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1. Introduction
Injuries are a global public health concern for children, ranking in the top 15 causes of death and disability-adjusted life years for children worldwide [1,2]. Dislocations, sprains and strains are among the most common types of injury-related emergency department visits in pediatric population [3,4].
The contribution of traditional and complementary medicine to individuals’ health and wellness has been increasingly recognized worldwide [5]. The recent publication of the World Health Organization on the future traditional medicine strategy has indicated the increasing demand of traditional and complementary medicine and the interests of many countries in the integration of traditional and complementary medicine into healthcare systems [5]. A U.S. study has shown that sprains and strains were the fourth most common medical conditions that adults sought treatments for unconventional medicine [6]. However, we are unaware of any population-based investigations providing data on the use of traditional and complementary medicine and its associated factors among pediatric population with injuries and orthopedic conditions.
Traditional Chinese medicine (TCM) is one of the major domains of traditional and complementary medicine that has a long history of use in the Chinese medical system and now has been used worldwide [5]. TCM use is likely to be common in patients with dislocations, sprains and strains because of the effectiveness of TCM modalities on pain management and function improvement [7,8], which are the main treatment goals of musculoskeletal injuries. In Taiwan, TCM is one of main sources of healthcare, and the universal health insurance (NHI) program offers TCM outpatient services coverage to all insurance enrollees. Using the nationwide representative claims data, we investigated factors associated with TCM use, including demographics, healthcare utilizations and common medical conditions, among pediatric populations with dislocations, sprains and strains. This information would aid in healthcare resource allocation and build the policy of integrative health services delivery for pediatric populations.
2. Methods and Materials
2.1. Data Source
The National Health Insurance Research Database (NHIRD) is a computerized database that contains encrypted claims records of subjects insured in the NHI Program of Taiwan. NHI has been implemented since March 1995, providing healthcare coverage to more than 99% of the total population of Taiwan and contracting more than 90% of the hospitals and clinics [9]. In this analysis, we used a...