Differential Acceptance of Advance Directives Between Millennials and Baby Boomer Generations: A Cross-Sectional Survey Study Among College Students and Their Relatives.

This study aims to explore the differentials of knowledge and attitude of advance directives (ADs) between millennials and baby boomer generations, and the effects of the intention to sign the advance directives. This is a cross-sectional study using a self-administered questionnaire to collect data from 325 students in a health-related college of a University of Science and Technology in Taiwan, and their parents, as total of 226, who are baby boomers. The statistical methods include descriptive statistics and inferential statistics.

Effects of health-information-based diabetes shared care program participation on preventable hospitalizations in Taiwan.

Background: Taiwan's Diabetes Shared Care Program has been implemented since 2012, and the health information system plays a vital role in supporting most services of this program. However, little is known regarding the effectiveness of this information-based program. Therefore, this study investigated the effects of the participation of the Diabetes Shared Care Program on preventable hospitalizations.

Is the United States in the middle of a healthcare bubble?

Objectives: This study investigates the possibility of multiple healthcare bubbles in the US healthcare market.

Methods: We first applied the newly developed Generalized Sup ADF test to locate multiple healthcare bubble episodes and then estimated the switching regression model specifying multiple healthcare bubble periods to evaluate to what extent macroeconomic variables (such as the interest rate, public debt, and fiscal deficit) and public financing healthcare programs influence the magnitude of healthcare bubbles in terms of the deviation of the medical care price inflation from either the overall price inflation or the money wage growth.

Results: Our results show that expansionary monetary and fiscal policies play important roles in determining the deviation of the medical care price inflation from the overall price inflation and that the net government debt has a positive impact on the deviation of the medical care price inflation from the money wage growth.

The effectiveness of a participatory program on fall prevention in oncology patients.

Falls are known to be one of the most common in patient adverse events. A high incidence of falls was reported on patients with cancer. The purpose of this study was to explore the effect of a participatory program on patient's knowledge and self-efficacy of fall prevention and fall incidence in an oncology ward.

The impact of job stressors on health-related quality of life of nursing assistants in long-term care settings.

This study aimed to investigate the relationship between various job stressors and health-related quality of life among female nursing assistants working in long-term care facilities. A cross-sectional study was conducted in Taiwan. Data were collected using a structured, well-designed, pre-tested questionnaire with background questions and questions about job stressors and health-related quality of life as measured by SF-12.

Factors affecting adequate prenatal care and the prenatal care visits of immigrant women to Taiwan.

This paper investigates prenatal care utilization, identifies factors affecting the adequacy of prenatal care, and explores the effect of adequate initial timing of prenatal care on total prenatal care visits among Taiwan new immigrant females. Data was obtained from the 2008 Prenatal Care Utilization among Taiwan New Immigrant Females Survey on women who either had at least one preschool-aged child or had delivered their infants but were still hospitalized (N = 476). The Adequacy of Prenatal Care Utilization Index was applied to rate the prenatal care adequacy.

Nurse staffing, direct nursing care hours and patient mortality in Taiwan: the longitudinal analysis of hospital nurse staffing and patient outcome study.

Background: Studies over the past decades have shown an association between nurse staffing and patient outcomes, however, most of these studies were conducted in the West. Accordingly, the purpose of this study aimed to provide an overview of the research/evidence base which has clarified the relationship between nurse staffing and patient mortality of acute care hospital wards under a universal health insurance system and attempted to provide explanations for some of the phenomena that are unique in Taiwan.

Methods: Through stratified random sampling, a total of 108 wards selected from 32 hospitals in Taiwan were collected over a consecutive seven month period.

Effects of nurse staffing ratios on patient mortality in Taiwan acute care hospitals: a longitudinal study.

Background: The nurse workload in Taiwan averages two to seven times more than that in the United States and other developed countries. Previous studies have indicated heavy nursing workload as an underlying cause of preventable patient death. No studies have yet explored the relationship between nurse staffing ratio and patient mortality in Taiwan.

The skill mix model: a preliminary study of changing nurse role functions in Taiwan.

Background: : Nursing shortage is a critical problem worldwide. Using nurse aides (NAs) within a skill mix model has been applied in the healthcare delivery system as a strategy to improve nursing workforce shortages.

Purpose: : The purpose of this study was to investigate changes in nurse perceptions of their role functions under the skill mix model in Taiwan.

Nonemergent emergency department visits under the National Health Insurance in Taiwan.

Objectives: To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits.

Methods: A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.

[Effect of nurse staffing on patient outcomes: a review of the literature].

Staff shortages present nurses with ever increasing levels of stress and working hours. This has resulted in a corresponding increase in talent flight away from the nursing profession. Responding to financial constraints imposed by the Bureau of National Health Insurance (NHI), Taiwan hospitals have reduced nursing staff numbers and recruited nurses at lower levels of competencies and experience.

Pricing-out effect from possible user-fee policies under Taiwan's National Health Insurance.

This article simulates the pricing-out effect due to various user-fee policies under Taiwan's National Health Insurance. Our simulation results indicate that the lower income group is more likely to be priced out of the healthcare system than the higher income group. On average, pricing-out effects are 0.

[A comparison of long-term care insurance in Germany and the Netherlands].

This paper reports on results of a comparative study of the long-term care systems and relevant laws in Germany and the Netherlands. Information and data used was obtained through articles in the literature. The character of long-term care systems and the major elements of such in both countries are described in detail, including system development, organizational structures, insurance coverage, payment systems, services, delivery systems, and financial mechanisms.

Utilization of emergency department in patients with non-urgent medical problems: patient preference and emergency department convenience.

Background/purpose: We investigated the factors associated with emergency department (ED) use among patients with non-urgent medical problems, with a focus on convenience and preference to use the ED instead of primary care clinics.

Methods: A five-level triage system was adopted by research nurses to decide each patient's triage level and the maximum time to physician interview. Patients who had a maximum time to physician interview of more than 60 minutes were assumed to be non-urgent in this study.

[Exploring the current state and progress of the skill-mixed model in Taiwan].

For many years assistant personnel have been an integral part of Taiwan's healthcare system, assisting nurses to take care of patients and helping out with various aspects of unit work. The skill-mixed model was discussed during the period of greatest SARS risk in Taiwan, when the tradition of family accompaniment in hospitals presented a real and present risk of nosocomial cross-infection. Since 2003, health care authorities have continued to attempt to implement an appropriate nursing model to improve overall delivery of healthcare.

Relationships between serious psychological distress and the use of health services in the United States: findings from the Behavioral Risk Factor Surveillance System.

Objective: To determine rates of access to and use of health services among adults with Serious Psychological Distress (SPD).

Methods: Adults > or = 18 years in the 2007 BRFSS were stratified based on the presence of SPD, assessed by scores > or = 13 using the Kessler-6 tool (N = 199,209). Access to and use of general and mental health services were compared for those with scores < 13 and those > or = 13 using Chi-square analyses and logistic regression models.

Valuing healthcare under Taiwan's national health insurance.

This paper provides a new assessment of the most recent premium policy - the second-generation National Health Insurance (NHI) policy under Taiwan's NHI system. The willingness to pay (WTP) value for a universal coverage NHI plan is NT$201 per month and NT$940 per month for an individual level and for a household level, respectively. We find that the WTP rate is approximately 3.