The Primary Care of Immigrant Workers and Their Associated Characteristics within A Taiwanese Fishing Community.

In Taiwan, immigrant workers play an important role in fisheries but they are easily ignored by society. The health problems and associated characteristics of immigrant workers in fisheries remain unclear. Descriptive and retrospective analyses were performed. Outpatient data were collected from a primary care clinic for six fishing villages in North Eastern Taiwan between 1 August 2016 and 31 July 2017. The data of immigrant workers was recorded and compared with that of natives. A total of 241 immigrant workers and 1342 natives were enrolled. Compared with the natives, the immigrant workers had a significantly younger age, male predominance, and fewer mean visits per year. The immigrant worker's visits tended to be more highly focused during the third quarter of the year. Immigrant workers paid more registration fees and self-payment, but they paid less on diagnosis fees, oral medication, laboratory exams and had reduced total costs. The top five diagnoses for immigrant workers were respiratory diseases (38.3%), trauma (15.2%), musculoskeletal diseases (11.2%), skin-related diseases (9.5%), and digestive diseases (9.1%). Immigrant workers were positively correlated with infectious/parasitic diseases, and negatively correlated with medical consults and endocrine/metabolic diseases. Immigrant workers were also positively associated with registration fees and self-payment, but negatively correlated with diagnosis fees and total costs (all p < 0.05). The distribution of skin diseases and trauma were affected by age and sex as opposed to ethnic group. Immigrant status' health issues should be given more attention.

Place of death for hospice-cared terminal patients with cancer: A nationwide retrospective study in Taiwan.

BACKGROUND: Hospice care has been part of the Taiwan health-care system for 20 years. Detailed information on the place of death for terminal cancer patients is lacking. Impending death discharge (IDD) is unique in Taiwan, and our study aims to compare IDD with in-hospice death among terminal cancer patients under hospice care. METHODS: This retrospective study used claims data of decedents of cancer from the National Health Insurance Research Database of Taiwan from 2007 to 2010. RESULTS: Of the 22,720 cancer decedents enrolled, 6316 had claims data marked with IDD and 16,404 with in-hospice death. Those with IDD were older; had a shorter hospice stay; and higher rates of gastrointestinal, peritoneal, and pulmonary cancers. The mean daily health-care expenditure was higher in those with IDD, however, the total expenditure of terminal hospice admission was lower than those dying in hospices. Patients who were treated at public hospitals had a higher rate of in-hospice death than those treated at private hospitals. Patients with IDD were positively correlated with increasing age and shorter hospice stay. Patients with IDD were positively correlated with private hospitals, especially religious corporation-based hospitals. Male sex, oropharyngeal cancer, bone/connective/breast cancers, and secondary/metastatic cancers were negatively correlated with IDD. CONCLUSION: Patients with IDD have characteristics distinct from those dying in hospices. Advanced age and short hospice stays were common in those with IDD, and in-depth investigations were needed. As a unique predying process in Taiwan, relevant health-care issues regarding IDD are warranted for further investigations.

Reconstruction of the coronoid process with iliac crest bone graft in complex fracture-dislocation of elbow.

A 36-year-old man sustained posterior dislocation of left elbow joint with olecranon fracture, comminuted coronoid fracture and subluxation of proximal radioulnar joint. We reconstructed the coronoid process with autogenous iliac crest bone graft and reduced the olecranon fracture with internal fixation. In addition, we also repaired the medial collateral ligament, annular ligament and anterior capsule during the operation. He received immobilization of the left elbow for 3 weeks after surgery and started range of motion exercises. The radiographic bone union was found 2 months after operation. The range of motion of the elbow was full at 12 months after operation. The latest 2-year follow-up, the functional result of the elbow was excellent.