The association between economic indicators and the incidence of tetraplegia from traumatic spinal cord injury in Taiwan

BMC Neurology

Fuhmei Wang¹  Wei-Chih Lien²  Jung-Der Wang³  Wei-Ming Wang⁴ 

[1] Department of Economics and Department of Public Health, National Cheng Kung University, 701, Tainan, Taiwan;Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 704, Tainan, Taiwan;Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng Kung University, 701, Tainan, Taiwan;Ph.D. Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, 402, Taichung, Taiwan;Department of Public Health, College of Medicine, National Cheng Kung University, 701, Tainan, Taiwan;Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, 704, Tainan, Taiwan;Department of Statistics, College of Management, National Cheng Kung University, 701, Tainan, Taiwan;

关键词: Incidence;    Spinal cord injuries;    Tetraplegia;    Gross domestic product;    Income elasticity;    Motor vehicle injury;   

DOI  :  10.1186/s12883-021-02141-8

来源: Springer

【 摘 要 】

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 16–99 years, per 103 person-years) and CIR16–59 (aged 16–59 years) 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 β 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‰, 1.55‰, 1.36‰, 1.46‰, 1.54‰, 1.54‰, and 1.62‰ for traumatic SCI, MV-related SCI, fall-related SCI, tetraplegia, traumatic tetraplegia, MV-related tetraplegia, and fall-related tetraplegia respectively. The β coefficients show that the compared areas of urbanization level were also inversely correlated with CIR16–59 in the SCI population.ConclusionsWe 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.

【 授权许可】

CC BY