OBJECTIVES

: Taiwan’s National Health Insurance (NHI), established in 1995, has offered every citizen nearly equal financial access to comprehensive health services and provides all citizens with financial risk protection from large medical expenses. Nevertheless, the escalating medical expenditure over the years has posed great pressure to the National Health Insurance Administration to re-evaluate its resource allocation. The objective of this study thus aimed to investigate the age- and gender-specific disease burden in the middle-aged and the elderly under Taiwan’s NHI system.

METHODS

: We conduct a cross-sectional analysis using the 2003-2013 Taiwan’s Longitudinal Health Insurance Database (LHID). All beneficiaries who aged 40 years or older were selected and further categorized into the middle-aged (40-64 years old) and the elderly (65+ years old) group. The age- and gender- specific total patient number and prevalence of the top five most frequently diagnosed diseases (defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes) were estimated.

RESULTS

: In 2003, the top five diseases that have been most frequently diagnosed and received ambulatory care for middle-aged men under Taiwan’s NHI system were acute upper respiratory infections (0.076%), hypertension (0.057%), diabetes mellitus (0.049%), hyperlipidemia (0.028%) and general symptoms (0.025%). Similar patterns were discovered in middle-aged women, except for menopausal and postmenopausal disorders (0.027%). In addition to the frequently diagnosed hypertension and diabetes mellitus, older men also suffered from hyperplasia of the prostate (0.034%) while older women suffered from osteoarthritis (0.035%). The prevalence of these diseases increased steadily through the ten years of the observation period (2003-2013).

CONCLUSIONS

: This study demonstrates the significant disease burden of in middle-aged and older men and women. In addition, different management strategies may be warranted for the four different groups according to the differences of disease burdens suggested by our study.