期刊
BMC NEUROLOGY
卷 21, 期 1, 页码 -出版社
BMC
DOI: 10.1186/s12883-021-02141-8
关键词
Incidence; Spinal cord injuries; Tetraplegia; Gross domestic product; Income elasticity; Motor vehicle injury
资金
- Ministry of Science and Technology, Taiwan [MOST 106-2314-B-006-017-MY3, MOST 108-2314-B-006-015, MOST 109-2314-B-006-093, MOST 107-2627-M-006-007, MOST 108-2627-M-006-001, MOST 109-2621-M-006-007]
- National Cheng Kung University Hospital, Taiwan [NCKUH-10909013, NCKUH-10705008]
This study found that the incidence of tetraplegia of traumatic SCI in Taiwan decreases with good economic performance, which may be resulted from the provision of public goods and services, possibly through improvements in the infrastructure of transportation and construction.
BackgroundEconomic performance may affect public health parameters. This study aimed to determine the time trend of incidence of traumatic spinal cord injury (SCI) and its association with income, presented by GDP (gross domestic product) per capita.MethodsThis study was a retrospective observational study in Taiwan. Newly diagnosed SCI patients with moderate to severe disability from 2002 to 2015 were identified from the reimbursement database of the National Health Insurance (NHI) system (1998-2015). CIR16-99 (cumulative incidence rate, aged 16-99years, per 10(3) person-years) and CIR16-59 (aged 16-59years) of SCI from 2002 to 2015 were measured.ResultsThere were 5048 newly diagnosed SCI patients during the study period. After controlling the factors of sex, urbanization level, literacy, income inequality, and global financial crisis (mixed effects models), the CIR16-99 of SCI, traumatic SCI, motor vehicle (MV)-related SCI, fall-related SCI, tetraplegia, traumatic tetraplegia, MV-related tetraplegia, and fall-related tetraplegia were inversely associated with GDP per capita; the beta coefficients ranged from -4.85 (95% confidence interval-7.09 to -2.6) for total SCI to -0.8 (-1.3 to -0.29) for fall-related tetraplegia. We restricted our comparison to Taipei City and the 4 lowest densely populated counties, which also corroborated with the above results. The income elasticity analysis revealed when GDP per capita increased by 1%, the total SCI decreased by 1.39; which was also associated with a decrease of 1.34 parts per thousand, 1.55 parts per thousand, 1.36 parts per thousand, 1.46 parts per thousand, 1.54 parts per thousand, 1.54 parts per thousand, and 1.62 parts per thousand for traumatic SCI, MV-related SCI, fall-related SCI, tetraplegia, traumatic tetraplegia, MV-related tetraplegia, and fall-related tetraplegia respectively. The beta coefficients show that the compared areas of urbanization level were also inversely correlated with CIR16-59 in the SCI population.Conclusions We conclude that the incidence of tetraplegia of traumatic SCI in Taiwan decreases with good economic performance, which may be resulted from the provision of public goods and services, possibly through improvements in the infrastructure of transportation and construction.
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