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Traditional Chinese medicine (TCM) is one of the most popular traditional medicine modalities worldwide. TCM is even covered by the National Health Insurance Program in Taiwan. Liver and lung cancers are the top two most common cancers in Taiwan. This study aimed to analyze the TCM utilization patterns of patients with liver cancer from 1996–2007 and lung cancer stratified by surgery status from 1996-2010 using a population-based random sample of one million insured patients. A cross-sectional study was conducted for liver cancer and a retrospective cohort study for lung cancer. The inpatient and outpatient claim datasets from 1996 to 2010 obtained from the Longitudinal Health Insurance Database 2005 (LHID2005) were used. The outpatient datasets contained the encounter form-based dates of visit, three items from the International Classification of Diseases (Ninth Revision, Clinical Modification codes), billed amount, and paid amount. Only ambulatory care was analyzed. For liver cancer, a total of 6358 liver cancer patients utilized ambulatory care. Among them, 1240 (19.50%) availed of TCM outpatient services. After multivariable adjustment, the likelihood of TCM users was lower in participants aged 70 years and older (odds ratio, OR = 0.79, 95% confidence interval, CI: 0.64–0.97), males (OR = 0.60, CI: 0.52–0.68), residents of Taipei (OR = 0.75, CI: 0.58–0.96) as well as farmers and fishermen (OR = 0.71, CI: 0.54–0.94), but was higher in residents of central Taiwan (OR = 1.99, CI: 1.56–2.54). For lung cancer, among 7,677 lung cancer patients, 1,826 (26.32%) and 230 (31.17%) availed of TCM outpatient services for lung cancer patients without and with surgery, respectively. For lung cancer patients without surgery, the likelihood of TCM users was lower in participants aged 70 years and older (odds ratio, OR = 0.60, 95% confidence interval, CI: 0.49–0.73), males (0.86, 0.75–0.98), members of occupational (0.69, 0.51-0.93), and farmers and fishermen (0.72, 0.53–0.97), but was higher in residents who had TCM use one year prior to lung cancer diagnosis (4.55, 4.00-5.17), patients with insured amount of 20,000-39,999 NT dollars (1.34, 1.12-1.60), residents of urban levels of 2 (1.35, 1.03-1.77) and 4 (1.47, 1.14-1.91), and residents of Central (1.55, 1.21–1.97) and Kao-Ping (1.32, 1.02–1.71) after multivariable adjustment. For lung cancer patients with surgery, the likelihood of TCM users was higher in residents who had TCM use one year prior to lung cancer diagnosis (4.07, 2.74-6.04), patients with insured amount of ≧60,000 NT dollars (3.18, 1.18-8.56). TCM was widely used by the patients with liver cancer and lung cancers. The findings of this study should be useful for health policy makers as well as researchers considering the integration of TCM and Western medicine.
Keywords: traditional medicine/therapies, liver cancer, lung cancer
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