| Summary: | 碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 102 === Rice wine is a popular alcoholic beverage in Taiwanese diet culture. Taiwan rice wine (Mijiu) is the cheapest distilled beverage, which is used for both drinking and cooking. Due to its huge sale amount and profit, the production of rice wine was a controversial political and economic issue. After entering the WTO, Taiwan government radically raised the price of rice wine (with the tax equal to other distilled beverage) during 2001-2003 from 20 NTD to 180 NTD. Under the pressure of public request, Taiwan government reduced the price of rice wine to 50 NTD in June 2009 and to 25 NTD in September 2010. This study intends to evaluate the health impact of the price cut in Taiwan.
Health economists had developed the relationship linking alcohol tax, price, per capita consumption, and health outcomes. It was well documented that alcohol price change was associated with morbidity and mortality in a number of countries. This study employed time-series analyses on monthly aggregated hospitalization for alcohol-related diseases and disorders by using the nationally representative sample of a million beneficiaries in the National Health Insurance Research database (NHIRD) during 2005 and 2011. We examined the policy effect in June 2009 and September 2010 by the autoregressive moving average (ARIMA) intervention model, while taking the trends and seasonal variation into account, and applying the impulse-response functions to evaluate the short-term and long-term policy effects. Further analysis was conducted for specific sub-groups such as gender, age groups and living areas.
There was a declining trend of alcohol-related hospitalization rate among the adults prior to the rice wine price reduction while the mean levels were higher in rural, male, and aged 45-64 subgroups. After the first price reduction in June 2009, the mean hospitalization rates increased 12.36% (95% CI: 3.29%-21.46%), which represents an increase of 2.16 monthly hospitalizations per 100,000 person-months. The effect was larger among subjects living in rural area, and no long-term effect for urban adults. The rate also increased after first price reduction among men, but not women. The largest impact appeared among aged 45-64 subgroup with an increase of 19.03%, and the rates also increased in the aged 18-44 subgroup. The effect of the second price reduction in 2010 was not significant in all population groups.
We concluded that the price reduction of rice wine in 2009 led to increased alcohol-related hospitalizations, especially among male, aged 18-64, and people living in rural area. No matter how the rice wine was taken from food ingredient or drink, Taiwan health authorities should pay more attention to the alcohol-related health problems associated with the consumption of rice wine.
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