Disability benefits as an incentive for hysterectomy: Uterine fibroid patients in Taiwan

ABSTRACT

Worker compensation insurance in Taiwan ensures that a woman under the age of 45 years who has her uterus removed can receive disability compensation benefits. The present study investigated whether such a compensation policy was related to a woman’s inclination to have a hysterectomy. We extracted the records of 16,030 women diagnosed with uterine fibroids (UF) between 2000 and 2010 from the Longitudinal Taiwan Health Insurance Database. Each younger and older age group had a significantly lower hysterectomy rate compared to that of the 44-year-old age group. Moreover, significantly more patients with lower monthly wages had had hysterectomies than those with higher monthly wages. Policy makers should be aware that worker compensation regulations in Taiwan might encourage women with economic need to undergo hysterectomy surgery when approaching the age of 45 years.

KEYWORDS:

• Disability benefit
• hysterectomy
• moral hazard
• uterine fibroid
• worker compensation

Acknowledgments

The authors are grateful to the National Health Research Institute’s members of the China Medical University Hospital for providing the necessary information.

Funding

This study was supported by a grant from the Taiwan Department of Health Clinical Trial and Research Center of Excellence (DOH101-TD-B-111-004), the Taiwan Department of Health Cancer Research Center of Excellence (DOH101-TD-C-111-005), and the China Medical University Hospital (CMU-REC-101-012).

Notes

1. For our NHI claim data, we can clearly identify whether the NHI insured is covered by civil servant insurance, labor insurance, farmers’ and fishermen’s insurance, or has no job-related insurance.

Additional information

Funding

This study was supported by a grant from the Taiwan Department of Health Clinical Trial and Research Center of Excellence (DOH101-TD-B-111-004), the Taiwan Department of Health Cancer Research Center of Excellence (DOH101-TD-C-111-005), and the China Medical University Hospital (CMU-REC-101-012).