| Summary: | 碩士 === 長庚大學 === 醫務管理學系 === 103 === The prevalence of diabetes is increasing worldwide and has become an epidemic. This has increased health care costs and if the disease is not effectively controlled, then these costs will continue to increase. This study uses health care statistics from Taiwan’s National Health Insurance program from 1998–2013 by establishing a Markov model, which is based on the probability distribution for each health status for the estimation of transfer parameters for former and subsequent health statuses. The purpose of the research is to understand the factors that affect probability distribution for health status and if the transfer parameters change with increased aged. We use annual data along with age group as the periods for our Markov model. First, we use the ordinary least square method to estimate the transfer matrix, and then adjust the estimated parameters with the characteristics of diabetes and the definition of the Markov model. Then, we use a restricted least square method to estimate the transfer matrix and to establish diabetic health status development model.
The parameter estimation results showed the probability of a “normal” health status will be maintained decreases with age for men and women. Within the same age group, men were less likely to maintain a “normal” health status and have a higher mortality rate than women. The probability of maintaining “diabetes” as health status among the 55–59 years of age group or younger or in the 80–84 years of age group or older was not significantly different between genders. However, the probability that women in the 60–64 years of age and 75–79 years of age group maintained diabetes as a health status was higher than for men. In addition, the probability that diabetes led to death increased with age for either gender. In particular, there was a significant increase in the diabetes mortality rates at or above the 80–84 years of age group.
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