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http://ir.nhri.org.tw/handle/3990099045/8483
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| Title: | Trend and factors associated with healthcare use and costs in type 2 diabetes mellitus: A decade experience of a universal health insurance program |
| Authors: | Cheng, JS;Tsai, WC;Lin, CL;Chen, L;Lang, HC;Hsieh, HM;Shin, SJ;Chen, T;Huang, CT;Hsu, CC |
| Contributors: | Division of Health Services and Preventive Medicine |
| Abstract: | BACKGROUND:: Little is known about how a universal National Health Insurance program with cost-containment strategies affect costs and quality of diabetes care. OBJECTIVES:: To examine the trends of healthcare use and costs for patients with type 2 diabetes mellitus (T2DM) in Taiwan over the last decade, and to identify factors associated with high healthcare cost and poor diabetes care. RESEARCH DESIGN:: We delineated the pattern of healthcare use and costs for T2DM in 2000-2010. Generalized linear and logistic regression models were used to identify factors associated with medical costs and diabetes care. SUBJECTS:: Representative adult T2DM patients and age-matched and sex-matched nondiabetes individuals were selected from the 2000, 2005, and 2010 National Health Insurance Research Databases. MEASURES:: Healthcare use included physician visits, hospital admissions, and antidiabetic drug prescriptions. Indicators of diabetes management included completeness of recommended diabetes tests and medication adherence, assessed using medication possession ratio. RESULTS:: The total healthcare cost per diabetes patient was approximately 2.8-fold higher than that for nondiabetes individual. The growth of healthcare cost per diabetes patient was significantly contained by about 3694 New Taiwan dollars (3.6%) between 2005 and 2010, but diabetes care improved over the decade. Diabetes duration, income, place of residence, continuity of care, and enrollment to a pay-for-performance program were associated with healthcare costs and diabetes management. Some public health measures implemented to support diabetes care were also discussed. CONCLUSIONS:: Healthcare costs could be controlled without sacrificing the quality of diabetes care by implementing pay-for-performance programs and effective health policies favorable for diabetes care. |
| Date: | 2015-02 |
| Relation: | Medical Care. 2015 Feb;53(2):116-124. |
| Link to: | http://dx.doi.org/10.1097/mlr.0000000000000288 |
| JIF/Ranking 2023: | http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0025-7079&DestApp=IC2JCR |
| Cited Times(WOS): | https://www.webofscience.com/wos/woscc/full-record/WOS:000349775000005 |
| Cited Times(Scopus): | http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84922059441 |
| Appears in Collections: | [許志成] 期刊論文
[陳麗光] 期刊論文
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| PUB25517075.pdf | | 405Kb | Adobe PDF | 416 | View/Open |
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