Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Institute of Population Health Sciences, National Health Research Institutes, Zhu-Nan, Taiwan.
J Formos Med Assoc. 2019 Nov;118 Suppl 2:S111-S121. doi: 10.1016/j.jfma.2019.08.010. Epub 2019 Oct 4.
BACKGROUND/PURPOSE: Diabetes mellitus (DM) prevalence has been rapidly increasing in Taiwan and globally. Team care for DM has been provided through diabetes shared-care networks in Taiwan more than 20 years.
The study analyzed the National Health Insurance (NHI) claims data from 2005 to 2014 to better understand diabetes care accountability and utilization in Taiwan.
The completion rate of annual check-ups for various metabolic measurements increased significantly, which indicates improvement in diabetes management quality. The average annual visits and drug cost for each patient increased enormously from 2005 to 2014. The annual number of outpatient department/inpatient department (OPD/IPD) patients with diabetes undergoing dialysis increased. The number of OPD visits in patients with diabetes was 1.9 times higher than that in all patients in general. IPD cost appeared to increase, whereas both drug cost and the average length of hospitalization per patient decreased. Endocrine and metabolic diseases were still the leading cause of OPD expenses. The leading cause of IPD expenses was respiratory diseases. An increasing trend was noted in the medical cost for patients with microvascular instead of macrovascular complications. OPD care for patients with diabetes was rather evenly distributed since 2009. Regarding IPD care, medical centers and regional hospitals each hospitalized 37% of the diabetic outpatients in 2014.
Accountability of diabetes care in Taiwan improved significantly till 2014. The ongoing fight against DM and tracing, examining and learning from the overall outcomes in future decades is still required.
背景/目的：糖尿病（DM）的患病率在台湾和全球范围内迅速上升。在台湾，通过糖尿病共享护理网络已经提供了超过 20 年的团队护理。
本研究分析了 2005 年至 2014 年的国家健康保险（NHI）理赔数据，以更好地了解台湾的糖尿病护理责任和利用情况。
各种代谢测量的年度检查完成率显著提高，这表明糖尿病管理质量有所改善。每位患者的平均年就诊次数和药物费用从 2005 年到 2014 年大幅增加。接受透析的糖尿病门诊/住院患者（OPD/IPD）的年人数增加。糖尿病患者的 OPD 就诊次数是一般患者的 1.9 倍。IPD 成本似乎增加了，而药物成本和每位患者的平均住院时间都有所下降。内分泌和代谢疾病仍然是 OPD 费用的主要原因。IPD 费用的主要原因是呼吸疾病。患有微血管而非大血管并发症的患者的医疗费用呈上升趋势。自 2009 年以来，糖尿病患者的 OPD 护理分布相当均匀。关于 IPD 护理，2014 年医疗中心和区域医院各收治了 37%的糖尿病门诊患者。
到 2014 年，台湾的糖尿病护理责任显著提高。未来几十年仍需要继续与糖尿病作斗争，并追踪、检查和学习整体结果。
