全民健康保險研究資料庫論文

產出分析及研究方向

陳曾基

台北榮民總醫院家庭醫學部

國立陽明大學醫學院醫務管理研究所

從自己的錯誤經歷中學習

… …

從自己的錯誤經歷中學習

真實

刻骨銘心

從別人的成功模式中學習

? ? ?

從別人的成功模式中學習

也很真實

esp. when the paper got accepted

心願有多大 力量就多大

標準有多寬 心情就多寬

標準有多鬆 心情就輕鬆

十 年 磨 一 劍

或 是 …

一 年 磨 十 刀

You are right here today !

Extract from Pubmed / Medline• Search criteria:

– ("taiwan"[MeSH Terms] OR taiwan[Text Word]) AND (("insurance, health"[MeSH Terms] OR health insurance[Text Word]) OR ("national health programs"[MeSH Terms] OR national health insurance[Text Word] OR national health program*[text word]) OR ("insurance"[MeSHTerms] OR insurance[Text Word]) OR ((claim data*[text word]) OR (claim* data[text word]) OR (administrative claim*[text word]) OR (administrative data[text word]) OR (claim* database[text word]) OR (medical claim*[text word])))

14

America’s two greatest gifts to

the world are jazz and

Medline.Smith R, Chalmers I. Britain's gift: a "Medline" of synthesised

evidence. BMJ 2001;323:1437-1438.

Weaknesses of Medline Approach

• Limited to biomedical journals

• Limited coverage of Taiwan journals

• Limited coverage of international journals

Advantages of Medline Approach

• Open access

• International visibility

• Linked to full texts

• Linked to related articles

Data processing

* Accuracy not guaranteed !

Papers Based on NHI Claims

only

All PubMed Articles

First Author's AD Pubmedonly SCI/SSCI

National Taiwan University 4 33Taipei Medical University 2 30National Yang-Ming University 3 26Taipei Veterans General Hospital 4 12National Health Research Institutes 2 7Kaohsiung Medical University 1 7Chang Gung University 1 4University of South Carolina 1 4Chung Shan Medical University 1 4Academia Sinica 1 3National Taipei University 1 3National Cheng Kung University 4Mackay Memorial Hospital 3Chang-Jung Christian University 3China Medical University 3National Chengchi University 2 1I-Shou University 2Chi Mei Medical Center 2Far-Eastern Memorial Hospital 2Bureau of National Health Insurance 2Taichung Veterans General Hospital 2Jianan Mental Hospital 2Others 3 21

SCI paper trend of prolific institutions

National Taiwan

University

Taipei Medical

University

National Yang-Ming University

Taipei Veterans General Hospital

2000 12001 22002 22003 2 2 32004 6 5 62005 6 2 32006 5 11 9 52007 5 8 5 12008 4 4 1 3

Increasing Output in Clinical Science

Most Prolific AuthorsAuthor Name # % to all

Lin HC 34 16.5 Chen TJ 18 8.7 Chou YJ 18 8.7 Hwang SJ 17 8.3 Chou LF 16 7.8 Xirasagar S 13 6.3 Chou P 13 6.3 Chang HJ 12 5.8 Lee HC 12 5.8 Lee CH 10 4.9 Huang N 10 4.9 Tang CH 9 4.4 Lin CH 8 3.9 Huang WF 8 3.9 Chen YC 8 3.9 Tsai YW 7 3.4 Yang CY 7 3.4 Chen CS 7 3.4 Chen FP 6 2.9 Chen CY 6 2.9 Chien IC 6 2.9 Bih SH 6 2.9

Data Sources

Publications Using NHIRD

SCI paper trend of prolific institutions (NHIRD)

Taipei Medical

University

National Taiwan

University

Taipei Veterans General Hospital

National Yang-Ming University

2002 1 22003 1 5 12004 1 4 32005 1 32006 9 1 5 22007 9 3 1 22008 3 5 3 1

Most Prolific Authors (NHIRD)Author Name # % to all

Lin HC 27 22.7 Chen TJ 17 14.3 Hwang SJ 17 14.3 Chou LF 16 13.4 Lee HC 11 9.2 Chou YJ 10 8.4 Xirasagar S 8 6.7 Lin CH 8 6.7 Chou P 8 6.7 Chen YC 7 5.9 Yang CY 7 5.9 Chen FP 6 5.0 Bih SH 6 5.0 Chang HJ 6 5.0 Chien IC 6 5.0 Chen CY 6 5.0 Chen CS 6 5.0 Tang CH 5 4.2 Liu TC 5 4.2 Kung YY 5 4.2 Chiu HF 5 4.2

Field distribution of

NHIRD papers

Subject Paper Count

Health services research 18

Medicine 13

Psychiatry 13

Public health 11

Allergy and immunology 7

Cardiology 7

Drug therapy 7

Epidemiology 7

Pediatrics 7

Surgery 7

Pulmonary disease (specialty) 6

Gastroenterology 5

Gynecology 5

Obstetrics 5

Therapeutics 5

Health services 4

Neurology 4

Orthopedics 4

Endocrinology 3

Pharmacology 3

Vascular diseases 3

Types of applied NHIRD datasets

住院檔 (DD) 44 55.0

門診檔 (CD) 38 47.5

門診處方檔 (OO) 21 26.3

中醫門診,處方 (TCM) 4 5.0

牙醫 (Dentistry) 1 1.3

Status: Jan. 2008

健保資料庫文獻計量分析系統

NHIRD Bibliography Manager

Types of Study Designs / Computation

• Simple description

• Association / Relationship

• Complex computation (Data mining)

Simple Description

• Disease– Epidemiologic features of Kawasaki disease in Taiwan, 1996-2002.– A nationwide survey on epidemiological characteristics of childhood Henoch-Schonlein

purpura in Taiwan.– Prevalence and risks of chronic airway obstruction: a population cohort study in Taiwan.

• Drug– Utilization of hepatoprotectants within the National Health Insurance in Taiwan.– Demographics and patterns of acupuncture use in the Chinese population: the Taiwan

experience.

• Specialty– Use frequency of traditional Chinese medicine in Taiwan.

• Sector– Patterns of ambulatory care utilization in Taiwan.

Association / Relationship

• A B (no temporal consideration)– Association between physician volume and hospitalization costs for patients

with stroke in Taiwan: a nationwide population-based study.

• A B (temporal change)– Seasonal variations in urinary calculi attacks and the association with climate:

a population-based study.

• A => B (temporal sequence)– Risk of extrapyramidal syndrome in schizophrenic patients treated with

antipsychotics: a population-based study.– Sudden sensorineural hearing loss increases the risk of stroke: A 5-year

follow-up study– Does elective caesarean section increase utilization of postpartum maternal

medical care?

Complex Computation

• Association rule mining– Application of a data-mining technique to analyze

coprescription patterns for antacids in Taiwan.

• Frequent itemset mining– The prescriptions frequencies and patterns of

Chinese herbal medicine for allergic rhinitis in Taiwan.

Simple Description

• Disease– Epidemiologic features of Kawasaki disease in Taiwan, 1996-2002.– A nationwide survey on epidemiological characteristics of childhood Henoch-Schonlein

purpura in Taiwan.– Prevalence and risks of chronic airway obstruction: a population cohort study in Taiwan.

• Drug– Utilization of hepatoprotectants within the National Health Insurance in Taiwan.– Demographics and patterns of acupuncture use in the Chinese population: the Taiwan

experience.

• Specialty– Use frequency of traditional Chinese medicine in Taiwan.

• Sector– Patterns of ambulatory care utilization in Taiwan.

Pediatrics : IF 4.473, Ranking 2 / 78 (Pediatrics)

Chest : IF 4.143, Ranking 6 / 34 (Respiratory system)

Rheumatology : IF 4.045, Ranking 3 / 21 (Rheumatology)

Association / Relationship

• A B (no temporal consideration)– Association between physician volume and hospitalization costs for patients

with stroke in Taiwan: a nationwide population-based study.

• A B (temporal change)– Seasonal variations in urinary calculi attacks and the association with climate: a

population-based study.

• A => B (temporal sequence)– Risk of extrapyramidal syndrome in schizophrenic patients treated with

antipsychotics: a population-based study.– Sudden sensorineural hearing loss increases the risk of stroke: A 5-year

follow-up study– Does elective caesarean section increase utilization of postpartum maternal

medical care?

Clin Pharmacol Ther : IF 8.033, Ranking 7 / 205 (Pharmacology …)

Med Care : IF 3.554, Ranking 2 / 57 (Health Care Sciences ...)

Stroke : IF 6.296, Ranking 4 / 146 (Clinical Neurology)

Stroke : IF 6.296, Ranking 4 / 146 (Clinical Neurology)

J Urology : IF 4.053, Ranking 8 / 55 (Urology …)

Complex Computation

• Association rule mining– Application of a data-mining technique to analyze

coprescription patterns for antacids in Taiwan.

• Frequent itemset mining– The prescriptions frequencies and patterns of

Chinese herbal medicine for allergic rhinitis in Taiwan.

Allergy : IF 5.014, Ranking 2 / 17 (Allergy)

Paper Production Flow

Idea

Journal

Method

Statistics / Computing

Writing

(in Engl.)

Materials Tools

Atmosphere

Infrastructure

修行在個人

Each author’s choice of where to

publish adds another brick to

a complex publishing structure.

Demo

OLAP of Bibliographic Records

DemoProf. HC Lin’s Publication Profile

( Lin, Herng-Ching [au] )

有您加入NHIRD行列

超英 (GPRD)

趕美 (NAMCS)

指 日 可 待

這 款 耶 題 目

嗎 耶 當 寫 paper ? !

請 pa po a感 恩

Thanks for Your Attention

!

全民健康保險研究資料庫論文產出分析及研究方向 從自己的錯誤經歷中學習從自己的錯誤經歷中學習從別人的成功模式中學習從別人的成功模式中學習心願有多大 力量就多大標準有多寬 心情就多寬�標準有多鬆 心情就輕鬆十 年 磨 一 劍或 是 …一 年 磨 十 刀You are right here today !Extract from Pubmed / MedlineAmerica’s two greatest gifts to the world are jazz and Medline.Weaknesses of Medline ApproachAdvantages of Medline ApproachData processingPapers Based on NHI ClaimsAll PubMed ArticlesSCI paper trend of prolific institutionsIncreasing Output in Clinical ScienceMost Prolific AuthorsData SourcesPublications Using NHIRDSCI paper trend of prolific institutions �(NHIRD)Most Prolific Authors (NHIRD)Field distribution of NHIRD papersTypes of applied NHIRD datasets健保資料庫文獻計量分析系統NHIRD Bibliography ManagerTypes of Study Designs / ComputationSimple DescriptionAssociation / RelationshipComplex ComputationSimple DescriptionAssociation / RelationshipComplex ComputationPaper Production Flow修行在個人Demo�OLAP of Bibliographic RecordsDemo�Prof. HC Lin’s Publication Profile�( Lin, Herng-Ching [au] )有您加入NHIRD行列�超英 (GPRD)�趕美 (NAMCS)�指 日 可 待這 款 耶 題 目�嗎 耶 當 寫 paper ? !