title: Gender-based differences in mortality and complementary therapies for patients with stroke in Taiwan.
abstract: BACKGROUND
  Stroke is a leading cause of death worldwide. In this retrospective study, we investigated the different effects of gender on medical behavior, medical service, medical cost, and death from stroke in Taiwan.
  
  
  METHODS
  We collected data on the stroke-associated mortality rate according to gender and age group for the period between 2009 and 2013 from the official registry of Ministry of Health and Welfare, Taiwan. We analyzed the data related to stroke-associated medical care and costs in 2013 from the National Health Insurance Research Database (NHIRD).
  
  
  RESULTS
  The mortality rate due to stroke was higher in men than in women, despite more inpatient or outpatient medical treatment and higher medical costs, especially in patients aged <50years. Married women showed a significantly lower stroke-associated mortality compared to married men. Women were significantly more likely to accept Western medicine combined with traditional Chinese medicine (TCM) treatment than men (81.51% of women and 74.27% of men). They had lower medical expenditure and lower mortality from stroke than men did. Combined use of integrative Chinese and Western medicine also was associated with lower mortality from stroke than use of conventional Western medicine alone.
  
  
  CONCLUSIONS
  In Taiwan, stroke-associated mortality is higher in men. Marriage or female sex hormone may have protective effect against stroke in women. Women also more tended to seek TCM complementary therapies combined with Western medicine. Integrated Chinese and Western medicine could thus be a potential treatment for stroke.
authors.affiliation: Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chun-Ting
authors.initials: CT
authors.lastname: Liu
authors.affiliation: Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Bei-Yu
authors.initials: BY
authors.lastname: Wu
authors.affiliation: Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan; Fooyin University College of Nursing, Kaohsiung, Taiwan.
authors.forename: Wen-Long
authors.initials: WL
authors.lastname: Hu
authors.affiliation: Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan. Electronic address: hungyuchiang@gmail.com.
authors.forename: Yu-Chiang
authors.initials: YC
authors.lastname: Hung
mesh_terms: D000368:Aged; D000529:Complementary Therapies / Q000379:methods; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality*; D013624:Taiwan
keywords: Gender differences; Stroke; Traditional chinese medicine