Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Healthcare Administration and Medical Informatics, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
Gen Hosp Psychiatry. 2015 Jul-Aug;37(4):299-304. doi: 10.1016/j.genhosppsych.2015.04.008. Epub 2015 Apr 16.
The aim of this study was to investigate and compare health care utilization and expenditures between persons with diabetes comorbid with and without anxiety disorder in Taiwan.
Health care utilization and expenditures among persons with diabetes with and without comorbid anxiety disorder in the period 2000-2004 were examined using the Taiwan's National Health Insurance claims data. Health care utilization included outpatient visits and use of hospital inpatient services, while expenditures included outpatient, inpatient and total medical expenditures. General estimation equation (GEE) models were used to analyze the factors associated with outpatient visits and expenditures, and multiple logistic regression analysis was applied to identify factors associated with hospitalization.
In the study period, the average number of annual outpatient visits was 43.11-50.37 and 29.82-31.42 for persons with diabetes comorbid with anxiety disorder and for those without anxiety disorder, respectively. The average annual total expenditure was NT$74,875-92,781 and NT$63,764-81,667, respectively. Controlling for covariates, the GEE models revealed that age and time were associated with outpatient visits. Income and time factor were associated with total expenditure.
Health care utilization and expenditures for persons with diabetes with comorbid anxiety disorder are significantly higher than those without anxiety disorder. The factors associated with health care utilization and expenditures are age, income and time.
本研究旨在调查和比较台湾地区合并和不合并焦虑障碍的糖尿病患者的医疗保健利用情况和支出。
使用台湾全民健康保险理赔数据，对 2000-2004 年期间合并和不合并焦虑障碍的糖尿病患者的医疗保健利用情况和支出进行了研究。医疗保健利用包括门诊就诊和住院服务的使用，而支出包括门诊、住院和总医疗支出。采用广义估计方程（GEE）模型分析与门诊就诊和支出相关的因素，并应用多因素逻辑回归分析确定与住院相关的因素。
在研究期间，合并焦虑障碍的糖尿病患者的年平均门诊就诊次数为 43.11-50.37 次，而不合并焦虑障碍的糖尿病患者的年平均门诊就诊次数为 29.82-31.42 次。合并焦虑障碍的糖尿病患者的年平均总支出为新台币 74875-92781 元，而不合并焦虑障碍的糖尿病患者的年平均总支出为新台币 63764-81667 元。在控制了协变量后，GEE 模型显示年龄和时间与门诊就诊次数有关。收入和时间因素与总支出有关。
合并焦虑障碍的糖尿病患者的医疗保健利用和支出明显高于不合并焦虑障碍的患者。与医疗保健利用和支出相关的因素是年龄、收入和时间。
