A Study of the Risk Analysis for Diabetes Mellitus Patients under Health Management

• Main Authors: CHANG, KO-YUN, 張可昀
• Other Authors: Shing-Her Juang
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/51739785623647348469

碩士 === 東吳大學 === 財務工程與精算數學系 === 104 === To further develop life insurance and health insurance policies for patients living with diabetes mellitus, this study discusses the outcomes associated with health management of the disease and healthcare utilization by the patient. On November 2001, the Bureau of National Health Insurance (BNHI) in Taiwan adapted a Pay-for-Performance program (P4P), which includes examination, inspection, health education, and tracking complete medical care services for those who have been diagnosed with diabetes mellitus. This program has been shown to assist patients with diabetes mellitus in deferring their associations with micro- and macrovascular complications. The National Health Insurance Research Database (NHIRD) randomly sampled the claims within the NHI database from 1996 to 2009. We separated the samples into three categories: P4P-program of health management, non-P4P-program of health management, and free style of health management. We then discussed the differences in outcomes within these three categories. The results indicated that those enrolled in the P4P-program of health management could experience a decrease in the mortality rate and healthcare utilization rate, as well as defer associations with micro- and macrovascular complications for 2–3 years. We believe that insurance companies could create new products for the aging population living with diabetes mellitus that would aid in maintaining a higher quality of health management. In particular, insurance commodities could include more diversified and competitive medical benefits. In this way, life insurance and health insurance products could be used as incentives for patients with diabetes mellitus to maintain proper health management, creating a situation that would benefit all involved parties.