Evidence-based Practice and Quality Improvement
The temporal trend (1997-2008) of patterns of anesthesia under Taiwan National Insurance System: a nationwide population-based study
Background and Goal of Study: The trends of modes of anesthesia of inpatient and ambulatory anesthesia can be an important reference for governmental health policy. Based on a nationwide database, we examined the trend changes of inpatient and outpatient anesthesia in Taiwan during 12 years from 1997 to 2008.
Material and methods: We used National health insurance discharge claim data to study the temporal change of modes of inpatient anesthesia, and the Longitudinal Health Insurance Database 2000 (LHID2000), a sub-dataset contains claim data of one million beneficiaries who were randomly selected from the system in 2000, to study the trend of outpatient anesthesia. Simple linear regression was used to distinguish the temporal trends over time of the modes of anesthesia.
Results and Discussion: The annual inpatient anesthetic practice in Taiwan increased gradually, except the Severe acute respiratory syndrome (SARS) outbreak year 2003, during 1997-2008. However, the annual outpatient anesthetic practice peaked at 2002, and decreased gradually. The predominant modes of inpatient anesthesia was general tube anesthesia (55.43%), followed by spinal anesthesia (23.69%) and epidural anesthesia (7.99%); whereas the most practiced outpatient anesthesia was intravenous/intramuscular general anesthesia (IV/IM GA) (60.77%), followed by general tube anesthesia (18.33%) and nerve block (5.27%). The temporal trend analysis revealed an increased trend for general tube anesthesia (52.8% at 1997; 59.26% at 2008) and mask general anesthesia (2.44% at 1997; 4.73% at 2008) and a decreased trend for nerve block (2.07% at 1997; 0.88% at 2008) for inpatients; whereas for outpatient anesthesia, an increased trend for IV/IM GA (47.51% at 1997; 70.47% at 2008) and a decreased trend for general tube anesthesia (22.15 at 1997; 18.33 at 2008).
Conclusions: Significant rising trend of application of tube and mask general anesthesia was observed in inpatients and IV/IM GA in outpatients in Taiwan 1997-2008.© 2013 European Society of Anaesthesiology