Cargando…

Universal health insurance, health inequality and oral cancer in Taiwan

INTRODUCTION: The introduction of universal health insurance coverage aims to provide equal accessibility and affordability of health care, but whether such a policy eliminates health inequalities has not been conclusively determined. This research aims to examine the healthcare outcomes of oral can...

Descripción completa

Detalles Bibliográficos
Autores principales: Wang, Fuhmei, Wang, Jung-Der, Hung, Yu-Wen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193672/
https://www.ncbi.nlm.nih.gov/pubmed/30335806
http://dx.doi.org/10.1371/journal.pone.0205731
_version_ 1783364104506834944
author Wang, Fuhmei
Wang, Jung-Der
Hung, Yu-Wen
author_facet Wang, Fuhmei
Wang, Jung-Der
Hung, Yu-Wen
author_sort Wang, Fuhmei
collection PubMed
description INTRODUCTION: The introduction of universal health insurance coverage aims to provide equal accessibility and affordability of health care, but whether such a policy eliminates health inequalities has not been conclusively determined. This research aims to examine the healthcare outcomes of oral cancer and determine whether the universal coverage system in Taiwan has reduced health inequality. METHODS: Linking the databases of the National Cancer Registry with the National Mortality Registry in Taiwan, we stratified patients with oral squamous cell carcinoma by gender and income to estimate the incidence rate, cumulative incidence rate aged from 20 to 79 (CIR20-79), life expectancy, and expected years of life lost (EYLL). The difficulties with asymmetries and short follow-up periods were resolved through applying survival analysis extrapolation methods. RESULTS: While all people showed a general improvement in life expectancy after the introduction of the NHI, the estimated change in EYLL’s of the high-, middle-, and low-income female patients were found to have +0.3, -0.5 and -7 years of EYLL, respectively, indicating a reduction in health inequality. Improvements for the male patients were unremarkable. There was no drop in the CIR20-79 of oral cancer in disadvantaged groups as in those with higher incomes. CONCLUSIONS: Universal coverage alone may not reduce health inequality across different income groups for oral cancer unless effective preventive measures are implemented for economically disadvantaged regions.
format Online
Article
Text
id pubmed-6193672
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-61936722018-11-05 Universal health insurance, health inequality and oral cancer in Taiwan Wang, Fuhmei Wang, Jung-Der Hung, Yu-Wen PLoS One Research Article INTRODUCTION: The introduction of universal health insurance coverage aims to provide equal accessibility and affordability of health care, but whether such a policy eliminates health inequalities has not been conclusively determined. This research aims to examine the healthcare outcomes of oral cancer and determine whether the universal coverage system in Taiwan has reduced health inequality. METHODS: Linking the databases of the National Cancer Registry with the National Mortality Registry in Taiwan, we stratified patients with oral squamous cell carcinoma by gender and income to estimate the incidence rate, cumulative incidence rate aged from 20 to 79 (CIR20-79), life expectancy, and expected years of life lost (EYLL). The difficulties with asymmetries and short follow-up periods were resolved through applying survival analysis extrapolation methods. RESULTS: While all people showed a general improvement in life expectancy after the introduction of the NHI, the estimated change in EYLL’s of the high-, middle-, and low-income female patients were found to have +0.3, -0.5 and -7 years of EYLL, respectively, indicating a reduction in health inequality. Improvements for the male patients were unremarkable. There was no drop in the CIR20-79 of oral cancer in disadvantaged groups as in those with higher incomes. CONCLUSIONS: Universal coverage alone may not reduce health inequality across different income groups for oral cancer unless effective preventive measures are implemented for economically disadvantaged regions. Public Library of Science 2018-10-18 /pmc/articles/PMC6193672/ /pubmed/30335806 http://dx.doi.org/10.1371/journal.pone.0205731 Text en © 2018 Wang et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Wang, Fuhmei
Wang, Jung-Der
Hung, Yu-Wen
Universal health insurance, health inequality and oral cancer in Taiwan
title Universal health insurance, health inequality and oral cancer in Taiwan
title_full Universal health insurance, health inequality and oral cancer in Taiwan
title_fullStr Universal health insurance, health inequality and oral cancer in Taiwan
title_full_unstemmed Universal health insurance, health inequality and oral cancer in Taiwan
title_short Universal health insurance, health inequality and oral cancer in Taiwan
title_sort universal health insurance, health inequality and oral cancer in taiwan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193672/
https://www.ncbi.nlm.nih.gov/pubmed/30335806
http://dx.doi.org/10.1371/journal.pone.0205731
work_keys_str_mv AT wangfuhmei universalhealthinsurancehealthinequalityandoralcancerintaiwan
AT wangjungder universalhealthinsurancehealthinequalityandoralcancerintaiwan
AT hungyuwen universalhealthinsurancehealthinequalityandoralcancerintaiwan