The impacts of the global financial crisis on hospitalizations due to depressive illnesses in Taiwan: A prospective nationwide population-based study

J Affect Disord. 2017 Oct 15:221:65-71. doi: 10.1016/j.jad.2017.06.028. Epub 2017 Jun 15.

Abstract

Background: In the third quarter of 2008, a major financial crisis hit many developed countries. Taiwan suffered its own share: a rise in unemployment and a severe decline in gross domestic product. This study is to address the health consequences of this crisis on different socioeconomic populations in Taiwan.

Methods: A sample of 6,225,766 men and 5,417,651 women, was obtained and their admissions data over 2007-2012 were retrieved. Stratified into three income levels, the sample was examined on the 147,921 episodes of hospitalization due to depressive illnesses (DIs) over that period by an interrupted time series analysis for monthly incidence rates of DI hospitalizations RESULTS: The adjusted incidence rates of hospitalization (AIRH) for DIs among the low income were 10 times that of the high income group. The AIRHs were generally higher in all of three female income groups than they were in the three male income groups. The low income men and women showed increases (of 18.0% and 14.2%, respectively) beginning in April 2008 that sustained for two years. The high income women exhibited a 5.0% monthly rise in the rate of DI hospitalizations.

Limitations: Our time series models can control some confounding factors, but the ecological fallacy remained.

Conclusions: This study provides evidence that the economic recession resulted in increased rates of DI hospitalization in Taiwan, especially among the low income population. Women of higher incomes may have suffered a more enduring impact.

Keywords: Depressive disorders; Economic recession; Financial crisis; Morbidity; Time series.

MeSH terms

  • Adult
  • Cost of Illness*
  • Depressive Disorder / economics*
  • Depressive Disorder / epidemiology
  • Economic Recession / statistics & numerical data*
  • Female
  • Hospitalization / economics*
  • Humans
  • Income / statistics & numerical data*
  • Interrupted Time Series Analysis
  • Male
  • Middle Aged
  • Poverty / psychology
  • Prospective Studies
  • Social Class
  • Taiwan / epidemiology
  • Unemployment / psychology