The Developments and Applications of Disease-based Statistics in Taiwan Pi-Joen Lee Statistics Office Department of Health Oecd/Korea RCHSP-APNHan Meeting of Regional Health Accounts Experts. Seoul, Korea ( June 18-20,2007) 附錄二

2007/06/20Department of Health2 Outline Background Data source Total Expenditure on Personal Medical Expenditure (PME)by Age, Gender and Diseases 1.Infectious and Parasitic 2.Neoplasms International comparison Appendices( reference documents ) disease classifications of ICD9CM in Taiwan 2. International comparisons (Japan vs. Taiwan)

2007/06/20Department of Health3 Allocation of NHE by Purpose of Use 91% 89% 86%

2007/06/20Department of Health4 Allocation of PME NT$624Billion = 91% NHE in Taiwan (NT$624Billion = 17,968 Billion Korea Won) -- One Taiwanese shares 781,000 Korea Won personal medical expenditure annually. Around 60% of Personal Medical Expenditures are for Disease of the Respiratory(19%),Digestive(11%), Circulatory(11%),Musculoskeleta(9%) Systems and Genitournary Organs(9%).

2007/06/20Department of Health5 Allocation of PME Personal Medical Expenditure by Disease

2007/06/20Department of Health6 Allocation of PME Personal Medical Expenditure by Disease and Gender

2007/06/20Department of Health7 Data Source (1) Data warehouse: National Health Insurance(NHI) System. For ambulatory care, there are about 343Million claims annually. For inpatient care,there are about 3 Million cases annually. No need to do sampling or surveys, vital statistical results can be derived from annual NHI data warehouse directly.

2007/06/20Department of Health8 Data Source (2) Classifications of cares provided by NHI ： Data from NHI are further classified as (1)Ambulatory care : western medicine outpatient, dental care, and chinese medicine care; (2)Inpatient care. Number of Institutions ： All medical care institutions under contract.

2007/06/20Department of Health9 Flow of Data Processing The ambulatory care and inpatient databases of the National Health Insurance in Taiwan are processed as follows ：

2007/06/20Department of Health10 Limitations 1.Data are collected as medical claims, thus are hard to be verified. Diseases that cannot be classified are listed unknown. 2.ID numbers that do not follow the principles of ID numbering are excluded in the statistics. 3.Disease codes are debugged by gender and age. Criteria for debugging are as follows: (1) Gender & disease debug: for example, man pregnant, prostate disease for female. (2) Age & disease debug.

2007/06/20Department of Health11 Personal Medical Care Service by Medical Institution Type

2007/06/20Department of Health12 Total Expenditure on Personal Health Care by Age and Gender Total ExpenditurePer Capita

2007/06/20Department of Health13 Total Expenditure on Personal Health Care by Disease and Age

2007/06/20Department of Health14 Total Expenditure on Personal Health Care by Disease and Age(table)

2007/06/20Department of Health15 Disease plots

2007/06/20Department of Health16 Total Expenditure on Personal Health Care by Age, Gender and Diseases Total population

2007/06/20Department of Health17 Total Expenditure on Personal Health Care by Age, Gender and Disease Infectious and Parasitic Diseases ICD9CM : , 7713,

2007/06/20Department of Health18 Total Expenditure on Personal Health Care by Age, Gender and Disease Neoplasms ICD9CM :

2007/06/20Department of Health19 Death Map of Malignant Neoplasm by Locale(Census Register) in 2005 Degree of Severity Orange : light Blue : severe Yulin County had the highest Crude Death Rate 243/ TaoYuang County had the lowest Crude Death Rate 123/00000.

2007/06/20Department of Health20 Medical Visits Map of Malignant Neoplasm by Locale (Census Register) in 2005 Degree of Severity Orange : light Blue : severe The Coast areas of Yulin, Chiayi, Tainan County & Northeastern area of Island had high rates. TaoYuang County had the lowest NHI visits

2007/06/20Department of Health21 International Comparison Malignant Neoplasm Japan Taiwan Unit: rates of patients per 100,000 population ~45~910~1415~1920~2425~ ~ ~45~910~1415~1920~2425~ ~ age

2007/06/20Department of Health22 International Comparison Infectious and parasitic diseases Japan Taiwan Unit: rates of patients per 100,000 population ~45~9 10~1415~1920~2425~ ~ ~4 5~9 10~14 15~19 20~2425~ ~ age

2007/06/20Department of Health23

Reference Part disease classifications of ICD9CM in Taiwan 2. International Comparisons (Japan vs. Taiwan)

2007/06/20Department of Health25 Total Expenditure on Personal Health Care by Age, Gender and Diseases Total population

2007/06/20Department of Health26 Total Expenditure on Personal Health Care by Age, Gender and Diseases Infectious and Parasitic Diseases ICD9CM : , 7713,

2007/06/20Department of Health27 Total Expenditure on Personal Health Care by Age, Gender and Diseases Neoplasms ICD9CM :

2007/06/20Department of Health28 Total Expenditure on Personal Health Care by Age, Gender and Diseases Endocrine, Nutritional and Metabolic Diseases and Immunity Disorders ICD9CM :

2007/06/20Department of Health29 Total Expenditure on Personal Health Care by Age, Gender and Diseases Diseases of Blood and Blood-Forming Organs ICD9CM :

2007/06/20Department of Health30 Total Expenditure on Personal Health Care by Age, Gender and Diseases Mental Disorders ICD9CM :

2007/06/20Department of Health31 Total Expenditure on Personal Health Care by Age, Gender and Diseases Diseases of the Nervous System and Sense Organs ICD9CM :

2007/06/20Department of Health32 Total Expenditure on Personal Health Care by Age, Gender and Diseases Diseases of the Circulatory System ICD9CM :

2007/06/20Department of Health33 Total Expenditure on Personal Health Care by Age, Gender and Diseases Diseases of the Respiratory System ICD9CM : , ,

2007/06/20Department of Health34 Total Expenditure on Personal Health Care by Age, Gender and Diseases Diseases of the Digestive System ICD9CM :

2007/06/20Department of Health35 Total Expenditure on Personal Health Care by Age, Gender and Diseases Diseases of the Genitourinary System ICD9CM :

2007/06/20Department of Health36 Total Expenditure on Personal Health Care by Age, Gender and Diseases Diseases of Skin and Subcutaneous Tissue ICD9CM :

2007/06/20Department of Health37 Total Expenditure on Personal Health Care by Age, Gender and Diseases Diseases of the Musculoskeletal System and Connective Tissue ICD9CM :

2007/06/20Department of Health38 Total Expenditure on Personal Health Care by Age, Gender and Diseases Congenital Anomalies ICD9CM :

2007/06/20Department of Health39 Total Expenditure on Personal Health Care by Age, Gender and Diseases Signs, Symptoms and Ill-Defined Conditions ICD9CM :

2007/06/20Department of Health40 Total Expenditure on Personal Health Care by Age, Gender and Diseases Injury and Poisoning ICD9CM :

2007/06/20Department of Health41 Total Expenditure on Personal Health Care by Age, Gender and Diseases Other Reasons for Contact with Health Services ICD9CM : V00-V82

2007/06/20Department of Health42 International Comparison Malignant Neoplasm Japan Taiwan Unit: rates of patients per 100,000 population ~45~910~1415~1920~2425~ ~ ~45~910~1415~1920~2425~ ~ age

2007/06/20Department of Health43 International Comparison Endocrine, Nutritional and Metabolic Diseases and Immunity Disorders Japan Taiwan Unit: rates of patients per 100,000 population age ~45~910~1415~1920~2425~ ~ ~45~910~1415~1920~2425~ ~

2007/06/20Department of Health44 International Comparison Diseases of the Digestive System Japan Taiwan Unit: rates of patients per 100,000 population age ~45~910~1415~1920~2425~ ~ ~45~910~1415~1920~2425~ ~

2007/06/20Department of Health45 International Comparison Complications of Pregnancy, Childbirth and the Puerperium Japan Taiwan Unit: rates of patients per 100,000 population age ~45~910~1415~1920~2425~ ~ ~45~910~1415~1920~2425~ ~

2007/06/20Department of Health46 International Comparison Diseases of Skin and Subcutaneous Tissue Japan Taiwan Unit: rates of patients per 100,000 population age ~45~910~1415~1920~2425~ ~ ~45~910~1415~1920~2425~ ~

2007/06/20Department of Health47 International Comparison Diseases of the Musculoskeletal System and Connective Tissue Japan Taiwan Unit: rates of patients per 100,000 population age 2002 年 0~45~910~1415~1920~2425~ ~ ~45~910~1415~1920~2425~ ~

2007/06/20Department of Health48 International Comparison Congenital Anomalies Japan Taiwan Unit: rates of patients per 100,000 population age ~45~910~1415~1920~2425~ ~ ~45~910~1415~1920~2425~ ~

2007/06/20Department of Health49 International Comparison Certain Conditions Originating in the Perinatal Period Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health50 International Comparison Other Reasons for Contact with Health Services Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health51 International Comparison Infectious and Parasitic Diseases Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health52 International Comparison Mental Disorders Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health53 International Comparison Diseases of the Nervous System Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health54 International Comparison Diseases of the Circulatory System Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health55 International Comparison Diseases of the Respiratory System Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health56 International Comparison Signs, Symptoms and Ill-Defined Conditions Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health57 International Comparison Diseases of Sense Organs Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health58 International Comparison Other neoplasms Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health59 International Comparison Diseases of the Genitourinary System Japan Taiwan Unit: rates of patients per 100,000 population age

2007/06/20Department of Health60 International Comparison Injury and Poisoning Japan Taiwan Unit: rates of patients per 100,000 population age