Extracorporeal membrane oxygenation use, expenditure, and outcomes in Taiwan from 2000 to 2010

Chiao Po Hsu, Wui Chiang Lee, Hsiu Mei Wei, Shih Hsien Sung, Chun Yang Huang, Chun Che Shih, Tse Min Lu

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: No study to date has systematically examined use, expenditure, and outcomes associated with extracorporeal membrane oxygenation (ECMO) use in Taiwan. The aim of this study was to examine ECMO use, expenditure, and outcomes during an 11-year period in Taiwan. Methods: Claims data were collected from the Taiwan National Health Insurance Research Database for patients who received ≥1 ECMO treatment between January 2000 and December 2010. Measurements included demographics, indications for ECMO use, length of hospital stay, outcome, and expenditure. Results: A total of 3969 patients received ECMO during the study period (median age: 54.6 years). The number of patients receiving ECMO increased from 52 in 2000 to 1045 in 2010. The major indication for ECMO was cardiovascular disease (68.7%), followed by respiratory disease (17.9%). Median length of hospital stay was 13 days in 2000 and 17 days in 2010. Median expenditure (New Taiwan dollars) was $604 317 in 2000 and $673 888 in 2010. Some variables significantly differed by age, sex, hospital setting, calendar year, and indication for ECMO, and were associated with in-hospital and after-discharge mortality. Conclusions: ECMO use has increased dramatically in Taiwan over the last decade. The high mortality rate of ECMO users suggested that ECMO may be being used in Taiwan for situations in which it provides no added benefit. This situation may be a reflection of the current reimbursement criteria for National Health Insurance in Taiwan. Refinement of the indications for use of ECMO is suggested.

Original languageEnglish
Pages (from-to)321-331
Number of pages11
JournalJournal of Epidemiology
Volume25
Issue number4
DOIs
Publication statusPublished - Jan 1 2015
Externally publishedYes

Fingerprint

Extracorporeal Membrane Oxygenation
Health Expenditures
Taiwan
Length of Stay
National Health Programs
Mortality
Cardiovascular Diseases

Keywords

  • Cost
  • Extracorporeal membrane oxygenation
  • Survival
  • Taiwan

ASJC Scopus subject areas

  • Epidemiology

Cite this

Extracorporeal membrane oxygenation use, expenditure, and outcomes in Taiwan from 2000 to 2010. / Hsu, Chiao Po; Lee, Wui Chiang; Wei, Hsiu Mei; Sung, Shih Hsien; Huang, Chun Yang; Shih, Chun Che; Lu, Tse Min.

In: Journal of Epidemiology, Vol. 25, No. 4, 01.01.2015, p. 321-331.

Research output: Contribution to journalArticle

Hsu, Chiao Po ; Lee, Wui Chiang ; Wei, Hsiu Mei ; Sung, Shih Hsien ; Huang, Chun Yang ; Shih, Chun Che ; Lu, Tse Min. / Extracorporeal membrane oxygenation use, expenditure, and outcomes in Taiwan from 2000 to 2010. In: Journal of Epidemiology. 2015 ; Vol. 25, No. 4. pp. 321-331.
@article{d1dc515b44114097914b006d45f94d10,
title = "Extracorporeal membrane oxygenation use, expenditure, and outcomes in Taiwan from 2000 to 2010",
abstract = "Background: No study to date has systematically examined use, expenditure, and outcomes associated with extracorporeal membrane oxygenation (ECMO) use in Taiwan. The aim of this study was to examine ECMO use, expenditure, and outcomes during an 11-year period in Taiwan. Methods: Claims data were collected from the Taiwan National Health Insurance Research Database for patients who received ≥1 ECMO treatment between January 2000 and December 2010. Measurements included demographics, indications for ECMO use, length of hospital stay, outcome, and expenditure. Results: A total of 3969 patients received ECMO during the study period (median age: 54.6 years). The number of patients receiving ECMO increased from 52 in 2000 to 1045 in 2010. The major indication for ECMO was cardiovascular disease (68.7{\%}), followed by respiratory disease (17.9{\%}). Median length of hospital stay was 13 days in 2000 and 17 days in 2010. Median expenditure (New Taiwan dollars) was $604 317 in 2000 and $673 888 in 2010. Some variables significantly differed by age, sex, hospital setting, calendar year, and indication for ECMO, and were associated with in-hospital and after-discharge mortality. Conclusions: ECMO use has increased dramatically in Taiwan over the last decade. The high mortality rate of ECMO users suggested that ECMO may be being used in Taiwan for situations in which it provides no added benefit. This situation may be a reflection of the current reimbursement criteria for National Health Insurance in Taiwan. Refinement of the indications for use of ECMO is suggested.",
keywords = "Cost, Extracorporeal membrane oxygenation, Survival, Taiwan",
author = "Hsu, {Chiao Po} and Lee, {Wui Chiang} and Wei, {Hsiu Mei} and Sung, {Shih Hsien} and Huang, {Chun Yang} and Shih, {Chun Che} and Lu, {Tse Min}",
year = "2015",
month = "1",
day = "1",
doi = "10.2188/jea.JE20140027",
language = "English",
volume = "25",
pages = "321--331",
journal = "Journal of Epidemiology",
issn = "0917-5040",
publisher = "Japan Epidemiology Association",
number = "4",

}

TY - JOUR

T1 - Extracorporeal membrane oxygenation use, expenditure, and outcomes in Taiwan from 2000 to 2010

AU - Hsu, Chiao Po

AU - Lee, Wui Chiang

AU - Wei, Hsiu Mei

AU - Sung, Shih Hsien

AU - Huang, Chun Yang

AU - Shih, Chun Che

AU - Lu, Tse Min

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: No study to date has systematically examined use, expenditure, and outcomes associated with extracorporeal membrane oxygenation (ECMO) use in Taiwan. The aim of this study was to examine ECMO use, expenditure, and outcomes during an 11-year period in Taiwan. Methods: Claims data were collected from the Taiwan National Health Insurance Research Database for patients who received ≥1 ECMO treatment between January 2000 and December 2010. Measurements included demographics, indications for ECMO use, length of hospital stay, outcome, and expenditure. Results: A total of 3969 patients received ECMO during the study period (median age: 54.6 years). The number of patients receiving ECMO increased from 52 in 2000 to 1045 in 2010. The major indication for ECMO was cardiovascular disease (68.7%), followed by respiratory disease (17.9%). Median length of hospital stay was 13 days in 2000 and 17 days in 2010. Median expenditure (New Taiwan dollars) was $604 317 in 2000 and $673 888 in 2010. Some variables significantly differed by age, sex, hospital setting, calendar year, and indication for ECMO, and were associated with in-hospital and after-discharge mortality. Conclusions: ECMO use has increased dramatically in Taiwan over the last decade. The high mortality rate of ECMO users suggested that ECMO may be being used in Taiwan for situations in which it provides no added benefit. This situation may be a reflection of the current reimbursement criteria for National Health Insurance in Taiwan. Refinement of the indications for use of ECMO is suggested.

AB - Background: No study to date has systematically examined use, expenditure, and outcomes associated with extracorporeal membrane oxygenation (ECMO) use in Taiwan. The aim of this study was to examine ECMO use, expenditure, and outcomes during an 11-year period in Taiwan. Methods: Claims data were collected from the Taiwan National Health Insurance Research Database for patients who received ≥1 ECMO treatment between January 2000 and December 2010. Measurements included demographics, indications for ECMO use, length of hospital stay, outcome, and expenditure. Results: A total of 3969 patients received ECMO during the study period (median age: 54.6 years). The number of patients receiving ECMO increased from 52 in 2000 to 1045 in 2010. The major indication for ECMO was cardiovascular disease (68.7%), followed by respiratory disease (17.9%). Median length of hospital stay was 13 days in 2000 and 17 days in 2010. Median expenditure (New Taiwan dollars) was $604 317 in 2000 and $673 888 in 2010. Some variables significantly differed by age, sex, hospital setting, calendar year, and indication for ECMO, and were associated with in-hospital and after-discharge mortality. Conclusions: ECMO use has increased dramatically in Taiwan over the last decade. The high mortality rate of ECMO users suggested that ECMO may be being used in Taiwan for situations in which it provides no added benefit. This situation may be a reflection of the current reimbursement criteria for National Health Insurance in Taiwan. Refinement of the indications for use of ECMO is suggested.

KW - Cost

KW - Extracorporeal membrane oxygenation

KW - Survival

KW - Taiwan

UR - http://www.scopus.com/inward/record.url?scp=84930244677&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930244677&partnerID=8YFLogxK

U2 - 10.2188/jea.JE20140027

DO - 10.2188/jea.JE20140027

M3 - Article

C2 - 25797598

AN - SCOPUS:84930244677

VL - 25

SP - 321

EP - 331

JO - Journal of Epidemiology

JF - Journal of Epidemiology

SN - 0917-5040

IS - 4

ER -