Biomedical subjects

Yu-Chi Tung

Publications and source records attributed to Yu-Chi Tung.

4 recordsLinked to original sources

PubMed2006

Impact of a cultural belief about ghost month on delivery mode in Taiwan.

BACKGROUND: Many Chinese believe the lunar month of July, "ghost month" is inauspicious for major surgical procedures. This study hypothesised that caesaren delivery (CS) rates will be significantly lower during lunar July, and higher than normal during June, representing preemptive caesaren delivery to avoid delivering in July. METHODS: Population based data from Taiwan on all singleton deliveries during 1997-2003 (1 750 862 cases) were subjected to multivariate autoregressive integrated moving average (ARIMA) modelling, adjusting for major obstetric complications (previous CS, breech presentation, dystocia, and fetal distress). RESULTS: ARIMA intervention models showed significantly lower CS rates in lunar July, and among younger age groups (p<0.001), but not among 35 plus aged mothers. Incidence of previous CS, is significantly higher among June deliveries, while the incidence of the remaining major complications is similar in July, June, and other months. Patients with clinically less salient obstetric complications show significantly lower CS rates in July. CONCLUSIONS: Adjusted CS rates during the ghost month are significantly lower than other months. Lunar June shows an increase in deliveries of previous CS mothers (almost all by CS), suggesting elective CS to preempt CS in July. A major policy implication is that health education must be launched to dissipate the cultural belief about the ghost month. Evidence also implies some proportion of clinically un-indicated CS in other months, showing the need for professional and policy initiatives to reduce unnecessary CS. Policy makers and researchers in other countries should be alert to cultural beliefs associated with delivery to enable informed delivery choices by mothers.

Adolescent↗

PubMed2003

Factors related to dissatisfaction with the National Health Insurance among primary care physicians in Taiwan.

BACKGROUND: Few studies were found that evaluated dissatisfaction with the National Health Insurance (NHI) by primary care physicians in Taiwan. Therefore, the purpose of this study was to identify factors related to dissatisfaction with the NHI among primary care physicians. METHODS: A structured questionnaire was developed through a literature review, a panel discussion, and 5 focus group interviews. In total, 9336 primary care physicians were surveyed. A logistic regression analysis was employed to identify factors related to dissatisfaction with the NHI by primary care physicians. RESULTS: There were 1822 surveys returned, yielding a 19.5% response rate. They showed that 5.7% of respondents were very dissatisfied and 22.3% were dissatisfied with the current medical environment under the NHI. The dissatisfaction of primary care physicians was significantly related to age (OR = 1.029, p<0.05) and dissatisfaction with the following aspects: malpractice claims (OR = 1.744, p<0.001), complexity of medical claims (OR = 1.454, p<0.01), excessive work hours (OR = 1.790, p<0.001), decreased income (OR = 2.812, p<0.001), difficulty in finding nurses (OR = 1.379, p<0.05), and the separation of dispensing medicine from medical practice (OR = 1.389, p<0.05). CONCLUSIONS: These results can provide valuable information to help policy makers identify areas for improvement and intervention in order to reduce levels of dissatisfaction of primary care physicians under the NHI.

Adult↗

PubMed2003

Relationships between length of stay and hospital characteristics under the case-payment system in Taiwan: using data for vaginal delivery patients.

BACKGROUND: Case payment has been implemented since the beginning of Taiwan's National Health Insurance Program in 1995. This study selected patients undergoing a vaginal delivery to explore the relationships between maternal length of stay (LOS) and hospital characteristics under the case-payment system in Taiwan. METHODS: The National Health Insurance Research Database of 1999 from Taiwan's National Health Research Institutes was used in this study. In total, 5456 patients who underwent a vaginal delivery in 1999 meeting the selection criteria were drawn from the database. A multiple regression analysis was performed in which LOS was regressed against the variables of hospital level, hospital location, hospital ownership, and teaching status. RESULTS: The regression model indicated that hospital level, hospital ownership, and hospital location were significantly related to LOS after adjustment for patient age, principal procedure, and the presence of a secondary diagnosis. The LOS for patients undergoing a vaginal delivery in private hospitals was shorter than those in public and non-profit proprietary hospitals. Patients admitted to medical centers or regional hospitals were more likely to have a longer mean LOS in comparison with their counterparts admitted to district hospitals. The LOS for patients hospitalized in northern Taiwan tended to be significantly longer on average than those in central and southern Taiwan. CONCLUSIONS: This study demonstrates that wide variations in LOS exist among hospitals in Taiwan under the case-payment system. It is recommended that the Bureau of the National Health Insurance develop a national system to monitor certain hospitals that have an unusually short LOS.

Adolescent↗

PubMedDate not supplied

Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: the case of a public hospital system in Taiwan.

Examining whether the causal relationships among the performance indicators of the balanced scorecard (BSC) framework exist in hospitals is the aim of this article. Data were collected from all twenty-one general hospitals in a public hospital system and their supervising agency for the 3-year period, 2000-2002. The results of the path analyses identified significant causal relationships among four perspectives in the BSC model. We also verified the relationships among indicators within each perspective, some of which varied as time changed. We conclude that hospital administrators can use path analysis to help them identify and manage leading indicators when adopting the BSC model. However, they should also validate causal relationships between leading and lagging indicators periodically because the management environment changes constantly.

Delivery of Health Care↗