title: Incidence of ambulatory care visits among female nursing staff in Taiwan: a claim data-based retrospective cohort analysis.
abstract: OBJECTIVE
  To investigate the incidence of ambulatory care visits among female nursing staff in Taiwan.
  
  
  BACKGROUND
  Literature frequently indicates increased risks of needlestick injury and musculoskeletal disorders among practicing nurses. With increased workload in the healthcare system, nursing staff could also be vulnerable to other diseases.
  
  
  METHODS
  A retrospective cohort study design including 27,624 female nursing staff with a contract with Taiwan's National Health Insurance (NHI) programme between 2001-2004.
  
  
  METHODS
  Information on ambulatory care visits was retrieved from the NHI claim data. Comparison groups included other female medical personnel and active non-medical working women. Incidence rates of ambulatory care visits were calculated using person-year approach. Rate ratio adjusted for potential confounders was estimated from the Poisson regression model.
  
  
  RESULTS
  The nurse cohort developed a total of 781,352 ambulatory care visits, representing an incidence rate of 85,285/10(4) person-years. Compared with the other female medical personnel, female nurses had significantly elevated incidence of genitourinary [adjusted rate ratio (ARR) = 1.20], circulatory (ARR = 1.14), mental (ARR = 1.12), infectious/parasitic diseases (ARR = 1.11) and pregnancy/birth complications (ARR = 1.07). Significantly increased incidence sustained for both infectious/parasitic diseases and pregnancy/birth complications as the nurse cohort was compared with the active non-medical working women. The nurses, on the contrary, had significantly lower ARRs than the comparison groups of neoplasm, injury, metabolic, respiratory, digestive and musculoskeletal diseases.
  
  
  CONCLUSIONS
  Female nurses had increased incidences of certain types of systemic illness when compared with other medical personnel and with women working outside of the health industry. Whether the findings found in this study were region specific or could be applicable to other nations, requires further investigations.
  
  
  CONCLUSIONS
  Policy makers and hospital administrators must not overlook nurses' potentially unseen health problems. A mandatory periodical physical examination for nursing staff must be considered.
authors.affiliation: Department of Public Health, College of Medicine, Fu-Jen Catholic University, Hsinchuanag, Taipei, Taiwan.
authors.forename: I-Chin
authors.initials: IC
authors.lastname: Huang
authors.forename: Chiang-Hsing
authors.initials: CH
authors.lastname: Yang
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Hua-Fen
authors.initials: HF
authors.lastname: Chen
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008875:Middle Aged; D009726:Nurses; D016012:Poisson Distribution; D012189:Retrospective Studies; D013624:Taiwan