Citation

Chen HY, Chang HY, Shih SF, Hsu CC, Lin YH, Shih YT. BMC Public Health 2006; 6(1): 107.

Copyright

(Copyright © 2006, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/1471-2458-6-107

PMID

16638154

PMCID

PMC1539003

Abstract

BACKGROUND: Injuries are the leading cause of death in teenagers worldwide. People in mountainous areas have 4 to 8 years shorter life span than the general population of Taiwan. Injury among teenagers is likely a major cause. The objective of this study was to investigate the regional differences in prevalence, risk factors, and medical expenditures for injury in Taiwanese teenagers. METHOD: An equal probability national sample was used. In addition, representative samples from mountainous areas and offshore islands were also used. Only those who aged between 12 and 21 years, signed the consent form permitting us to link their National Health Insurance (NHI) claim data were included in the analysis. Injury related visits and expenditures were extracted from the NHI data. Logistic regression was used to examine the factors associated with injury. Mixed model was used to examine the factors associated with injury-related medical expenditures account for multiple visits of the same individuals. RESULTS: The injury mortality rate of teenagers in mountainous areas was about three times higher in males and twice as high in females than those of Taiwan. The prevalence of nonfatal injuries was highest in mountainous areas. The results showed that males (adjusted odds ratio [OR]: 1.4; 95%; confidence interval [CI]: 1.15-1.59), older teens (18-21), those who lived in mountainous areas (OR: 1.7; 95%; CI: 1.26-2.25), and smokers (OR: 1.5; 95%; CI: 1.17-1.99) were positively associated with injury. These factors were also associated with the number of injury-related outpatient visits. However, teenagers in mountainous areas spent less on medical care than those who lived in metropolitan Taiwan. CONCLUSIONS: Teenagers in mountainous areas had a higher prevalence of injuries and a higher injury-related mortality rate, but spent less to treat injuries. Possible causes were hazardous environments, high-risk behaviors or use of alternative medicine. Lack of medical resources was another concern. Although Taiwanese government has implemented some injury prevention programs, better enforcement is required in mountainous areas.

Language: en