Introduction
Incidence and mortality of liver cancer (LC)
Use of Complementary and Alternative Medicine worldwide
Use of Traditional Chinese Medicine (TCM) in Asian countries
Therapeutic effect of TCM against hepatocellular carcinoma (HCC) in previous studies
How the current study helps resolve the uncertainties regarding TCM use
Methods
Data sources
Statistical analysis
Results
Prevalence of TCM use over time
Factors associated with TCM use
Characteristic | TCM Nonusers | TCM Users | AdjustedaOR | 95% CI | ||
---|---|---|---|---|---|---|
Total | % | Total | % | |||
Patient no. | 5118 | 1240 | ||||
Age | 59.65 ± 12.30 | 57.95 ± 11.46 | ||||
<50 (reference) | 1315 | 25.69 | 343 | 27.66 | 1.00 | |
50s | 1283 | 25.07 | 383 | 30.89 | 1.15 | 0.97-1.37 |
60s | 1274 | 24.89 | 275 | 22.18 | 0.84 | 0.69-1.02 |
> = 70s | 1246 | 24.35 | 239 | 19.27 | 0.79 | 0.64-0.97 |
Gender | ||||||
Female (reference) | 1957 | 38.24 | 631 | 50.89 | 1.00 | |
Male | 3161 | 61.76 | 609 | 49.11 | 0.60 | 0.52-0.68 |
Insured amount (NT$/month) | ||||||
<20,000 (reference) | 3491 | 68.21 | 815 | 65.73 | 1.00 | |
20,000-39,999 | 964 | 18.84 | 245 | 19.76 | 0.92 | 0.77-1.11 |
40,000-59,999 | 459 | 8.97 | 121 | 9.76 | 1.01 | 0.78-1.30 |
> = 60,000 | 204 | 3.99 | 59 | 4.76 | 1.21 | 0.87-1.70 |
Urban Level | ||||||
1 (reference) | 1456 | 29.19 | 348 | 28.74 | 1.00 | |
2 | 1461 | 29.29 | 358 | 29.56 | 0.91 | 0.75-1.10 |
3 | 708 | 14.19 | 187 | 15.44 | 0.91 | 0.71-1.15 |
4 | 817 | 16.38 | 201 | 16.6 | 0.85 | 0.66-1.08 |
> = 5 | 546 | 10.95 | 117 | 9.67 | 0.80 | 0.58-1.08 |
Residential Area | ||||||
Northern (reference) | 667 | 13.03 | 149 | 12.02 | 1.00 | |
Taipei | 1923 | 37.57 | 383 | 30.89 | 0.75 | 0.58-0.96 |
Central | 709 | 13.85 | 306 | 24.68 | 1.99 | 1.56-2.54 |
Southern | 931 | 18.19 | 215 | 17.34 | 1.12 | 0.86-1.44 |
Eastern | 89 | 1.74 | 28 | 2.26 | 1.40 | 0.83-2.36 |
Kao-Ping | 783 | 15.3 | 153 | 12.34 | 0.91 | 0.69-1.18 |
Insured unit | ||||||
Government, school employees (reference) | 530 | 10.93 | 158 | 13.4 | 1.00 | |
Private enterprise employees | 1390 | 28.68 | 361 | 30.62 | 0.92 | 0.73-1.15 |
Member of occupational | 960 | 19.81 | 271 | 22.99 | 0.99 | 0.77-1.27 |
Farmers, fishermen | 1215 | 25.07 | 246 | 20.87 | 0.71 | 0.54-0.94 |
Low-income households Veterans, other regional | 752 | 15.51 | 143 | 12.13 | 0.80 | 0.60-1.07 |
Medical institutes
Outpatient visits specifically for liver cancer Characteristic | Biomedicine | TCM users | P value for | ||
---|---|---|---|---|---|
Visits | Percentage (95%CI) | Visits | Percentage (95%CI) | χ2
| |
Type of providers | <0.001 | ||||
Public hospitals | 75716 | 11.91 (11.83-11.99) | 20455 | 8.98 (8.86-9.1) | |
Public Chinese medicine hospitals | 34 | 0.01 (0.01-0.01) | 636 | 0.28 (0.26-0.30) | |
Private hospitals | 250469 | 39.40 (39.28-39.52) | 70631 | 30.99 (30.80-31.18) | |
Private Chinese medicine hospitals | 326 | 0.05 (0.04-0.06) | 2754 | 1.21 (1.17-1.25) | |
Public clinics | 20175 | 3.17 (3.13-3.21) | 4253 | 1.87 (1.81-1.93) | |
Private clinics | 252442 | 39.71 (39.59-39.83) | 120067 | 52.69 (52.49-52.89) | |
Unknown | 36543 | 5.75 (5.69-5.81) | 9098 | 3.99 (3.91-4.07) | |
Total | 635705 | 100 | 227894 | 100 |
Existing diseases
Western medicine | Traditional chinese medicine | |||||
---|---|---|---|---|---|---|
Ranking
|
Disease (Code)
|
No.
|
Percentage (95% CI)
|
Disease (Code)
|
No.
|
Percentage (95% CI)
|
Outpatient visits specifically for liver cancer
| ||||||
Total = 1,181,130
|
Total = 384,074
| |||||
1 | Chronic liver disease and cirrhosis (571) | 84,263 | 7.31 (7.26-7.36) | Chronic liver disease and cirrhosis (571) | 22,419 | 5.84 (5.77-5.91) |
2 | Malignant neoplasm of the liver and hepatic bile ducts (155) | 75,881 | 6.42 (6.38-6.46) | Malignant neoplasm of the liver and hepatic bile ducts (155) | 1,9847 | 5.17 (5.10-5.24) |
3 | Diabetes Mellitus (250) | 49,506 | 4.19 (4.15-4.23) | General symptoms (780) | 13,060 | 3.4 (3.34-3.46) |
4 | Essential hypertension (401) | 48,762 | 4.13 (4.09-4.17) | Acute upper respiratory infections (465) | 12,231 | 3.18 (3.12-3.24) |
5 | Acute upper respiratory infections (465) | 40,502 | 3.43 (3.40-3.46) | Essential hypertension (401) | 11,604 | 3.02 (2.97-3.07) |
Ranking
|
Disease (Code)
|
No.
|
Percentage (95%CI)
|
Disease (Code)
|
No.
|
Percentage (95%CI)
|
All outpatient visits
| ||||||
Total = 86,850,726
|
Total = 29,277,941
| |||||
1 | Acute upper respiratory infections (465) | 5,932,918 | 6.84 (6.83-6.85) | Acute upper respiratory infections (465) | 1,757,625 | 6.00 (5.99-6.01) |
2 | Essential hypertension (401) | 3,884,150 | 4.47 (4.47-4.47) | General symptoms (780) | 857,752 | 2.93 (2.92-2.94) |
3 | Diabetes Mellitus (250) | 3,027,309 | 3.49 (3.49-3.49) | Essential hypertension (401) | 805,130 | 2.75 (2.74-2.76) |
4 | General symptoms (780) | 2,030,401 | 2.34 (2.34-2.34) | Other and unspecified disorders of the back (724) | 706,248 | 2.41 (2.40-2.42) |
5 | Disorders of conjunctica (372) | 1,642,787 | 1.89 (1.89-1.89) | Diabetes Mellitus (250) | 635,054 | 2.17 (2.16-2.18) |
Expenditures
Biomedicine (N = 53999777) | TCM (N = 20253460) | Biomedicine/ TCM Ratio | |||||||
---|---|---|---|---|---|---|---|---|---|
Characteristic
|
Total
|
Percentage (95% CI)
|
Average (95% CI)
|
Total
|
Percentage (95% CI)
|
Average (95% CI)
|
t value
|
Total
|
Average
|
Medical expenses for all outpatient visits | |||||||||
Fees for consultation, treatment, andmedical supply | 23,205,324,170 | 43.8 (43.8-43.8) | 429.73 (429.71-429.75) | 6,115,161,733.80 | 40.02 (40.02-40.02) | 301.93 (301.90-301.96) | 226.64* | 3.79 | 1.42 |
Diagnosis fee | 11,725,511,578 | 22.13 (22.13-22.13) | 217.14 (217.14-217.14) | 4,425,149,296 | 28.96 (28.96-28.96) | 218.49 (218.49-218.49) | −59.07* | 2.65 | 0.99 |
Drug fee | 18,043,485,487 | 34.06 (34.06-34.06) | 334.14 (334.13-334.15) | 4,738,494,125 | 31.01 (31.01-31.01) | 233.96 (233.95-233.97) | 388.04* | 3.81 | 1.43 |
Total amount | 52,974,321,235 | 100 | 981.01 (980.98-981.04) | 15,278,805,154.80 | 100 | 754.38 (754.35-754.41) | 365.10* | 3.47 | 1.30 |
Biomedicine (N = 635705)
|
TCM (N = 227894)
|
Biomedicine/ TCM Ratio
| |||||||
Characteristic
|
Total
|
Percentage (95% CI) |
Average (95% CI)
|
Total
|
Percentage (95% CI)
|
Average (95% CI)
|
t value
|
Total
|
Average
|
Medical expenses for outpatient visits specifically for liver cancer
| |||||||||
Fees for consultation,treatment, andmedical supply | 470,152,992 | 50.75 (50.75-50.75) | 739.58 (739.32-739.84) | 115449,750 | 46.87 (46.86-46.87) | 506.59 (506.22-506.96) | 29.19* | 4.07 | 1.46 |
Diagnosis fee | 137,611,256 | 14.85 (14.85-14.85) | 216.47 (216.46-216.48) | 50,252,360 | 20.40 (20.39-20.40) | 220.51 (220.5-220.52) | −16.35* | 2.74 | 0.98 |
Drug fee | 318,652,124 | 34.40 (34.40-34.40) | 501.26 (501.13-501.39) | 80,595,549 | 32.72 (32.71-32.72) | 353.65 (353.44-353.86) | 33.91* | 3.95 | 1.42 |
Total amount | 926,416,372 | 100 | 1457.31 (1457.02-1457.60) | 246,297,659 | 100 | 1080.76 (1080.33-1081.19) | 40.99* | 3.76 | 1.35 |