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      • An Empirical Investigation on Customer Dissatisfaction toward using Mobile Applications

        Chien-Ta Ho,Chung-Lun Wei,Kai-Ting Lin 보안공학연구지원센터 2015 International Journal of Database Theory and Appli Vol.8 No.4

        As technology advances, mobile phones have changed significantly with devices and operating systems becoming more sophisticated. Mobile Applications (Apps) have been increasingly popular in the recent years and are changing the people’s daily lives in leisure and businesses. The Booming industry of Apps makes great profit and the awareness to prevent customers or users from feeling dissatisfied is, accordingly, an important issue. Customer dissatisfaction may cause switching behavior, decreasing loyalty, and negative word-of-mouth among customers which may be the potential problem of business losses. Scarce researches have been done in discussing the effects of dissatisfaction among mobile products especially in applications issues. The purpose of this research is to propose a conceptual model and make an empirical investigation about the elements influencing customer dissatisfaction on using mobile applications. The sample consists of 200 respondents by using online questionnaires to collect data. The analysis employing structural equation modeling (SEM) shows that functionality, perceived usefulness and content have significant impacts on customer dissatisfaction. Implications for managerial perception and future research are discussed.

      • SCISCIESCOPUS
      • Poster Session : PS 0318 ; Hematology : Increased Mortality after Stroke in Patients with Immune Thrombocytopenia: A Nationwide Population- Based Study

        ( Chien Chang Liao ),( Ta Liang Chen ),( Chun Chuan Shih ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Limited information was available on the outcomes after stroke in patients with immune thrombocytopenia (ITP). This study evaluated the adverse events after stroke in patients with ITP. Methods: From the claims data of National Health Insurance Database, we conducted a nationwide retrospective cohort study consisted of 2183 stroke patients with ITP between 2002 and 2009. Using matching procedure by propensity score with age, sex, low income, urbanization, teaching hospital, diabetes, hypertension, hyperlipidemia, myocardial infarction, mental disorders, liver cirrhosis, dementia, renal dialysis, anticoagulants, anti-platelet agents, lipid-lowering agents, and types of stroke, we selected 21830 non-ITP patients with stroke during the index date for comparison. Results: After adjustment for sociodemographics, coexisting medical conditions, medications, and types of stroke in the multivariate logistic regressions, patients with ITP had higher 30-day mortality after stroke compared with stroke patients without ITP (odds ratio=1. 41, 95% confi dence interval=1. 15-1. 74). ITP was also associated withincreased medical expenditure after stroke (odds ratio=1. 13, 95% confi dence interval= 1. 01-1. 27). Conclusions: Our nationwide retrospective cohort study investigated the increased risk of mortality after stroke in patients with ITP.

      • Poster Session : PS 0435 ; Infectious Disease ; Adverse Outcomes after Major Surgery in HIV-Infected Patients: A Nationwide Matched Cohort Study

        ( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Patients with infection of human immunodeficiency virus (HIV) were known to have a higher risk of complications during hospitalization. However, the association between HIV-infection and postoperative adverse events were not completely understood. Methods: We conducted a population-based study in 2566 HIV-infected patients and 10,264 non-HIV controls receiving major surgery from the Taiwan National Health Insurance Research Database in 2004 and 2010. Propensity-score methods were used to construct a matched-pairs cohort that reduced important baseline differences between patients who with and without HIV infection. Adjusted rate ratios (RRs) and 95% confi dence intervals (CIs) of major postoperative complications and 30-day mortality were evaluated among HIV-infected patients with different severity in the multivariable logistic regressions. Results: After the adjustment, HIV-infected patients had higher risks of postoperative pneumonia (RR 1.66; 95% CI 1.25-2.20), septicemia (RR 1.32; 95% CI 1.08-1.62), acute renal failure (RR 2.15; 95% CI 1.27-3.66), surgical site infection (RR 1.59; 95% CI 1.38-1.82) and overall complications (RR 1.46; 95% CI 1.31-1.61). Compared with surgical patients without HIV infection, HIV-infected patients had increased 30-day postoperative mortality (RR 2.71; 95% CI 1.82-4.05), particularly in those with viral hepatitis (RR 4.14; 95% CI 2.23-7.70), pulmonary tuberculosis (RR 11.1; 95% CI 3.39- 36.4), diabetes (RR 6.20; 95% CI 2.11-18.2), preoperative HIV-related hospitalization (RR 3.70; 95% CI 2.38-5.74), opportunistic infection (RR 6.31; 95% CI 3.50-11.4) and highly active antiretroviral therapy (RR 4.14; 95% CI 2.34-7.33). Conclusions: HIV-infected patients showed signifi cantly higher postoperative adverse outcome rates with risk of 30-day mortality nearly fi vefold when compared with patients without HIV infection. Our fi ndings suggest the urgency revising the protocol of postoperative care for this specifi c population.

      • Poster Session : PS 0150 ; Neurology : Increased Risk of Fracture and Post-Fracture Adverse Events in Patients with Parkinson`s Disease: Two Nationwide Population-Based Retrospective Cohort Studies

        ( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: The relationship between Parkinson`s disease (PD) and fracture is not completely understood. This study evaluated fracture risk and post-fracture mortality in patients with diabetes. Methods: We identifi ed 1624 adults aged 40 years and older newly diagnosed with PD in 2000-2003 using the Taiwan National Health Insurance Research Database. Comparison cohort consisted of 6496 adults without PD randomly selected from the same dataset, frequency matched by age and sex. Events of fracture in 2000-2008 were ascertained from medical claims. Adjusted hazard ratios (HR) and 95% confidence interval (CI) of fracture associated with PD was calculated. Another nested cohort study consisting of 397,766 patients with fracture admission between 2004 and 2010 calculated the adjusted odds ratios (ORs) and 95% CIs of adverse events after fracture in patients with and without PD. Results: During 51,287 person-years of follow-up, there were 1402 newly diagnosed fracture cases. The incidences of fracture for people with diabetes and without diabetes were 40.4 and 24.1 per 1000 person-years, respectively (P < 0.0001). Compared with people without PD, the adjusted HR of fracture was 1.96 (95% CI 1.74-2.21) for people with PD. The ORs of post-fracture urinary tract infection, pneumonia, septicemia, stroke, and mortality associated with PD were 1.61 (95% CI 1.54-1.69), 1.48 (95% CI 1.40-1.56), 1.45 (95% CI 1.37-1.54), 1.50 (95% CI 1.41-1.60), and 1.27 (95% CI 1.18-1.38), respectively. Conclusions: PD was associated with fracture. Patients with PD had more adverse events and subsequent mortality after fracture. Prevention of fracture and post-fracture adverse events is needed in this susceptible population.

      • Slide Session : OS-RHEU-04 ; Rheumatology : Increased Risk of Acute Myocardial Infarction and Mortality in Patients with Systemic Lupus Erythematosus: Two Nationwide Retrospective Cohort Studies

        ( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: This study evaluated the risk of acute myocardial infarction (AMI) and mortality among patients with systemic lupus erythematosus (SLE) in two nationwide retrospective cohort studies. Methods: Using Taiwan`s National Health Insurance Research Database, we conducted a retrospective cohort study and identifi ed 1207 adults newly diagnosed with SLE in 2000-2004. Non-SLE cohort consisted of 9656 adults without SLE, frequency- matched for age and sex and randomly selected from the same data set. Events of AMI were considered as outcome during the follow-up period between 2000 and 2008. Another nested cohort study of 6900 patients with AMI receiving cardiac surgeries was conducted to analyze the impact of SLE on post-AMI mortality. Results: During the follow-up period, there were 52 newly diagnosed AMI cases. The incidences of AMI for SLE cohort and non-SLE cohort were 2.10 and 0.49 per 1000 person-years, respectively, with an adjusted hazard ratio (HR) of 5.11 (95% confi dence interval [CI] 2.63-9.92). For females, the adjusted HR of AMI associated with SLE was as high as 6.28 (95% CI 2.67-14.7). Further analyses in the nested cohort showed SLE was signifi cantly associated with post-AMI mortality (odds ratio, 2.83; 95% CI 1.21- 6.64). Conclusions: Patients with SLE had higher risk of AMI compared with non-SLE control, and this risk was more signifi cant in females. In addition, SLE is an independent risk factor for post-AMI mortality.

      • The Korean Society of Gastroenterology & SIDDS 2037 : Slide Session ; S-LI-02 : Liver ; Postoperative Adverse Outcomes after Non-Hepatic Surgery in Patients with Liver Cirrhosis: A Nationwide Cohort Study

        ( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Postoperative adverse outcomes in patients with liver cirrhosis are not completely understood. This study evaluated the association between liver cirrhosisand adverse outcomes after non-hepatic surgery. Methods: Reimbursement claims were used to identify patients with preoperative liver cirrhosis who underwent non-hepatic surgery from 2004 to 2007. Control patients without cirrhosis were matched by age, sex, type of surgery and anaesthesia. The adjusted odds ratios (ORs) and 95% confi dence intervals (CI) of postoperative adverse events associated with liver cirrhosis were analysed by multivariable logistic regression. Results: Thirty-day mortality rates among 24282 patients with cirrhosis and 97128 control patients were 1.2% (299 deaths) and 0.7% (635 deaths), respectively. Liver cirrhosis was associated with postoperative 30-day mortality (OR 1.88, 95% CI 1.63- 2.16), acute renal failure (OR 1.52, 95% CI 1.34-1.74), septicaemia (OR 1.42, 95% CI 1.33-1.51) and intensive care unit admission (OR 1.39, 95% CI 1.33-1.45). Postoperative mortality increased in patients who had liver cirrhosis with viral hepatitis (OR 2.87, 95% CI 1.55-5.30), alcohol dependence syndrome (OR 3.74, 95% CI 2.64-5.31), jaundice (OR 5.47, 95% CI 3.77-7.93), ascites (OR 5.85, 95% CI 4.62-7.41), gastrointestinal haemorrhage (OR 3.01, 95% CI 2.33-3.90) and hepatic coma (OR 5.11, 95% CI 3.79-6.87). Conclusions: Patients with liver cirrhosis had increased mortality and complications after non-hepatic surgery, particularly those with cirrhosis-related clinical indicators.

      • Poster Session : PS 0145 ; Neurology : Stroke Risk and Outcomes in Patients with Epilepsy: Two Nationwide Studies

        ( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: The association between epilepsy and stroke was not completely understood. The purpose of this study is to investigate whether patients with epilepsy have an increased risk of stroke or post-stroke mortality. Methods: Using Taiwan`s National Health Insurance Research Database, we conducted a retrospective cohort study of 3,284 patients with new-diagnozed epilepsy and 13,136 persons without epilepsy between 2000 and 2004. The risk of stroke was compared between 2 cohorts through December 31, 2008. To investigate the association between in-hospital mortality after stroke and history of epilepsy, we conducted a case-control study of 135,220 hospitalized patients with newly diagnosed stroke between January 1, 2005, and December 31, 2008. The post-stroke in-hospital mortality and complications were compared between stroke patients with and without previous epilepsy. Results: The epilpesy cohort had an increased stroke risk (hazard ratio [HR] 2.18; 95% CI 1.87-2.54). Among patients with stroke, those with a history of epilepsy had a higher risk of post-stroke mortality compared withthose without epilepsy (odds ratio 1.26; 95% CI 1.17-1.36). Epilepsy was also associated with post-stroke pneumonia (odds ratio 1.52; 95% CI 1.44-1.62) and urinary tract infection (odds ratio 1.48; 95% CI 1.39- 1.56). The association between epilepsy and stroke risk remains signifi cant in every age group (20-39, 40-49, 50-59, 60-69, >=70) and both sexes. Conclusions: Epilepsy was associated with risk of stroke and post-stroke pneumonia, urinary tract infection and mortality. This research shows the importance of prevention, early recognition, and treatment of stroke in epileptic population.

      • Poster Session:PS 0001 ; Allergy : Postoperative Adverse Outcomes in Patients with Asthma: A Nationwide Population-Based Cohort Study

        ( Chien Chang Liao ),( Chao Shun Lin ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Limited information was available regarding the postoperative adverse outcomes among surgical patients with asthma in population-based study. The purpose of this study is to investigate postoperative major complications and mortality in surgical patients with asthma. Methods: Using reimbursement claims from the Taiwan National Health Insurance Research Database, we identifi ed 24,109 surgical patients with preoperative asthma and 24,109 non-asthma patients undergoing major surgeries using matching procedure with propensity score by sociodemographics, coexisting medical conditions and surgical characteristics. Adjusted odds ratios (ORs) and 95% confi dence intervals (CIs) of 30-day postoperative complications and mortality associated with asthma were analyzed in the multivariate logistic regressions. Results: Predisposing asthma increased postoperative pneumonia (OR, 1.48; 95% CI, 1.34-1.64), septicemia (OR, 1.11; 95% CI, 1.02-1.21), and urinary tract infection (OR, 1.17; 95% CI, 1.09-1.26). Preoperative emergency care for asthma was signifi cantly associated with postoperative 30-day in-hospital mortality, with an OR of 1.84 (95% CI, 1.11-3.04). Preoperative emergency service, hospitalizations, intensive care unit (ICU) admissions, and systemic use of corticosteroids for asthma were also associated with higher postoperative complication rates for asthmatic patients. Admission to intensive care unit for caring asthma preoperatively was associated with postoperative pneumonia (OR, 1.64; 95% CI, 1.37-1.97), septicemia (OR, 1.75; 95% CI, 1.50-2.05), urinary tract infection (OR, 1.85; 95% CI, 1.60-2.15) and mortality (OR, 1.88; 95% CI, 1.35- 2.62). Conclusions: Postoperative complications and 30-day mortality rates were significantly increased in asthmatic patients undergoing major surgeries. We suggest special attention and urgency revising the protocol of perioperative care for this specifi c population.

      • Adverse outcomes after non-thoracic surgery in patients with chronic obstructive pulmonary diseases

        ( Chien-chang Liao ),( Ta-liang Chen ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

        Background: The relationship between chronic obstructive pulmonary disease (COPD) and perioperative outcomes remains incompletely understood. Our purpose is to evaluate the features of postoperative adverse outcomes for geriatric surgical patients with COPD receiving non-thoracic surgeries. Methods: We conducted a nationwide study of 15359 COPD patients aged 65 years and older who received major non-thoracic surgeries in 2008-2013 from the Taiwan National Health Insurance Research Database. Comprehensive matching procedure with propensity score were used to select 15359 surgical patients without COPD for comparison. Major postoperative complications and 30-day in-hospital mortality were evaluated among patients with and without COPD by calculating adjusted odds ratios (ORs) and 95% CIs. Results: Patients with COPD had significantly increased risk for postoperative complications, including pneumonia (OR 90.3, 95% CI 60.3-135), septicemia (OR 3.11, 95% CI 2.82-3.43), acute renal failure (OR 2.53, 95% CI 2.11-3.02), pulmonary embolism (OR 2.74, 95% CI 1.52- 4.96), and 30-day postoperative mortality (adjusted OR 2.09, 95% CI 1.76-2.50), compared with surgical patients without COPD. Longer length of hospital stay and higher medical expenditures were also noted in COPD patients than those without COPD. Conclusions: Geriatric patients with COPD showed significantly higher postoperative adverse outcome rates with risk of 30-day mortality nearly twofold when compared with patients without COPD. Our findings remind surgical care team pay more attention to this specific population.

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