Objectives: Many studies have found that high-tech medical utilization is one of the most important factors on rising healthcare expenditure. Some studies pointed out that cardiac catheterization facilities were ranked as the highest utilization among high-tech medical instruments. Therefore, this study focused on the utilization of cardiac catheterization in Taiwan with emphasis on its impact on the government’s policy for the health care system.
Methods: The study used the National Health Insurance (NHI) database from year 1997 to year 2005. According to the 17 healthcare regions which designed by the Department of Health, the study analyzed the utilization of cardiac catheterization facilities in each region after the national health insurance implemented. Multiple regression analysis was applied to analyze the factors associated with utilization of cardiac catheterization in healthcare regions.
Results: The utilization of cardiac catheterization increased sharply year by year. The study found that the utilization was 70,259 person-time in year 2005 compared to 10,385 person-time in year 1997. The average utilization was 44,108 person-times per year. The growth rate for 9 year period (1997-2005) was 576.54%, and average growth rate was 27% per year. Males had significant higher utilization of cardiac catheterization than females. However, the growth rate for females was higher than males. The highest utilization of cardiac catheterization located in the group of patients’ age above than 65 years old. In the point of growth rate, patients’ aged between 45-54 years old had higher rate than the aged above than 65 years old. The result of multiple regression analysis showed that the proportion of female population, age, and number of cardiac catheterization facilities per million population were factors that influenced the utilization of cardiac catheterization (p<0.01) .
Conclusions: The study indicated that utilization of cardiac catheterization increased year by year from 1997 to 2005. The most important factor was patients’ age (45-54 years old population). The result indicated that patients’ age for coronary heart disease was decreasing. Otherwise, the utilization of cardiac catheterization did not decreased after global budget system implemented. And the effects of medical demands (female population) and supplies (numbers of facilities) were significant factors that influenced the utilization of cardiac catheterization.
