PMID- 25517075
OWN - NLM
STAT- MEDLINE
DCOM- 20150309
LR  - 20181202
IS  - 1537-1948 (Electronic)
IS  - 0025-7079 (Linking)
VI  - 53
IP  - 2
DP  - 2015 Feb
TI  - Trend and factors associated with healthcare use and costs in type 2 diabetes 
      mellitus: a decade experience of a universal health insurance program.
PG  - 116-24
LID - 10.1097/MLR.0000000000000288 [doi]
AB  - BACKGROUND: Little is known about how a universal National Health Insurance 
      program with cost-containment strategies affect costs and quality of diabetes 
      care. OBJECTIVES: To examine the trends of healthcare use and costs for patients 
      with type 2 diabetes mellitus (T2DM) in Taiwan over the last decade, and to 
      identify factors associated with high healthcare cost and poor diabetes care. 
      RESEARCH DESIGN: We delineated the pattern of healthcare use and costs for T2DM 
      in 2000-2010. Generalized linear and logistic regression models were used to 
      identify factors associated with medical costs and diabetes care. SUBJECTS: 
      Representative adult T2DM patients and age-matched and sex-matched nondiabetes 
      individuals were selected from the 2000, 2005, and 2010 National Health Insurance 
      Research Databases. MEASURES: Healthcare use included physician visits, hospital 
      admissions, and antidiabetic drug prescriptions. Indicators of diabetes 
      management included completeness of recommended diabetes tests and medication 
      adherence, assessed using medication possession ratio. RESULTS: The total 
      healthcare cost per diabetes patient was approximately 2.8-fold higher than that 
      for nondiabetes individual. The growth of healthcare cost per diabetes patient 
      was significantly contained by about 3694 New Taiwan dollars (3.6%) between 2005 
      and 2010, but diabetes care improved over the decade. Diabetes duration, income, 
      place of residence, continuity of care, and enrollment to a pay-for-performance 
      program were associated with healthcare costs and diabetes management. Some 
      public health measures implemented to support diabetes care were also discussed. 
      CONCLUSIONS: Healthcare costs could be controlled without sacrificing the quality 
      of diabetes care by implementing pay-for-performance programs and effective 
      health policies favorable for diabetes care.
FAU - Cheng, Jur-Shan
AU  - Cheng JS
AD  - *Clinical Informatics and Medical Statistics Research Center, College of 
      Medicine, Chang Gung University, Taoyuan daggerDepartment of Health Services 
      Administration, China Medical University, Taichung double daggerTaipei City Hospital Fuyou 
      Branch, Taipei  section signInstitute of Population Health Sciences, National Health Research 
      Institutes, Zhunan, Miaoli County  parallelInstitute of Hospital and Health Care 
      Administration, National Yang-Ming University, Taipei  paragraph signDepartment of Public 
      Health, Kaohsiung Medical University, Kaohsiung #Department of Internal Medicine, 
      Division of Endocrinology and Metabolism, Kaohsiung Medical University Hospital, 
      Kaohsiung, Taiwan **Department of Global Community Health and Behavioral 
      Sciences, School of Public Health and Tropical Medicine, Tulane University, New 
      Orleans, LA.
FAU - Tsai, Wen-Chen
AU  - Tsai WC
FAU - Lin, Chen-Li
AU  - Lin CL
FAU - Chen, Likwang
AU  - Chen L
FAU - Lang, Hui-Chu
AU  - Lang HC
FAU - Hsieh, Hui-Min
AU  - Hsieh HM
FAU - Shin, Shyi-Jang
AU  - Shin SJ
FAU - Chen, Ted
AU  - Chen T
FAU - Huang, Chi-Ting
AU  - Huang CT
FAU - Hsu, Chih-Cheng
AU  - Hsu CC
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Med Care
JT  - Medical care
JID - 0230027
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Diabetes Mellitus, Type 2/*economics/*therapy
MH  - Female
MH  - Health Care Costs/*trends
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - National Health Programs/*economics/statistics & numerical data/trends
MH  - Quality of Health Care/*economics
MH  - Reimbursement, Incentive/*economics
MH  - Taiwan
MH  - Young Adult
EDAT- 2014/12/18 06:00
MHDA- 2015/03/10 06:00
CRDT- 2014/12/18 06:00
PHST- 2014/12/18 06:00 [entrez]
PHST- 2014/12/18 06:00 [pubmed]
PHST- 2015/03/10 06:00 [medline]
AID - 10.1097/MLR.0000000000000288 [doi]
PST - ppublish
SO  - Med Care. 2015 Feb;53(2):116-24. doi: 10.1097/MLR.0000000000000288.