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Chou CW, Lin CR, Chung YT, Tang CS. Epidemiology of Oral Cancer in Taiwan: A Population-Based Cancer Registry Study. Cancers (Basel) 2023; 15:cancers15072175. [PMID: 37046836 PMCID: PMC10092957 DOI: 10.3390/cancers15072175] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/15/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023] Open
Abstract
Oral cancer (OC) is one of the most common cancers worldwide, and its incidence has regional differences. In this study, the cancer registry database obtained from 1980 to 2019 was used to analyze the characteristic of incidence of OC by average annual percentage change (AAPC) and an age–period–cohort model. Spearman’s correlation was used to analyze the relationship between the age-standard incidence rates (ASR) of OC and related risk factors. Our results showed that the ASR of OC increased from 4.19 to 27.19 per 100,000 population with an AAPC of 5.1% (95% CI = 3.9–6.3, p value < 0.001) in men and from 1.16 to 2.8 per 100,000 population with an AAPC of 3.1% (95% CI = 2.6–3.6, p value < 0.001) in women between 1980–1984 and 2015–2019. The age–period–cohort model reported a trend of rising then declining for the rate ratio in men, with peaks occurring in the 1975 cohort, with a rate ratio of 6.80. The trend of incidence of oral cancer was related to changes in the consumption of cigarettes and alcohol and production of betel quid, with r values of 0.952, 0.979 and 0.963, respectively (all p values < 0.001). We strongly suggest avoiding these risk factors in order to prevent OC.
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Affiliation(s)
- Chao-Wei Chou
- School of Public Health, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 242, Taiwan
| | - Chun-Ru Lin
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan
| | - Yi-Ting Chung
- School of Public Health, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 242, Taiwan
| | - Chin-Sheng Tang
- School of Public Health, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 242, Taiwan
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2
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Chen CC, Cheng KW, Chang HY, Chang SS. Changes in alcoholic beverage preference and consumption in Taiwan following accession to the World Trade Organization. Addiction 2021; 116:497-505. [PMID: 32621300 DOI: 10.1111/add.15184] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/08/2019] [Accepted: 06/28/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Given the growing concerns that international trade agreements may increase the supply of health-harming commodities, including alcohol, this study aimed to investigate the changes in alcoholic beverage preference and consumption after Taiwan's accession to the World Trade Organization (WTO). DESIGN A before-and-after comparison analysis using data from two waves (1993-1996 and 2005-2008) of the Nutrition and Health Survey in Taiwan (NAHSIT), before and after Taiwan's accession to the WTO in 2002. SETTING Taiwan. PARTICIPANTS A total of 5031 and 2910 participants aged 19 years or older in NAHSIT 1993-1996 and 2005-2008, respectively. MEASUREMENTS Alcohol measures included beverage-specific preference, mean daily ethanol consumption, and heavy drinking. Logistic regression was used to estimate the prevalence rate ratios and rate differences of beverage preferences between the two waves and the risk ratios of heavy drinking associated with different beverage preferences. FINDINGS A reduced prevalence rate of drinkers who preferred rice spirits (prevalence rate ratio [PRR] = 0.47; 95% confidence interval [CI] = 0.24, 0.91) and Asian wine (PRR = 0.11; 95% CI = 0.04, 0.29) was found in contrast to an increase in the preference for fruit wine (PRR = 2.90; 95% CI = 1.75, 4.79); the preference for Asian spirits showed a non-significant increase (PRR = 1.63; 95% CI = 0.88, 3.02). Similarly, the mean daily ethanol consumption decreased for Asian wine and increased for Asian spirits. Compared with beer, an increased risk of heavy drinking was associated with rice spirits (adjusted risk ratio [aRR] = 3.30; 95% CI = 1.68, 6.47) and Asian spirits (aRR = 2.64; 95% CI = 1.38, 5.01). CONCLUSIONS After Taiwan became a member of the World Trade Organization and abolished its alcohol monopoly in 2002, the pattern of alcoholic beverage preference changed markedly, including a decrease in drinkers who preferred rice spirits and Asian wine (53% and 89% decrease, respectively) and an increase in drinkers who preferred fruit wine and Asian spirits (2.9-fold and 1.6-fold increase, respectively).
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Affiliation(s)
- Cheng-Che Chen
- Division of Psychiatry and Center of Medical Education and Research, National Taiwan University Hospital Chu-Tung Branch, Hsinchu, Taiwan
| | - Kai-Wen Cheng
- Department of Health Administration, Governors State University, University Park, IL, USA.,Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Hsin-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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3
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Xiao J, Wang F, Wong NK, Lv Y, Liu Y, Zhong J, Chen S, Li W, Koike K, Liu X, Wang H. Epidemiological Realities of Alcoholic Liver Disease: Global Burden, Research Trends, and Therapeutic Promise. Gene Expr 2020; 20:105-118. [PMID: 32690129 PMCID: PMC7650014 DOI: 10.3727/105221620x15952664091823] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Globally, alcohol consumption contributes to more than 3 million deaths each year. While much of its ramifications is preventable, a coherent public health discourse on how to limit alcohol-related harm has been overdue. By synthesizing information from national and global databases, we show in this analysis that alcohol consumption level and alcohol-attributable burden of diseases, particularly alcoholic liver disease (ALD), are intimately linked to national income distribution, cultural norms, religion, sex, age, and health status. Prevalence and burden of ALD are positively associated with economic standing in most countries, which necessitate active governmental control via cost-effective policies, such as the best buys proposed by the World Health Organization. To date, a number of critical questions remain unanswered over the molecular mechanisms underlying ALD pathophysiology; the insights gained thereof should provide new opportunities for the advancement of novel diagnostic and management strategies. In comparison with other prevailing liver diseases (e.g., viral hepatitis and nonalcoholic fatty liver disease), governmental support to ALD investigation has been sluggish in most Western countries and China, resulting in a dearth of breakthroughs on both the basic and clinical research fronts in the past decades. Emerging foci of clinical trials for ALD therapy include empirical use of probiotics, antioxidants, growth factors, monoclonal antibodies against key inflammatory mediators, and technology-enhanced behavioral interventions. In this article, we seek to provide a comprehensive analysis on the progress and challenges in tackling ALD as a global health problem, with particular emphasis on global disease burden, socioeconomic influences, research trends, government roles, and future therapies.
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Affiliation(s)
- Jia Xiao
- *Laboratory of Neuroendocrinology, Fujian Key Laboratory of Developmental and Neuro Biology, School of Life Sciences, Fujian Normal University, Fuzhou, China
- †Clinical Medicine Research Institute, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Fei Wang
- ‡Division of Gastroenterology, Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Nai-Kei Wong
- §National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Yi Lv
- *Laboratory of Neuroendocrinology, Fujian Key Laboratory of Developmental and Neuro Biology, School of Life Sciences, Fujian Normal University, Fuzhou, China
| | - Yingxia Liu
- §National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Jiajun Zhong
- †Clinical Medicine Research Institute, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shuaiyin Chen
- ¶Department Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei Li
- #Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Kazuo Koike
- #Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Xiaowei Liu
- **Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, China
| | - Hua Wang
- ††Department of Oncology, the First Affiliated Hospital, Institute for Liver Diseases of Anhui Medical University, Hefei, China
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4
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Hsiao JR, Huang CC, Ou CY, Chang CC, Lee WT, Tsai ST, Huang JS, Chen KC, Lai YH, Wu YH, Hsueh WT, Wu SY, Yen CJ, Chang JY, Lin CL, Weng YL, Yang HC, Chen YS, Chang JS. Investigating the health disparities in the association between lifestyle behaviors and the risk of head and neck cancer. Cancer Sci 2020; 111:2974-2986. [PMID: 32539207 PMCID: PMC7419018 DOI: 10.1111/cas.14530] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/28/2020] [Accepted: 06/06/2020] [Indexed: 12/15/2022] Open
Abstract
Many studies have reported a positive association between lower socioeconomic status (SES) and higher head and neck cancer (HNC) risk. Fewer studies have examined the impact of SES on the association between alcohol or cigarette use and HNC risk. The current case‐control study (1104 HNC cases and 1363 controls) investigated the influence of education, a SES indicator, on the association between HNC and the use of alcohol, cigarettes, or betel quids in Taiwan, a country with universal health care. Our results showed a larger increase in HNC risk associated with alcohol among those with lower educational level (odds ratio [OR] = 2.07; 95% confidence interval [CI], 1.53‐2.80) than those with higher educational level (OR = 1.38; 95% CI, 1.04‐1.85) (heterogeneity‐P = .03). Educational level had an influence on the association between alcohol use and HNC risk among those with genetic susceptibility (ALDH2‐deficient) to the carcinogenic effect of alcohol. The association between cigarette or betel quid use and HNC risk was similar between the high and low educational groups. National policies and social interventions have led to the decline in the prevalence of cigarette and betel quid users in Taiwan. In contrast, due to the lack of adequate alcohol control policies, alcohol consumption in Taiwan has continued to rise. A higher impact of alcohol on HNC risk among lower SES individuals even with universal health care could be the result of insufficient alcohol control policies in Taiwan.
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Affiliation(s)
- Jenn-Ren Hsiao
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Chih Huang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Yen Ou
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chan-Chi Chang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ting Lee
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sen-Tien Tsai
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jehn-Shyun Huang
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ken-Chung Chen
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Hsuan Lai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuan-Hua Wu
- Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ting Hsueh
- Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shang-Yin Wu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Jui Yen
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jang-Yang Chang
- Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chen-Lin Lin
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Ling Weng
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Han-Chien Yang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Yu-Shan Chen
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jeffrey S Chang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
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Huang CC, Hsiao JR, Lee WT, Lee YC, Ou CY, Chang CC, Lu YC, Huang JS, Wong TY, Chen KC, Tsai ST, Fang SY, Wu JL, Wu YH, Hsueh WT, Yen CJ, Wu SY, Chang JY, Lin CL, Wang YH, Weng YL, Yang HC, Chen YS, Chang JS. Investigating the Association between Alcohol and Risk of Head and Neck Cancer in Taiwan. Sci Rep 2017; 7:9701. [PMID: 28851901 PMCID: PMC5574999 DOI: 10.1038/s41598-017-08802-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/13/2017] [Indexed: 12/15/2022] Open
Abstract
Although alcohol is an established risk factor of head and neck cancer (HNC), insufficiencies exist in the literature in several aspects. We analyzed detailed alcohol consumption data (amount and type of alcoholic beverage) of 811 HNC patients and 940 controls to evaluate the association between alcohol and HNC by HNC sites and by genotypes of ADH1B and ALDH2. Alcohol was associated with an increased HNC risk in a dose-response relationship, with the highest risk observed for hypopharyngeal cancer, followed by oropharyngeal and laryngeal cancers. Liquor showed a stronger positive association with HNC than beer and wine. The highest HNC risk occurred in individuals with the slow ADH1B and slow/non-functional ALDH2 genotype combination. In our study population, 21.8% of HNCs, 55.7% of oropharyngeal cancers, and 89.1% of hypopharyngeal cancers could be attributed to alcohol. Alcohol accounted for 47.3% of HNCs among individuals with the slow ADH1B and slow/non-functional ALDH2 genotype combination. The HNC risk associated with alcohol became comparable to that of never/occasional drinkers after ten or more years of cessation from regular alcohol drinking. In conclusion, alcohol use is associated with an increased HNC risk, particularly for individuals with slow ethanol metabolism. HNC incidence may be reduced by alcohol cessation.
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Affiliation(s)
- Cheng-Chih Huang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Jenn-Ren Hsiao
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Wei-Ting Lee
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Yao-Chou Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Chun-Yen Ou
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Chan-Chi Chang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Yu-Cheng Lu
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Jehn-Shyun Huang
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Tung-Yiu Wong
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Ken-Chung Chen
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Sen-Tien Tsai
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Sheen-Yie Fang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Jiunn-Liang Wu
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Yuan-Hua Wu
- Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Wei-Ting Hsueh
- Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Chia-Jui Yen
- Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Shang-Yin Wu
- Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Jang-Yang Chang
- Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
- National Institute of Cancer Research, National Health Research Institutes, 1F No 367, Sheng-Li Road, Tainan, 70456, Taiwan
| | - Chen-Lin Lin
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Yi-Hui Wang
- National Institute of Cancer Research, National Health Research Institutes, 1F No 367, Sheng-Li Road, Tainan, 70456, Taiwan
| | - Ya-Ling Weng
- National Institute of Cancer Research, National Health Research Institutes, 1F No 367, Sheng-Li Road, Tainan, 70456, Taiwan
| | - Han-Chien Yang
- National Institute of Cancer Research, National Health Research Institutes, 1F No 367, Sheng-Li Road, Tainan, 70456, Taiwan
| | - Yu-Shan Chen
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Jeffrey S Chang
- National Institute of Cancer Research, National Health Research Institutes, 1F No 367, Sheng-Li Road, Tainan, 70456, Taiwan.
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Lin CM, Liao CM. Inpatient expenditures on alcohol-attributed diseases and alcohol tax policy: a nationwide analysis in Taiwan from 1996 to 2010. Public Health 2014; 128:977-84. [PMID: 25443132 DOI: 10.1016/j.puhe.2014.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 08/07/2014] [Accepted: 09/08/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To assess the two opposing effects of alcohol tax policy interventions (tax rate increase in 2002 and decrease in 2009) on hospitalization in monetary terms of alcohol-attributed diseases (AADs) in Taiwan. STUDY DESIGN An interrupted time-series analysis. METHODS Admissions data from 1996 to 2010 were retrieved from the National Health Insurance Research Database claims file and analysed in this study. Data for 430,388 males and 34,874 females aged 15 or above who were admitted due to an AAD were collected. An interrupted time-series analysis examining the effects of the implementation of alcohol tax policy on quarterly adjusted hospital inpatient charges (HICs) for AADs was employed. RESULTS The study showed significant (p < 0.001) changes in the adjusted HICs for AADs in 2002. Quarterly HICs showed an abrupt 14.8% decline (i.e., a 1.3 million US dollar reduction) after the first tax policy was implemented. No change in quarterly HICs for AADs was found after the alcohol tax increase. The total cost of treating these AAD inpatients over the course of the 15-year period was 640.9 million US dollars. Each inpatient with an AAD costs an average of $900-$2000 depending on the patient's sex and age with the cost increasing gradually after the two tax interventions. More than 80% of the HICs were attributed to alcoholic liver diseases. Psychoses accounted for 6%-18% of the total HICs. Alcohol abuse and alcohol poisoning accounted for less than 2% of the total HICs. CONCLUSIONS This study provides evidence that alcohol taxation has resulted in an immediate reduction of medical expenditures related to AADs. The policy of increasing alcohol tax rates may have favourable influences on health care resources related to treating AADs.
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Affiliation(s)
- C-M Lin
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan.
| | - C-M Liao
- Department of Applied Statistics and Information Science, Ming Chuan University, Taoyuan, Taiwan
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