Utilization of rehabilitation services for inpatient with cancer in Taiwan: a descriptive analysis from national health insurance database.
BACKGROUND
Cancer is a major cause of global morbidity and mortality. Since a high prevalence of functional impairments has been observed among cancer patients, rehabilitation has been proposed as a strategy to restore patients' functional independence. The increasing number of cancer patients combined with a growing need for rehabilitation may result in increased utilization of rehabilitation services. This study aimed to investigate the utilization of rehabilitation services among hospitalized cancer patients in Taiwan between 2004 and 2008.


METHODS
Annual admissions and total inpatient expenditures for admissions with a cancer diagnosis were calculated from the National Health Insurance Research Database (NHIRD). Rehabilitation services used by cancer and non-cancer patients, as well as the distributions of rehabilitation service type among the different hospital departments were also analyzed.


RESULTS
The percentages of inpatient admissions with a cancer diagnosis increased from 14.01% to 17.1% between 2004 and 2008. During 2004, 5.25% of all inpatient admissions received rehabilitation services; this percentage increased to 5.62% by 2008. Among cancer admissions, 2.26% to 2.62% received rehabilitation services from 2004 to 2008. By comparison, 5.68% to 6.24% of non-cancer admissions received rehabilitation services during this period. Of the admissions who received rehabilitation services, only 6.44% and 7.96% had a cancer diagnosis in 2004 and 2008, respectively. Sixty-one percent of rehabilitation services were delivered in the departments of orthopedics (25.6%), neurology (14.4%), rehabilitation (11.9%), and neurosurgery (9.2%).


CONCLUSIONS
In Taiwan, the utilization of rehabilitation services during hospitalization increased from 2004 to 2008. Although this trend was noted for cancer and non-cancer admissions, the utilization of rehabilitation services was generally greater by non-cancer admissions. Despite the benefits of rehabilitation, the actual rehabilitation needs of cancer patients remain unmet.
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Heui-Fen
HF
Lin
Ying-Tai
YT
Wu
Jau-Yih
JY
Tsauo
D005102:Health Expenditures; D006801:Humans; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D009313:National Health Programs; D009369:Neoplasms / Q000191:economics / Q000534:rehabilitation*; D009789:Occupational Therapy Department, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data* / Q000639:trends; D010814:Physical Therapy Department, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology; D019472:Universal Health Insurance