A retrospective fixed cohort population was used as the original study population. Every claimant of the NHI Program at any time during 2005 was included in the population (22,717,053 people) selected for random sampling. Using a random number generator to produce 1,073,891 random numbers, the original claims data of 1,000,000 randomly-sampled beneficiaries from the year 2005 was the original study population of the present study. The majority of the sample population of 1,000,000 subjects were aged from 20 to 65 years, and the male and female subpopulations were of a similar size (49.6% vs. 50.4%, respectively). There were no significant differences in the gender distribution, age distribution or average insured payroll-related amount between the claimants in the 2005 sampled data and the original NHIRD [7 (link),8 (link)]. The registration and claims data of these 1,000,000 individuals collected by the NHI Program could be followed until 2008. In 2008, all the subjects aged 65 years or older were selected from the original study population to be the sampled population for a further analysis.
If a patient’s ailment is diagnosed by a physician as a “catastrophic illness” under Department of Health guidelines, the patient can submit related information and apply for a catastrophic illness certificate. The application will be formally reviewed, and if approved, the information is entered into his or her IC card [10 ]. Therefore, the 2008 registered catastrophic illness dataset of Taiwan (including 30 categories, presented in the result section) was used to verify the target cases from the sampled population.
Moreover, emergency cases served by the NHI system are recorded within the dataset of “ambulatory care expenditure by visit”, and all cases classified as a “medical emergency” could be identified. Finally, to study the difference in ED utilization between Taiwan’s elderly with a catastrophic illness and those without, subjects aged 65 years or older in 2008 were selected and their medical records regarding ambulatory services in 2008 were analyzed.
If a patient’s ailment is diagnosed by a physician as a “catastrophic illness” under Department of Health guidelines, the patient can submit related information and apply for a catastrophic illness certificate. The application will be formally reviewed, and if approved, the information is entered into his or her IC card [10 ]. Therefore, the 2008 registered catastrophic illness dataset of Taiwan (including 30 categories, presented in the result section) was used to verify the target cases from the sampled population.
Moreover, emergency cases served by the NHI system are recorded within the dataset of “ambulatory care expenditure by visit”, and all cases classified as a “medical emergency” could be identified. Finally, to study the difference in ED utilization between Taiwan’s elderly with a catastrophic illness and those without, subjects aged 65 years or older in 2008 were selected and their medical records regarding ambulatory services in 2008 were analyzed.
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