Mental Disabilities Increase the Risk of Respiratory Infection-Related Healthcare Utilization
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Data and Design
2.2. Study Subjects
2.3. Statistical Analysis
3. Results
3.1. Analysis of the Basic Characteristics of Individuals with Mental Disabilities and Reference Groups
3.2. Analysis of Respiration Infection in Individuals of the MD and Reference Groups
3.3. Analysis of the Visits for Respiratory Infection-Related Utilization in Individuals of the MD and Reference Groups
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | Pre-Matched | p Value | Matched | p Value | ||
---|---|---|---|---|---|---|
Mental Disabilities | Reference | Mental Disabilities | Reference | |||
(n = 117,874) | (n = 21,853,264) | (n = 117,031) | (n = 234,062) | |||
% | % | % | % | |||
Gender | 0.0687 | >0.9999 | ||||
Male | 49.0 | 49.2 | 49.0 | 49.0 | ||
Female | 51.0 | 50.8 | 51.0 | 51.0 | ||
Age group (years) | <0.0001 | >0.9999 | ||||
<20 | 0.5 | 21.4 | 0.5 | 0.5 | ||
20–44 | 34.5 | 38.9 | 34.6 | 34.6 | ||
45–64 | 53.6 | 29.0 | 53.5 | 53.5 | ||
≥65 | 11.4 | 10.8 | 11.4 | 11.4 | ||
Premium-based monthly salary (US$) | <0.0001 | <0.0001 | ||||
<760 (Q1) | 6.7 | 13.2 | 6.7 | 10.2 | ||
760–1160 | 85.9 | 58.4 | 85.9 | 58.4 | ||
>1160 (Q3) | 7.4 | 28.4 | 7.4 | 31.4 | ||
Urbanization of residence area | <0.0001 | <0.0001 | ||||
Low | 23.3 | 28.4 | 23.3 | 29.0 | ||
Medium | 52.5 | 53.6 | 52.5 | 53.5 | ||
High | 24.2 | 18.0 | 24.2 | 17.6 | ||
Charlson comorbidity index (CCI) | <0.0001 | <0.0001 | ||||
No (CCI = 0) | 62.6 | 79.4 | 62.6 | 73.9 | ||
Mild (CCI = 1) | 20.4 | 12.7 | 20.4 | 15.3 | ||
Severe (CCI ≥ 2) | 17.0 | 7.9 | 17.1 | 10.7 | ||
Severity of disability | <0.0001 | <0.0001 | ||||
Non | 100.0 | 100.0 | ||||
Mild | 2.1 | 2.1 | ||||
Moderate | 17.5 | 17.5 | ||||
Severe | 54.2 | 54.2 | ||||
Profound | 26.2 | 26.3 | ||||
Dental cavities history | <0.0001 | <0.0001 | ||||
Yes | 12.7 | 14.1 | 12.7 | 11.8 | ||
No | 87.3 | 85.9 | 87.3 | 88.2 | ||
Periodontal disease history | <0.0001 | 0.8634 | ||||
Yes | 18.5 | 15.8 | 18.5 | 18.5 | ||
No | 81.5 | 84.2 | 81.5 | 81.5 |
Variables | MD Group | Reference Group | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mild, Moderate | Severe | Profound | Total | ||||||||||||
n | % | p | n | % | p | n | % | p | n | % | p | n | % | p | |
Total | 22,839 | 47.1 | 63,447 | 52.7 | 30,745 | 61.1 | 117,031 | 53.8 | 234,062 | 56.6 | |||||
Gender | <0.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | ||||||||||
Male | 12,030 | 45.5 | 32,046 | 48.5 | 13,271 | 55.3 | 57,347 | 49.4 | 114,694 | 51.7 | |||||
Female | 10,809 | 48.9 | 31,401 | 56.9 | 17,474 | 65.5 | 59,684 | 58.0 | 119,368 | 61.3 | |||||
Age group (years) | <0.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | ||||||||||
<20 | 54 | 61.1 | 181 | 71.8 | 392 | 75.5 | 627 | 73.2 | 1254 | 69.2 | |||||
20–44 | 5325 | 49.0 | 22,123 | 55.3 | 13,042 | 63.2 | 40,490 | 57.0 | 80,980 | 57.7 | |||||
45–64 | 13,102 | 45.1 | 34,822 | 51.1 | 14,701 | 59.5 | 62,625 | 51.8 | 125,250 | 55.0 | |||||
≥65 | 4358 | 50.6 | 6321 | 51.7 | 2610 | 57.5 | 13,289 | 52.5 | 26,578 | 60.6 | |||||
Premium-based monthly salary (US$) | <0.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | ||||||||||
<760 (Q1) | 654 | 54.4 | 3819 | 58.9 | 3377 | 65.2 | 7850 | 61.2 | 23,951 | 58.6 | |||||
760–1160 | 21,056 | 46.7 | 55,452 | 51.9 | 23,994 | 60.4 | 100,502 | 52.8 | 136,675 | 55.3 | |||||
>1160 (Q3) | 1129 | 50.5 | 4176 | 57.1 | 3374 | 61.9 | 8679 | 58.1 | 73,436 | 58.4 | |||||
Urbanization of residence area | 0.007 | <0.0001 | 0.016 | <0.0001 | 0.02 | ||||||||||
High | 6809 | 48.2 | 15,654 | 51.1 | 5825 | 61.1 | 28,288 | 52.5 | 41,124 | 57.1 | |||||
Medium | 11,610 | 47.2 | 33,309 | 53.4 | 16,519 | 61.7 | 61,438 | 54.5 | 125,123 | 56.8 | |||||
Low | 4420 | 45.2 | 14,484 | 52.5 | 8401 | 59.8 | 27,305 | 53.6 | 67,815 | 56.0 | |||||
Charlson comorbidity index (CCI) | <0.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | ||||||||||
No (CCI = 0) | 14,016 | 40.7 | 39,706 | 46.9 | 19,481 | 57.1 | 73,203 | 48.4 | 173,027 | 53.5 | |||||
Mild (CCI = 1) | 4699 | 55.2 | 12,988 | 60.1 | 6166 | 67.2 | 23,853 | 61.0 | 35,880 | 65.8 | |||||
Severe (CCI ≥ 2) | 4124 | 59.7 | 10,753 | 64.7 | 5098 | 68.8 | 19,975 | 64.7 | 25,155 | 64.8 | |||||
Dental cavities history | <0.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | ||||||||||
No | 20,580 | 46.2 | 55,340 | 51.2 | 26,214 | 60.0 | 102,134 | 52.5 | 206,341 | 55.9 | |||||
Yes | 2259 | 55.3 | 8107 | 62.5 | 4531 | 67.0 | 14,897 | 62.8 | 27,721 | 62.3 | |||||
Periodontal disease history | <.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | ||||||||||
No | 19,422 | 45.2 | 51,692 | 50.3 | 24,283 | 59.4 | 95,397 | 51.6 | 190,738 | 55.4 | |||||
Yes | 3417 | 57.6 | 11,755 | 63.2 | 6462 | 67.3 | 21,634 | 63.6 | 43,324 | 62.0 |
Variables | Respiratory Infections1 | Visits of Respiratory Infections Utilization (Only Users)2 | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Crude OR | 95% CI | P | Adj OR | 95% CI | P | Crudeβ | SE | P | Adj β | SE | P | |
Intercept | 3.85 | 0.05 | <0.0001 | |||||||||
Severity of mental disability (Reference: non) | ||||||||||||
Mild, Moderate | 0.68 | 0.66–0.71 | <0.0001 | 0.66 | 0.63–0.68 | <0.0001 | 1.19 | 0.06 | <0.0001 | 0.77 | 0.06 | <0.0001 |
Severe | 0.86 | 0.84–0.88 | <0.0001 | 0.80 | 0.78–0.82 | <0.0001 | 1.34 | 0.03 | <0.0001 | 0.99 | 0.04 | <0.0001 |
Profound | 1.17 | 1.14–1.20 | <0.0001 | 1.10 | 1.07–1.14 | <0.0001 | 1.24 | 0.04 | <0.0001 | 0.98 | 0.05 | <0.0001 |
Premium-based monthly salary (Reference: <760 US$) | ||||||||||||
760–1160 | 0.85 | 0.83–0.88 | <0.0001 | 0.87 | 0.85–0.90 | <0.0001 | 0.32 | 0.04 | <0.0001 | 0.01 | 0.04 | 0.8741 |
>1160 | 1.04 | 1.01–1.08 | 0.0159 | 1.02 | 0.99–1.06 | 0.166 | −0.35 | 0.05 | <0.0001 | −0.22 | 0.05 | <0.0001 |
Urbanization of residence area (Reference: High) | ||||||||||||
Medium | 1.02 | 1.00–1.05 | 0.0421 | 0.97 | 0.95–1.00 | 0.018 | −0.31 | 0.03 | <0.0001 | −0.17 | 0.03 | <0.0001 |
Low | 0.99 | 0.97–1.01 | 0.3575 | 0.92 | 0.89–0.94 | <0.0001 | −0.44 | 0.04 | <0.0001 | −0.24 | 0.04 | <0.0001 |
Charlson comorbidity index (CCI) (Reference: CCI = 0) | ||||||||||||
Mild (CCI = 1) | 1.69 | 1.65–1.73 | <0.0001 | 1.72 | 1.68–1.76 | <0.0001 | 1.11 | 0.03 | <0.0001 | 0.98 | 0.03 | <0.0001 |
Severe (CCI ≥ 2) | 1.80 | 1.75–1.85 | <0.0001 | 1.85 | 1.80–1.90 | <0.0001 | 1.73 | 0.04 | <0.0001 | 1.52 | 0.04 | <0.0001 |
Dental cavities history (Reference: No) | ||||||||||||
Yes | 1.34 | 1.31–1.37 | <0.0001 | 1.16 | 1.13–1.19 | <0.0001 | 0.40 | 0.04 | <0.0001 | 0.22 | 0.04 | <0.0001 |
Periodontal disease history (Reference: No) | ||||||||||||
Yes | 1.41 | 1.38–1.44 | <0.0001 | 1.22 | 1.19–1.26 | <0.0001 | 0.40 | 0.03 | <0.0001 | 0.14 | 0.04 | 0.0004 |
MD*PD (Reference: No) | ||||||||||||
Mild, Moderate*PD | - | - | - | 1.29 | 1.17–1.42 | <0.0001 | - | - | - | 0.59 | 0.14 | <0.0001 |
Severe*PD | - | - | - | 1.26 | 1.19–1.33 | <0.0001 | - | - | - | 0.34 | 0.08 | <0.0001 |
Profound*PD | - | - | - | 1.04 | 0.96–1.12 | 0.333 | - | - | - | 0.27 | 0.10 | 0.0069 |
Variables | MD Group | Reference Group | p Value * | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Mild, Moderate | Severe | Profound | Total | ||||||||
(n = 10,755) | (n = 33,409) | (n = 18,777) | (n = 62,941) | (n = 132,553) | |||||||
Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | ||
Total | 5.2 | 7.11 | 5.4 | 7.18 | 5.3 | 6.93 | 5.3 | 7.09 | 4.0 | 4.54 | <0.0001 |
Gender | <0.0001 | ||||||||||
Male | 5.3 | 7.66 | 5.2 | 7.30 | 4.9 | 6.97 | 5.1 | 7.29 | 3.8 | 4.39 | |
Female | 5.1 | 6.48 | 5.5 | 7.07 | 5.5 | 6.88 | 5.5 | 6.92 | 4.2 | 4.65 | |
Age group (years) | <0.0001 | ||||||||||
<20 | 4.6 | 4.65 | 4.9 | 4.91 | 4.4 | 4.33 | 4.5 | 4.52 | 3.6 | 3.98 | |
20–44 | 5.5 | 8.71 | 5.2 | 6.88 | 5.1 | 6.85 | 5.2 | 7.10 | 3.6 | 3.81 | |
45–64 | 5.2 | 6.77 | 5.5 | 7.47 | 5.5 | 7.13 | 5.5 | 7.25 | 4.1 | 4.71 | |
≥65 | 5.0 | 5.77 | 5.3 | 6.69 | 5.6 | 6.48 | 5.2 | 6.37 | 4.9 | 5.54 | |
Premium-based monthly salary (US$) | <0.0001 | ||||||||||
<760(Q1) | 5.4 | 7.67 | 5.3 | 7.48 | 5.2 | 7.50 | 5.3 | 7.50 | 4.0 | 4.48 | |
760–1160 | 5.2 | 7.14 | 5.4 | 7.20 | 5.3 | 6.98 | 5.4 | 7.13 | 4.2 | 4.73 | |
>1160(Q3) | 5.1 | 6.08 | 5.2 | 6.54 | 5.0 | 5.82 | 5.1 | 6.20 | 3.8 | 4.20 | |
Urbanization of residence area | <0.0001 | ||||||||||
High | 5.7 | 7.25 | 5.7 | 7.68 | 5.4 | 7.23 | 5.6 | 7.48 | 4.2 | 4.65 | |
Medium | 5.1 | 7.31 | 5.3 | 6.82 | 5.3 | 6.91 | 5.2 | 6.93 | 4.1 | 4.59 | |
Low | 4.8 | 6.19 | 5.4 | 7.44 | 5.2 | 6.73 | 5.3 | 7.04 | 3.9 | 4.39 | |
Charlson comorbidity index (CCI) | <0.0001 | ||||||||||
No (CCI = 0) | 4.7 | 6.23 | 4.7 | 6.16 | 4.7 | 6.25 | 4.7 | 6.20 | 3.7 | 4.02 | |
Mild (CCI = 1) | 5.4 | 6.50 | 5.9 | 7.64 | 5.8 | 7.20 | 5.8 | 7.32 | 4.7 | 5.19 | |
Severe (CCI ≥ 2) | 6.2 | 9.19 | 6.6 | 8.79 | 6.6 | 8.27 | 6.5 | 8.73 | 5.1 | 5.87 | |
Dental cavities history | <0.0001 | ||||||||||
No | 5.2 | 6.76 | 5.3 | 7.05 | 5.2 | 6.96 | 5.3 | 6.97 | 4.0 | 4.51 | |
Yes | 5.6 | 9.32 | 5.9 | 7.85 | 5.7 | 6.73 | 5.8 | 7.72 | 4.3 | 4.73 | |
Periodontal disease history | <0.0001 | ||||||||||
No | 5.1 | 6.52 | 5.2 | 6.92 | 5.2 | 6.91 | 5.2 | 6.85 | 4.0 | 4.53 | |
Yes | 5.9 | 9.27 | 5.9 | 8.01 | 5.7 | 6.94 | 5.8 | 7.89 | 4.2 | 4.60 |
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Share and Cite
Chiang, C.-H.; Tsai, M.-C.; Ng, Y.-Y.; Wu, S.-C. Mental Disabilities Increase the Risk of Respiratory Infection-Related Healthcare Utilization. Int. J. Environ. Res. Public Health 2019, 16, 3845. https://doi.org/10.3390/ijerph16203845
Chiang C-H, Tsai M-C, Ng Y-Y, Wu S-C. Mental Disabilities Increase the Risk of Respiratory Infection-Related Healthcare Utilization. International Journal of Environmental Research and Public Health. 2019; 16(20):3845. https://doi.org/10.3390/ijerph16203845
Chicago/Turabian StyleChiang, Chen-Hung, Ming-Che Tsai, Yee-Yung Ng, and Shiao-Chi Wu. 2019. "Mental Disabilities Increase the Risk of Respiratory Infection-Related Healthcare Utilization" International Journal of Environmental Research and Public Health 16, no. 20: 3845. https://doi.org/10.3390/ijerph16203845