Prevalence、Medical Utilization、Mortality and Related Factors of Diabetic Patients with Mental Illness

• Main Authors: Chun-Jen Huang, 黃俊仁
• Other Authors: Shing-Yaw Wang
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/35266224319284438585

博士 === 高雄醫學大學 === 醫學研究所 === 99 === Background and Objective: According to the world health organization’s survey, there are 171 million people with diabetes in 2000. The diabetic patients (DP) will increase to 366 million people in 2030. The comobility of diabetes would increase the medical utilization. Some of the comobility is the mental illness (MI), but there are few papers discussed about the direct and indirect cost of DP with MI. According to the world health organization’s survey, there are 3.2 million people died due to diabetes and complications in 2000. Most of the papers are discussed about the mortality of diabetes, and few are focus on the mortality of DP with MI. The purposes of the study are estimated the prevalence, medical utilization, mortality and related factors of DP with MI. Method: We use the National Insurance Research Database including 200 thousands people to conduct a retrospective longitudinal study from 2000 to 2004. We select DP, DP with MI, DP with depression disorder (DD) and DP with anxiety disorder (AD) from the database. After that we estimate the prevalence, medical utilization (outpatient use, outpatient expenditure, inpatient use, inpatient expenditure and total expenditure), mortality and related factors of them. Results: The prevalence of DP with MI (DD ; AD) during 2000 to 2004 is 19.69％-21.28％ (3.39％-3.90％; 11.80％-13.30％). The average annual outpatient use of DP with MI (DD; AD) during 2000 to 2004 is 41.56-46.89 (44.23-52.20; 42.81-50.37). The average annual outpatient expenditure of DP with MI (DD; AD) during 2000 to 2004 is NT $46,850-$59,910 (NT $50,693-$76,943; NT $46,446-$60,355). The average annual inpatient use of DP with MI (DD; AD) during 2000 to 2004 is 0.80-0.88 (0.93-1.02; 0.56-0.73). The average annual inpatient expenditure of DP with MI (DD; AD) during 2000 to 2004 is NT $30,272-$53,956 (NT $36,803-$56,134; NT $25,726-$32,426). The average annual total expenditure of DP with MI (DD; AD) during 2000 to 2004 is NT $77,123-$113,866 (NT $87,496-$133,077; NT $74,875-$92,781). The positive related factors of outpatient use in DP with MI (DD; AD) are age and character of illness (character of illness; age and character of illness), and the negative related factors is time (sex; time). The positive related factors of total expenditure in DP with MI (DD; AD) are sex, insurance amount, character of illness and time (time; insurance amount, character of illness and time). The positive related factors of admission in DP with MI (DD; AD) are insurance amount and character of illness (urbanization and character of illness; character of illness). The mortality is lower in DP with MI and DP with AD compared with DP without MI and DP without AD. There is no difference in mortality between the DP with DD and DP without DD. Conclusions: The prevalence of MI is higher in DP compared with non-DP. The medical utilization is higher in DP with MI compared with DP without MI. The related factors of medical utilization in DP with MI are sex, age, insurance amount, character of illness and time. The mortality is lower in DP with MI and DP with AD. The related factors of mortality are sex, age, urbanization, insurance amount and character of illness.