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The claims files contained comprehensive records of utilization of inpatient care, ambulatory care, pharmacy store, dental care and Chinese medicine, including date of service, ICD-9-CM diagnosis codes, claimed medical expenses and amount of co-payment for each encounter. At least 48 months enrollment from year 2002 to year 2005 was required to be included in this analysis, resulting in the final sample size of 147 892. An annual total cost was aggregated from all inpatient, outpatient and pharmacy store claims for every enrollee, including out-of-pocket claimed reimbursement, medication expenses and co-payments; expenses for dental care and Chinese medicine were excluded from this aggregation.