Impact Of Infectious Keratitis On Healthcare Utilization In Taiwan: A Nationwide Analysis

To investigate the epidemiologic characteristics of infectious keratitis and its overall burden on the health care system in Taiwan.

A population-based study.

We conducted a retrospective study utilizing claims data from the Taiwan National Health Insurance Research Database (2000–2013). Disease and procedure definitions were established based on diagnostic codes, medication prescriptions, and procedure codes. Participants were stratified according to hospitalization status and the necessity for surgical intervention. The primary outcome measures included disease incidence, risk factors, predictors of hospitalization and surgical intervention, and associated healthcare expenditures.

Among 2,071 patients, the incidence of microbial keratitis rose significantly from 8.4 to 20.2 per 100,000 person-years between 2000 and 2013. The highest incidence occurred in those aged 18–40 years, while healthcare expenditures were greatest in patients over 65. Among 704 patients (33.99%) with identifiable risk factors, the most common were diabetes mellitus (11.52%), ocular trauma (10.55%), and dry eye disease (8.72%). Older age, corticosteroid or antiglaucoma medication use, and ocular or systemic comorbidities increased the likelihood of hospitalization and surgical intervention, whereas prior ocular surgery, including cataract surgery, did not.

In Taiwan, diabetes mellitus, ocular trauma, and dry eye disease were identified as key predisposing factors for microbial keratitis. Patients older than 40 years accounted for approximately 80% of total healthcare expenditures associated with the management of infectious keratitis. Given their higher risk of severe disease requiring hospitalization and surgical intervention, special attention should be given to older patients, particularly those with medication-related risk factors and concurrent ocular or systemic comorbidities.