ArticleBMJ open2016
Impact of universal health coverage on urban-rural inequity in psychiatric service utilisation for patients with first admission for psychosis: a 10-year nationwide population-based study in Taiwan.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Mental illness, crime and mental health resources: insights from Taiwan using text analysis and spatio-temporal analysis.BMJ public health · 2026Article
- Timely outpatient follow-up and readmission risk in schizophrenia.Frontiers in psychiatry · 2026Article
- Healthcare for individuals with schizophrenia in Taiwan: 10-year national trend analysis.BJPsych open · 2025Article
- Aripiprazole use and lowering the risk of breast cancer in patient with schizophrenia in a national cohort study.PloS one · 2025Article
- Exploring the Operational Status and Challenges of Community-Based Mental Healthcare Centers in Taiwan: A Qualitative Analysis of Healthcare Professionals' Insights.Healthcare (Basel, Switzerland) · 2023Article
- Treatment Retention Rates of 3-monthly Paliperidone Palmitate and Risk Factors Associated with Discontinuation: A Population-based Cohort Study.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2023Article
- Comparative Effectiveness of Antipsychotics in Preventing Readmission for First-Admission Schizophrenia Patients in National Cohorts From 2001 to 2017 in Taiwan.Schizophrenia bulletin · 2022Article
- Hospital utilization in Indonesia in 2018: do urban-rural disparities exist?BMC health services research · 2022Article
- Determinants of never-treated status in rural versus urban contexts for individuals with schizophrenia in a population-based study in China.BMC psychiatry · 2022Article
- Endocrine Dysfunction Following Stroke.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2021Article
- Investigation of early and lifetime clinical features and comorbidities for the risk of developing treatment-resistant depression in a 13-year nationwide cohort study.BMC psychiatry · 2020Article
- PMScientific reports · 2020Article
- Increasing risk of diabetes mellitus in postmenopausal women with newly diagnosed primary breast cancer.Journal of diabetes investigation · 2020Article
- Article
- Urban and Rural Disparities in Hospital Utilization among Indonesian Adults.Iranian journal of public health · 2019Article
- Statin and metformin therapy in prostate cancer patients with hyperlipidemia who underwent radiotherapy: a population-based cohort study.Cancer management and research · 2019Article
- The synergic effects of frailty on disability associated with urbanization, multimorbidity, and mental health: implications for public health and medical care.Scientific reports · 2018Article
- Time trends in first admission rates for schizophrenia and other psychotic disorders in Taiwan, 1998-2007: a 10-year population-based cohort study.Social psychiatry and psychiatric epidemiology · 2017Article
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7 authors.
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Abstract
objectiveTo examine the disparities in psychiatric service utilisation over a 10-year period for patients with first admission for psychosis in relation to urban-rural residence following the implementation of universal health coverage in Taiwan.
designPopulation-based retrospective cohort study.
settingTaiwan's National Health Insurance Research Database, which has a population coverage rate of over 99% and contains all medical claim records of a nationwide cohort of patients with at least one psychiatric admission between 1996 and 2007.
participants69,690 patients aged 15-59 years with first admission between 1998 and 2007 for any psychotic disorder. MAIN EXPOSURE MEASURE: Patients' urban-rural residence at first admissions.
main outcome measuresAbsolute and relative inequality indexes of the following quality indicators after discharge from the first admission: all-cause psychiatric readmission at 2 and 4 years, dropout of psychiatric outpatient service at 30 days, and emergency department (ED) treat-and-release encounter at 30 days.
resultsBetween 1998 and 2007, the 4-year readmission rate decreased from 65% to 58%, the 30-day dropout rate decreased from 18% to 15%, and the 30-day ED encounter rate increased from 8% to 10%. Risk of readmission has significantly decreased in rural and urban patients, but at a slower speed for the rural patients (p=0.026). The adjusted HR of readmission in rural versus urban patients has increased from 1.00 (95% CI 0.96 to 1.04) in 1998-2000 to 1.08 (95% CI 1.03 to 1.12) in 2005-2007, indicating a mild widening of the urban-rural gap. Urban-rural differences in 30-day dropout and ED encounter rates have been stationary over time.
conclusionsThe universal health coverage in Taiwan did not narrow urban-rural inequity of psychiatric service utilisation in patients with psychosis. Therefore, other policy interventions on resource allocation, service delivery and quality of care are needed to improve the outcome of rural-dwelling patients with psychosis.
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