| Summary: | 碩士 === 長庚大學 === 醫務管理學研究所 === 92 === As the demography structure and the life style in Taiwan progressively change over the years, and the average life expectancy continuously increases, the national top ten causes of death have moved from the acute infectious diseases to chronic diseases. Diabetes mellitus, one of the most common chronic diseases among the residents in Taiwan, has various accompanied complications. If the disease has not been properly treated, and the conditions have not come to control, this may lead to the aspects of possible pathological alterations on renal, cardiovascular, and nerve systems. The diseases could even cause the incidents of amputation, and the symptoms of blindness and renal failure etc. As a matter of fact, diabetes has generated a higher social cost, and it compels patients to consume more medical resources. Thus, diabetes prevention and control will become vital for the future health policy and health insurance.
The samples selected from National Health Insurance Research Database of diabetic claimed data during 1996-2001, which were analyzed to give description on medical consumptions of patients with different pattern of medical needs in both outpatient department and inpatient department. Moreover, this research will also investigate from the aspects of patients’ characteristics and complications to direct the discussion on resource allocation and possible classification rule for disease management of diabetes patients in Taiwan.
The major findings of this thesis are listed as follows：
1.According to the analyses, the demands of health insurance among diabetes patients were increased markedly in all aspects such as outpatient department, inpatient department, and other medical resources during the 6-year study period.
2.As patients with diabetes have more complications, the more consumption of medical resources was observed. Among the study complications, cardiovascular diseases were found to share the largest amount of medical resources while endocrine disease being the smallest one.
3.Based on the statistical analyses for purposes of disease management, patients with diabetes in Taiwan have been classifiable to some distinguished complications, namely neurological symptoms, cardiovascular diseases, renal complications, endocrine complications, and other complications.
4.This thesis applied rules from concepts of diagnosis related group to come out with simple criteria for disease management of diabetes in Taiwan. That is to use certain characteristics of patients such as age and complications for prediction of total medical consumptions useful for future payment system and budgeting on preventive medicine.
As a result of diabetic medical consumptions shared a large proportion of total medical expenditure, the findings of this research provided different ways of thinking that resource allocation, cost containment, and preventive medicine can be integrated by efficient disease management. The study gives clues for future systems and policy making, the benefits derived from this study will be in preventive medicine, disease prognostic predictions, capitation, and diagnosis related group researches.
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