Association of availability of tap water system with admission rate after 30 days among burn injury patients: A nationwide population-based study

Background: We investigated whether the availability of a tap water supply system is associated with lowering the admission rate 30 days after burn injury. Methods: We analysed data from the Longitudinal Health Insurance Database 2000 from the National Health Research Institutes. It contains a random sample of 1,000,000 subjects out of 22 million beneficiaries of the National Health Insurance of Taiwan from 1996 to 2010. The included patients were diagnosed twice with burn injuries in local medical departments. The odds ratios and 95% confidence intervals were estimated by logistic regression model to evaluate the correlations of baseline characteristics and comorbidities. Results: A total of 5,996 patients were identified after 1:1 propensity score matching. They had similar basic characteristics. Ultimately, 96 patients in the case cohort (1.10 per 1,000 person years) and 58 patients in the control cohort (0.66 per 1,000 person-years) were admitted 30 days after a burn injury (adjusted hazard ratio 1.67, 95% confidence interval 1.21-2.32). A lower incidence of admission because of burn injury was found in the control cohort (log rank test, p = 0.019). The advantageous effect of a well-equipped tap water system on a lower admission rate in burn patients was independent of comorbidities. Conclusions: The results of this study demonstrated the association between lowering the admission rate at 30 days in burn patients in Taiwan and using a well-equipped tap water system. It also could offer important information to the government for enhancing the availability of tap water system in those areas lack adequate tap water supply which is useful to protect burn patients from following admission. (C) 2020 Elsevier Ltd and ISBI. All rights reserved.