Validation of the uncertainty stress scale-high-risk pregnancy - Chinese brief version: Rasch analysis.

Background: High-risk pregnancy leads to uncertainty and stress in pregnant women due to the threatened of mother and fetus health. The Uncertainty Stress Scale High-Risk Pregnancy Version, a 54-item Chinese version (USS-HRPV-C), has been widely used to assess the uncertainty and stress that women experience during pregnancy. However, the length of the scale may result in a burden for respondents.

The trend and factors associated with severe maternal morbidity among delivery and postpartum hospitalizations in Taiwan: A nationwide study, 2011-2021.

Objective: To investigate the prevalence and longitudinal trend of severe maternal morbidity (SMM) at nationwide level in Taiwan. The associated maternal factors contributing to SMM were also analyzed.

Materials And Methods: A population-based secondary analysis using administrative datasets released by Ministry of Health and Welfare of Taiwan from 2011 to 2021 was carried out.

Reexamining the association of care continuity and health care outcomes.

Objectives: This study examined the relationship between claims-based and patient-reported continuity of care (COC) measures and investigated the effects of the 2 types of COC measures on subjective and objective health care outcomes.

Study Design: A prospective, cross-sectional, correlational survey design was used. A nationwide face-to-face interview survey of community-dwelling older adults was conducted, and the survey participants' health claims records were retrieved and linked under the universal health insurance system of Taiwan in 2018.

Longitudinal care continuity and avoidable hospitalization: the application of claims-based measures.

Background: Longitudinal continuity between a patient and his/her primary care physician is an important aspect in measuring continuity of care (COC). The majority of previous studies employed questionnaire surveys to patients to measure the continual relationship between patients and their physicians. This study aimed to construct a provider duration continuity index (PDCI) by using longitudinal claims data and to examine its agreement with commonly used COC measures.

Does continuity of care improve patient satisfaction? An instrumental variable approach.

Numerous studies have investigated the relationship between continuity of care (COC) and patient satisfaction. However, COC and patient satisfaction were measured simultaneously; therefore, the direction of causality remains understudied. This study examined the effect of COC on the patient satisfaction of elderly individuals using an instrumental variable (IV) approach.

Continuity of Care and Coordination of Care: Can they Be Differentiated?

Introduction: Both care continuity and coordination are considered essential elements of health care system. However, little is known about the relationship between care continuity and coordination. This study aimed to differentiate the concepts of care continuity and coordination by developing and testing the reliability and validity of the Combined Outpatient Care Continuity and Coordination Assessment (COCCCA) questionnaire under the universal coverage health care system in Taiwan from a patient perspective.

Examining the Long-term Spillover Effects of a Pay-for-Performance Program in a Healthcare System That Lacks Referral Arrangements.

Background: Several studies have examined the intended effects of pay-for-performance (P4P) programs, yet little is known about the unintended spillover effects of such programs on intermediate clinical outcomes. This study examines the long-term spillover effects of a P4P program for diabetes care.

Methods: This study uses a nationwide population-based natural experimental design with a 3-year follow-up period under Taiwan's universal coverage healthcare system.

Development and Validation of an Integrated Healthy Workplace Management Model in Taiwan.

Background: Impacts of exposure are generally monitored and recorded after injuries or illness occur. Yet, absence of conventional after-the-effect impacts (i.e.

An Exploratory Strategy to Identify and Define Sources of Differential Item Functioning.

The sources of differential item functioning (DIF) items are usually identified through a qualitative content review by a panel of experts. However, the differential functioning for some DIF items might have been caused by reasons outside of the experts' experiences, leading to the sources for these DIF items possibly being misidentified. Quantitative methods can help to provide useful information, such as the DIF status and the number of sources of the DIF, which in turn help the item review and revision process to be more efficient and precise.

A psychometric analysis of a short form of the Chinese version of the ISPCAN child abuse screening tools - Children's home version (SC-ICAST-CH) using multidimensional item response theory.

Background: The development of measures of child maltreatment for the Chinese population were limited until the Chinese version of the ISPCAN Child Abuse Screening Tools - Children's Home version (ICAST-CH-C) was proposed. Although the ICAST-CH-C was found to be effective in assessing the scope and prevalence of child maltreatment, it has several potential drawbacks. The time that is required to complete the ICAST-CH-C scale is longer than usual for a 36-item scale, because many of its items have one or more follow-up questions.

Keeping up with guideline recommendations: does patient volume matter in diabetes care?

Objectives: To examine the association between service volume and guideline adherence via multiyear observations.

Study Design: Repeated cross-sectional study.

Methods: This study employed nationwide claims data from Taiwan's National Health Insurance scheme and identified patients with newly diagnosed type 2 diabetes from 2001, 2005, and 2009; a new prescription guideline for diabetes care was introduced in 2006.

Care Continuity and Care Coordination: A Preliminary Examination of Their Effects on Hospitalization.

Both care continuity and care coordination are important features of the health care system. However, little is known about the relationship between care continuity and care coordination, their effects on hospitalizations, and whether these effects vary across patients with various levels of comorbidity. This study employed a panel study design with a 3-year follow-up from 2007 to 2011 in Taiwan's universal health coverage system.

Escalating utilization of inpatient surgery for pelvic floor dysfunction in the elderly in Taiwan.

Aims: The direct cost of operations and health care expenditure for treating pelvic floor dysfunction are substantial. In this study, we evaluate the number of inpatient surgical procedures and direct expenditures for treating pelvic organ prolapse and urinary incontinence under the coverage of National Health Insurance (NHI) in Taiwan.

Methods: Thirteen years of population-based NHI inpatient claims were used in this study.

Reimbursement changes and drug switching: are severe patients more affected?

Objectives To examine the long-term effects of drug reimbursement adjustments on drug-switching decisions and to investigate whether patients with complicated or severe conditions are more affected. Methods A population-based, longitudinal study with a before-and-after design. Analysis of 141,703 patients with type 2 diabetes covered by the universal health insurance program in Taiwan.

Continuity of care and changes in medication adherence among patients with newly diagnosed diabetes.

Objectives: Recent studies have revealed significant variation in medication adherence among patients with chronic conditions. Little is known about the effect of continuity of care (COC) on changes in medication adherence. This study aims to identify medication adherence trajectories among patients with newly diagnosed diabetes, as well as to examine the association of COC and medication adherence among various adherence trajectories.

Potentially Inappropriate Medication and Health Care Outcomes: An Instrumental Variable Approach.

Objective: To examine the effects of potentially inappropriate medication (PIM) use on health care outcomes in elderly individuals using an instrumental variable (IV) approach.

Data Sources/study Setting: Representative claim data from the universal health insurance program in Taiwan from 2007 to 2010.

Study Design: We employed a panel study design to examine the relationship between PIM and hospitalization.

Half-Managed Care: A Preliminary Assessment of a Capitation Program in a Health Care System Without Gatekeepers.

In 2011, a novel capitation program was launched in Taiwan under its universal health insurance plan. This study aimed to assess the short-term impact of the program. Two hospitals in the greater Taipei area, one participating in the "loyal patient" model (13,319 enrollees) and one in the "regional resident" model (13,768 enrollees), were analyzed.

Does pay-for-performance benefit patients with multiple chronic conditions? Evidence from a universal coverage health care system.

Introduction: Numerous studies have examined the impact of pay-for-performance (P4P) programmes, yet little is known regarding their effects on continuity of care (COC) and the role of multiple chronic conditions (MCCs). This study aimed to examine the effects of a P4P programme for diabetes care on health care provision, COC and health care outcomes in diabetic patients with and without comorbid hypertension.

Methods: This study utilized a large-scale natural experiment with a 4-year follow-up period under a compulsory universal health insurance programme in Taiwan.

Medication supply, healthcare outcomes and healthcare expenses: longitudinal analyses of patients with type 2 diabetes and hypertension.

Introduction: Patients with chronic conditions largely depend on proper medications to maintain health. This study aims to examine, for patients with diabetes and hypertension, whether the appropriateness of the quantity of drug obtained is associated with favorable healthcare outcomes and lower expenses.

Methods: This study utilized a longitudinal design with a seven-year follow-up period from 2002 to 2009 under a universal health insurance program in Taiwan.

Effects of continuity of care on medication duplication among the elderly.

Background: The effects of continuity of care on health care outcomes are well documented. However, little is known about the effect of continuity at the physician or the site level on the process of care for patients with multiple chronic conditions (MCCs).

Objective: The objective of this study was to examine the effects of physician continuity versus site continuity on duplicated medications received by patients with and without MCCs.

Does medication adherence lead to lower healthcare expenses for patients with diabetes?

Objectives: To examine the relationship between medication adherence and healthcare outcomes and expenses and to investigate whether the duration of type 2 diabetes mellitus (T2DM) has a role in the aforementioned relationship.

Data Source/study Setting: Health insurance claims data under a universal coverage system in Taiwan.

Study Design: Seven years of longitudinal analysis was performed to examine the association between medication adherence of oral antihyperglycemic drugs and outcomes among patients with newly diagnosed T2DM.

Continuity of care, medication adherence, and health care outcomes among patients with newly diagnosed type 2 diabetes: a longitudinal analysis.

Background: The effects of continuity of care (COC) on health care outcomes are well established. However, the mechanism of this association is not fully understood.

Objective: The objective of this study was to examine the relationship between COC and medication adherence, as well as to investigate the mediating effect of medication adherence on the association between COC and health care outcomes, in patients with newly diagnosed type 2 diabetes.

Continuity of care, potentially inappropriate medication, and health care outcomes among the elderly: evidence from a longitudinal analysis in Taiwan.

Background: Better continuity of care (COC) is associated with improved health care outcomes, such as decreased hospitalization and emergency department visit. However, little is known about the effect of COC on potentially inappropriate medication.

Objectives: This study aimed to investigate the association between COC and the likelihood of receiving inappropriate medication, and to examine the existence of a mediating effect of inappropriate medication on the relationship between COC and health care outcomes and expenses.

The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: a population-based study.

Objective: To examine the impacts of diagnosis-related group (DRG) payments on health care provider's behavior under a universal coverage system in Taiwan.

Methods: This study employed a population-based natural experiment study design. Patients who underwent coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty, which were incorporated in the Taiwan version of DRG payments in 2010, were defined as the intervention group.

A longitudinal examination of a pay-for-performance program for diabetes care: evidence from a natural experiment.

Background: Numerous studies have examined the impacts of pay-for-performance programs, yet little is known about their long-term effects on health care expenses.

Objectives: This study aimed to examine the long-term effects of a pay-for-performance program for diabetes care on health care utilization and expenses.

Methods: This study represents a nationwide population-based natural experiment with a 4-year follow-up period under a compulsory universal health insurance program in Taiwan.