsu YN, Chu D, Yang NP - BMC Public Health (2013)

Bottom Line: In Taiwan, a gender difference and age and period effects on the invasively-treated incidence of LE PAD were observed.Female, young and middle-aged people (30-50 and 50-65 years of age), DM patients and those on a low income had a tendency to undergo amputation.The number of PTA procedures remarkably increased, but the 2-year failure rate of PTAs reduced from 2000 to 2011.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Research, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan. yang.nanping@gmail.com.

ABSTRACT

Background: Lower extremity (LE) peripheral artery disease (PAD), which is associated with a reduced quality of life and increased mortality from atherosclerotic cardio-/cerebro-vascular occlusion, is a significant public health problem, especial for an aging society such as that of Taiwan.

Methods: Specific datasets of the 2000-2011 nationwide inpatient databases were analyzed. Two inclusion criteria, including one of the major diagnosis codes of PAD and one of three categorical invasive treatments of LE PAD, were used consecutively to select cases diagnosed as LE PAD and receiving invasive treatment. The epidemiology of invasively-treated PAD in Taiwan was estimated, and the influences of potential confounders on these invasively-treated methods were evaluated.

Results: In general, the invasively-treated incidence of PAD in Taiwan doubled, from 3.73/10,000 (in 2000) to 7.48/10,000 (in 2011). On average, the total direct medical cost of one hospitalized and invasively-treated PAD case ranged from $US 4,600 to $US 5,900. The annual cases of bypass surgery for the PAD cases averaged 1,000 and the cases for limb amputation ranged from 4,100 to 5,100 annually. However, the number of percutaneous transluminal angioplasty (PTA) procedures remarkably increased by 15 times, from 600/year to 9,100/year, from 2000 to 2011. 51.3% of all the enrolled cases were treated with limb amputations, and female, young and middle-aged people (30-65 years of age), DM patients and those on a low income had a tendency to undergo amputation due to PAD. 37.6% of all the enrolled cases were treated with PTAs related to hypertension, cardiovascular disease, hyperlipidemia and catastrophic Illness. 2-year PTA failure rates of 22.13%, 11.91% and 10.61% were noted among the first (2000-2001), second (2004-2005) and the third (2008-2009) cohort groups, respectively.

Conclusions: In Taiwan, a gender difference and age and period effects on the invasively-treated incidence of LE PAD were observed. Female, young and middle-aged people (30-50 and 50-65 years of age), DM patients and those on a low income had a tendency to undergo amputation. The number of PTA procedures remarkably increased, but the 2-year failure rate of PTAs reduced from 2000 to 2011.

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Annual national hospitalization costs and averaged individual hospitalization costs of admitted PAD cases in Taiwan from 2000 to 2011.
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Figure 1: Annual national hospitalization costs and averaged individual hospitalization costs of admitted PAD cases in Taiwan from 2000 to 2011.

Mentions: Table 2 shows the annual enrolled subjects hospitalized in order to receive one of the invasive treatments for PAD. The invasively-treated incidence of PAD could be estimated classified by gender and age stratum. In general, the invasively-treated incidence of PAD in Taiwan doubled, from 3.73/10,000 (in 2000) to 7.48/10,000 (in 2011). There was an obvious increasing trend of the treated incidence of PAD by age stratum. Male patients were more likely to suffer from PAD with invasive treatment needed, and the incidence ratio (IR) of male vs female increased from 1.34 (in 2000, the estimated incidences of the male and female patients being 4.27 and 3.18 per 10,000, respectively) to 1.57 (in 2011, the estimated incidences of the male and female patients being 9.17 and 5.83 per 10,000, respectively). The nationwide and averaged individual medical costs are shown in Figure 1. On average, the total direct medical cost of one hospitalized and invasively-treated PAD case ranged from $US 4,600 to $US 5,900, and the treatment fee accounted for 14.8-18.2% of the total medical cost. Along with the increase in enrolled case numbers annually, the national total medical expenditure for these invasively-treated PAD cases increased greatly from $US 15.5 million per year (in 2000) to $US 59.6 million per year (in 2011) in Taiwan.


Invasively-treated incidence of lower extremity peripheral arterial disease and associated factors in Taiwan: 2000-2011 nationwide hospitalized data analysis.

Chang NT, Chan CL, Lu YT, Hsu JC, Hsu YN, Chu D, Yang NP - BMC Public Health (2013)

Annual national hospitalization costs and averaged individual hospitalization costs of admitted PAD cases in Taiwan from 2000 to 2011.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219520&req=5

Figure 1: Annual national hospitalization costs and averaged individual hospitalization costs of admitted PAD cases in Taiwan from 2000 to 2011.
Mentions: Table 2 shows the annual enrolled subjects hospitalized in order to receive one of the invasive treatments for PAD. The invasively-treated incidence of PAD could be estimated classified by gender and age stratum. In general, the invasively-treated incidence of PAD in Taiwan doubled, from 3.73/10,000 (in 2000) to 7.48/10,000 (in 2011). There was an obvious increasing trend of the treated incidence of PAD by age stratum. Male patients were more likely to suffer from PAD with invasive treatment needed, and the incidence ratio (IR) of male vs female increased from 1.34 (in 2000, the estimated incidences of the male and female patients being 4.27 and 3.18 per 10,000, respectively) to 1.57 (in 2011, the estimated incidences of the male and female patients being 9.17 and 5.83 per 10,000, respectively). The nationwide and averaged individual medical costs are shown in Figure 1. On average, the total direct medical cost of one hospitalized and invasively-treated PAD case ranged from $US 4,600 to $US 5,900, and the treatment fee accounted for 14.8-18.2% of the total medical cost. Along with the increase in enrolled case numbers annually, the national total medical expenditure for these invasively-treated PAD cases increased greatly from $US 15.5 million per year (in 2000) to $US 59.6 million per year (in 2011) in Taiwan.

Bottom Line: In Taiwan, a gender difference and age and period effects on the invasively-treated incidence of LE PAD were observed.Female, young and middle-aged people (30-50 and 50-65 years of age), DM patients and those on a low income had a tendency to undergo amputation.The number of PTA procedures remarkably increased, but the 2-year failure rate of PTAs reduced from 2000 to 2011.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Research, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan. yang.nanping@gmail.com.

ABSTRACT

Background: Lower extremity (LE) peripheral artery disease (PAD), which is associated with a reduced quality of life and increased mortality from atherosclerotic cardio-/cerebro-vascular occlusion, is a significant public health problem, especial for an aging society such as that of Taiwan.

Methods: Specific datasets of the 2000-2011 nationwide inpatient databases were analyzed. Two inclusion criteria, including one of the major diagnosis codes of PAD and one of three categorical invasive treatments of LE PAD, were used consecutively to select cases diagnosed as LE PAD and receiving invasive treatment. The epidemiology of invasively-treated PAD in Taiwan was estimated, and the influences of potential confounders on these invasively-treated methods were evaluated.

Results: In general, the invasively-treated incidence of PAD in Taiwan doubled, from 3.73/10,000 (in 2000) to 7.48/10,000 (in 2011). On average, the total direct medical cost of one hospitalized and invasively-treated PAD case ranged from $US 4,600 to $US 5,900. The annual cases of bypass surgery for the PAD cases averaged 1,000 and the cases for limb amputation ranged from 4,100 to 5,100 annually. However, the number of percutaneous transluminal angioplasty (PTA) procedures remarkably increased by 15 times, from 600/year to 9,100/year, from 2000 to 2011. 51.3% of all the enrolled cases were treated with limb amputations, and female, young and middle-aged people (30-65 years of age), DM patients and those on a low income had a tendency to undergo amputation due to PAD. 37.6% of all the enrolled cases were treated with PTAs related to hypertension, cardiovascular disease, hyperlipidemia and catastrophic Illness. 2-year PTA failure rates of 22.13%, 11.91% and 10.61% were noted among the first (2000-2001), second (2004-2005) and the third (2008-2009) cohort groups, respectively.

Conclusions: In Taiwan, a gender difference and age and period effects on the invasively-treated incidence of LE PAD were observed. Female, young and middle-aged people (30-50 and 50-65 years of age), DM patients and those on a low income had a tendency to undergo amputation. The number of PTA procedures remarkably increased, but the 2-year failure rate of PTAs reduced from 2000 to 2011.

Show MeSH
Related in: MedlinePlus