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使用中醫之台灣糖尿病患者醫療利用使用情形探討--以台灣全民健保資料庫進行六年之回溯性配對研究
Other Title
The effect of Chinese Medicine use on the utilization of medical services for diabetic patients in Taiwan: A 6 year retrospective propensity score matching study using National Health Insurance Research Database
Type
thesis
Date Issued
2015-06-24
Author(s)
史哪婷
Advisor
許 怡欣
Subjects
系所名稱：醫務管理學研究所
Description
學位別：碩士
語文別：英文
指導教授：許 怡欣
共同指導教授：
口試委員：施純全;邱瓊萱
中文關鍵字：糖尿病, 中醫, 台灣全民健保資料庫
英文關鍵字：Diabetes, Chinese Medicine, Taiwan National Health Insurance Research Database,
語文別：英文
指導教授：許 怡欣
共同指導教授：
口試委員：施純全;邱瓊萱
中文關鍵字：糖尿病, 中醫, 台灣全民健保資料庫
英文關鍵字：Diabetes, Chinese Medicine, Taiwan National Health Insurance Research Database,
Abstract
Introduction: Diabetes is a chronic global disease that is growing at an alarming rate. It leads to a decrease in quality of life, and has significant direct and indirect costs for individuals and governments alike.
With the use of alternative medicine growing worldwide, and Chinese medicine being a popular form adjuvant therapy, it is important for authorities to consider the role that these alternative medications can take as treatment options for diabetic patients. It has previously been seen that Chinese medicine has proven cost effect as well as effect for the disease outcomes for disease such as stroke, and asthma.
Aims: This study seeks to determine whether usage of Chinese medicine alongside western medicine will in any way affect the utilization of medical services by diabetic patients in terms of frequency of use of hospital and expenditure within various hospital departments.
Method: The Taiwan National Health Insurance Research database was used to select diabetic patients who had attended the doctor at least twice between 1st Jan 2004 and 31st Dec 2004. These patient were then divided according to their medical usage whether they used Chinese and western medicine or western medicine only. They were then followed over a 6 year period from 2005 to 2010.
Propensity score matching was carried out based on age, gender, medication usage and presence or absence of certain comorbid diseases. Their usage of and expenditure in the outpatient, emergency and inpatient departments was compared using independent t-Test.
Results/Conclusion: The study showed that patients who used Chinese medicine concurrently with their western medicine would have an increase in the number of visits to outpatient clinic, but a decrease in the number of inpatient visits when compared to those who use western medicine only. Chinese medicine usage was found to not have any significant effect on frequency of emergency department usage or expenditure when compared to that for patients who use only western medicine.
With the use of alternative medicine growing worldwide, and Chinese medicine being a popular form adjuvant therapy, it is important for authorities to consider the role that these alternative medications can take as treatment options for diabetic patients. It has previously been seen that Chinese medicine has proven cost effect as well as effect for the disease outcomes for disease such as stroke, and asthma.
Aims: This study seeks to determine whether usage of Chinese medicine alongside western medicine will in any way affect the utilization of medical services by diabetic patients in terms of frequency of use of hospital and expenditure within various hospital departments.
Method: The Taiwan National Health Insurance Research database was used to select diabetic patients who had attended the doctor at least twice between 1st Jan 2004 and 31st Dec 2004. These patient were then divided according to their medical usage whether they used Chinese and western medicine or western medicine only. They were then followed over a 6 year period from 2005 to 2010.
Propensity score matching was carried out based on age, gender, medication usage and presence or absence of certain comorbid diseases. Their usage of and expenditure in the outpatient, emergency and inpatient departments was compared using independent t-Test.
Results/Conclusion: The study showed that patients who used Chinese medicine concurrently with their western medicine would have an increase in the number of visits to outpatient clinic, but a decrease in the number of inpatient visits when compared to those who use western medicine only. Chinese medicine usage was found to not have any significant effect on frequency of emergency department usage or expenditure when compared to that for patients who use only western medicine.