title: Significantly increased medical expenditure on breast cancer failing to bring down its mortality and incidence rate.
abstract: BACKGROUND
  The direct impact of medical expenses on breast cancer incidence and mortality rate has not been sufficiently addressed. The purpose of this study is to investigate the potential correlation between the incidence and mortality rate of breast cancer and the medical expenses in Taiwan.
  
  
  METHODS
  Breast cancer cases were identified from the National Health Insurance Research Database (NHIRD) with corresponding to International Classification of Diseases, and the Ninth Revision (ICD-9) code 174, 1740-1749, 175, 1750 and 1759 from January 1999 to December 2006. Age-specific incidences were estimated by population data obtained from the Department of Statistics, Ministry of the Interior. Medical expenses, including outpatient and inpatient services, were also retrieved from the NHIRD.
  
  
  RESULTS
  The incidence increased from 20.06 per 100,000 in 1999 to 30.34 per 100,000 in 2006; the total expenses increased from 1,449,333,521 in 1999 to 4,350,400,592 Taiwan dollars in 2006. The age-standardized mortality rate for female breast cancer remained essentially unchanged, while the age-standardized incidence increased steadily (except 2002-2003). Among the top 20 coexisting ICD-9 codes for expenses, four are directly on cancers, while 16 are on other diseases or symptoms, which are not necessarily caused by breast cancer.
  
  
  CONCLUSIONS
  Significantly increased medical expenditure on breast cancer failed to bring down its mortality and incidence rate. The finding has implications for healthcare policy planners in proposing strategies for breast cancer control and allocating the resources.
authors: 1. Institute of Medicine, Chung Shan Medical University, No. 110 Sec 1 Chien-Kuo N. Road, Taichung City 40201, Taiwan; ; Division of Pulmonary Medicine, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua, 500 Taiwan;
authors: Ming-Lin
authors: ML
authors: Ho
authors: Yung-Po
authors: YP
authors: Liaw
authors: Chien-Hsu
authors: CH
authors: Lai
authors: Yen-Yu
authors: YY
authors: Chen
authors: Horng-Der
authors: HD
authors: Tsai
authors: Ming-Chih
authors: MC
authors: Chou
authors: Yi-Hsuan
authors: YH
authors: Hsiao
keywords: Taiwan.; breast cancer; incidence; medical expense
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