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Along with the implementation of National Health Insurance and changes in payment system, the hospital management in Taiwan has been greatly modified for the best medical outcomes for patients and hospitals’ profits. From the initial payment by case volume to total budget, and then to the implementation of the newest Diagnosis related groups (DRG), hospital managers have faced a difficult situation since the profit rate of hospital has been reduced from over 40% to 3-4% and even negative. Therefore, the establishment of an ideal clinical path for a specific clinical event may become a vital way for a desirable medical outcome with reasonable medical expense. With venous thromboembolism as the study model and using the Panel Claims Data of National Health Insurance, this study aimed to study the relationship between the occurrence of venous thromboembolism and major surgeries and underlying chronic diseases, which will be of great value for the establishment of an ideal clinical path. Results from statistical analysis indicated that elder and female subjects are prone to venous thromboembolism while major surgery is indeed a major risk factor with 4.7 fold, along with heart failure, hypertension, coronary heart disease, stroke, and diabetics. In addition, this study is the first to point out that the risk for venous thromboembolism after surgery is even higher for patients with certain underlying diseases. Patients with chronic diseases may have a risk as high as 3.28 for venous thromboembolism if receiving a major surgery, with the risk is 3.14 for diabetics and 3.00 for neurological diseases. We strongly suggest that patients with the abovementioned conditions should receive adequate anti-coagulation therapy to prevent the occurrence of post-operative venous thromboembolism.
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