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Echoing the advocates of deliberative methods sensitive to specific socio-political contexts, we designed the “civic groups forum” method and tested it in 2003 in Taiwan. Our goals were to design a participatory method that suited newly democratic countries and to engage people in discussing national health insurance premium reform in Taiwan. This innovative forum emphasized: (1) civic groups as the participants and (2) engaging a moderate number of participants. We combined and modified the methods of the consensus conference and deliberative polling to design the civic groups forum. Comprehensible reading materials, expert lectures, expert testimony, and group discussions were provided to enhance deliberative discussion of policy issues. A total of 74 group representatives from four types of civic groups—health care provider associations, labor unions, social welfare organizations, and patient organizations—participated. We conducted a before-and-after comparison to evaluate the method, using a self-administered questionnaire to collect data on participants' policy preferences, National Health Insurance policy literacy, comments, and socio-demographic characteristics. We also used in-depth interviews and participant observation to collect complementary information. After the forum, the social welfare and the patient organizations showed increased deliberation skills, empowerment, and confidence in policy involvement compared to the health care provider associations and the labor unions. We also found that when participants are civic group representatives, it is suitable to design an open-structured, early involvement, and participant-controlled format.

Summary Aims The purpose of this study was to perform a cross-sectional population-based study of hospitalised cases due to acute spinal trauma in Taiwan, based on information from the nationwide National Health Insurance (NHI) database. Methods To calculate the annual incidence of hospitalised acute spinal trauma, evaluate the distribution of neurological injury and its surgical intervention, and analyse the use of medical resources and related factors in Taiwan, the entire inpatient datasets were selected between 2000 and 2003 for use in the present study. Results There were 13,371, 13,800, 13,728 and 13,585 cases identified in 2000, 2001, 2002 and 2003, respectively, the average incidence of hospitalised acute spinal trauma in Taiwan was 61.61/100,000, and it was similar in both genders (rate ratio of male to female: 0.99). There was a significant trend of increased incidence with increasing age in both genders, particularly after the age of 60. The decreasing incidence rate ratios of neurological deficit to neurological intactness are 0.75, 0.58, 0.45, 0.26 and 0.16 in the age strata of 0–19, 20–39, 40–59, 60–79 and 80 or more years, respectively. In general, the operation rate is only 17.3% of all acute spinal injury cases, but it would be up to a significant 29.5% if the patients had spinal fractures with neurological insufficiency. There is an obvious decreasing trend of operation rate in spinal bony trauma with age, but a reverse trend is noted in the group with spinal nerve injury without spinal fracture. Finally, the enrolled subjects of acute spinal injuries spent $NT 43336.3 ± 80270.2 (equal to US$ 1313 ± 2432) and stayed for 8.5 ± 8.9 days in hospital. The above two variables of hospitalised medical utilisation are significantly different when considering gender, neurological status, and surgical intervention or not. Noticeably, if operative treatment for acute spinal injury is necessary, the LOS would increase by two times and the medical cost by six times. Conclusion In Taiwan, the annual incidence of hospitalised acute spinal injuries was higher but the direct cost was much lower. The characterisation of gender ratio, neurological condition, and surgical performance had been significantly effected by age.