Risk Management and Healthcare Policy (Feb 2021)

Shifted Firefighter Health Investigation by Personal Health Insurance Record in Taiwan

  • Hsu WC,
  • Wang CH,
  • Chang KM,
  • Chou LW

Journal volume & issue
Vol. Volume 14
pp. 665 – 673

Abstract

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Wei-Ching Hsu,1,2 Chun-Hsiang Wang,3 Kang-Ming Chang,4– 6 Li-Wei Chou2,7,8 1Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan; 2Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan; 3Fire Bureau of Taichung City Government, Taichung, Taiwan; 4Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan; 5Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan; 6Department of Digital Media Design, Asia University, Taichung, Taiwan; 7Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 8Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung, TaiwanCorrespondence: Kang-Ming ChangDepartment of Computer Science and Information Engineering, Asia University, 500, Lioufeng Road, Wufeng, Taichung, 41354, TaiwanTel +886-4-23323456Fax +886-4-23316699Email [email protected] ChouDepartment of Physical Medicine and Rehabilitation, China Medical University Hospital, No. 91, Hsueh-Shih Road, Taichung, 40402, TaiwanTel +886-4-22053366Fax +886-4-23316699Email [email protected]: Taiwan’s firefighters use a shift rotation system with 2 days of work and 1 day of rest. Numerous papers have already explored the risks of shift work to the body. However, little data concern the impact of shift work on health as reflected in medical visits. This study used individuals’ medical visit record in Taiwan’s health insurance system. The locally called “health bank” contains individuals’ medical visit record, health insurance payment points and the medicine used.Methods: Consent was obtained from 150 firefighters who were serving under the shift rotation system to obtain their 2015 individual “My Health Bank” medical data. Comparisons were made between national health insurance data norm.Results: Firefighters make significantly more visits for Western medicine than the annual average (firefighters 6.27 vs norm 5.24, P = 0.04142), more total number of medical visits (9.57 vs 7.75, P = 0.0102), more annual average payment points for Western medicine (4079 vs 2741, P = 0.003151), and a greater average number of total annual medical visit points (7003 vs 4940, p = 0.0003157). Firefighters had significantly higher incidents of respiratory diseases, urogenital diseases, skin and subcutaneous tissue diseases, musculoskeletal system and connective tissue diseases, injuries, and illness from poisoning than did the norm (P< 0.05).Conclusion: A persuasive health-survey-based method for workers in high occupational hazard industries was proposed in this study, and the result was highly correlated with risk factors of fireworkers. The proposed study method is potential to investigate risk factors of other working.Keywords: firefighters, shift worker, health insurance record

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