Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Psychiatry, School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Psychiatr Q. 2024 Jun;95(2):233-252. doi: 10.1007/s11126-024-10072-z. Epub 2024 Apr 19.
This study investigated the healthcare utilization and medical expenditure of type 2 diabetes mellitus (T2DM) patients with generalized anxiety disorder (GAD) and identified the associated factors. The healthcare utilization and expenditure of T2DM patients with (case group) and without (control group) GAD between 2002 and 2013 were examined using the population-based Taiwan National Health Insurance Research Database. Healthcare utilization included outpatient visits and hospitalization; health expenditure included outpatient, inpatient, and total medical expenditure. Moreover, nonpsychiatric healthcare utilization and medical expenditure were distinguished from total healthcare utilization and medical expenditure. The average healthcare utilization, including outpatient visits and hospitalization, was significantly higher for the case group than for the control group (total and nonpsychiatric). The results regarding differences in average outpatient expenditure (total and nonpsychiatric), inpatient expenditure (total and nonpsychiatric), and total expenditure (total and nonpsychiatric) between the case and control groups are inconsistent. Sex, age, income, comorbidities/complications, and the diabetes mellitus complication severity index were significantly associated with outpatient visits, medical expenditure, and hospitalization in the case group (total and nonpsychiatric). Greater knowledge of factors affecting healthcare utilization and expenditure in comorbid individuals may help healthcare providers intervene to improve patient management and possibly reduce the healthcare burden in the future.
本研究旨在探讨伴有广泛性焦虑障碍（GAD）的 2 型糖尿病（T2DM）患者的医疗保健利用情况和医疗支出，并确定相关因素。利用基于人群的台湾全民健康保险研究数据库，对 2002 年至 2013 年间患有（病例组）和不患有（对照组）GAD 的 T2DM 患者的医疗保健利用情况和支出进行了检查。医疗保健利用包括门诊就诊和住院治疗；医疗支出包括门诊、住院和总医疗支出。此外，还区分了非精神科保健利用和总医疗支出。病例组的平均医疗保健利用情况，包括门诊就诊和住院治疗，明显高于对照组（包括总医疗保健和非精神科医疗保健）。病例组和对照组之间的平均门诊支出（包括总支出和非精神科支出）、住院支出（包括总支出和非精神科支出）和总支出（包括总支出和非精神科支出）方面的差异结果不一致。性别、年龄、收入、合并症/并发症以及糖尿病并发症严重程度指数与病例组（包括总支出和非精神科支出）的门诊就诊、医疗支出和住院治疗显著相关。更深入地了解影响合并症患者医疗保健利用和支出的因素，可能有助于医疗保健提供者进行干预，以改善患者管理，并在未来可能减轻医疗保健负担。
