Diabetes Shared Care Program (DSCP) and risk of infection mortality: a nationwide cohort study using administrative claims data in Taiwan
Autor: | David Hung-Tsang Yen, Chorng-Kuang How, Vivian Chia-Rong Hsieh, Jen-Huai Chiang, Cheng-Han Chen, Sheng-Hsiang Ma, Chia-Ming Chang, Sung-Yuan Hu, Ming-Shun Hsieh |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male medicine.medical_specialty Taiwan 030209 endocrinology & metabolism Type 2 diabetes Lower risk law.invention Insurance Claim Review Young Adult 03 medical and health sciences 0302 clinical medicine law Diabetes mellitus medicine Humans 030212 general & internal medicine Aged Retrospective Studies Diabetes Shared Care Program (DSCP) Shared care Delivery of Health Care Integrated business.industry Research Bacterial Infections General Medicine Middle Aged medicine.disease Intensive care unit infection Integrated care Hospitalization Diabetes and Endocrinology Diabetes Mellitus Type 2 Emergency medicine Cohort Female business Diabetic Angiopathies Program Evaluation Cohort study |
Zdroj: | BMJ Open |
ISSN: | 2044-6055 |
Popis: | ObjectiveThe Diabetes Shared Care Program (DSCP) is an integrated care model in Taiwan that has been proven to improve the care quality of patients with diabetes. We aimed to evaluate the efficacy of DSCP in decreasing the hospital mortality of infectious diseases.MethodsFrom 1 662 929 patients with type 2 diabetes newly diagnosed between 1999 and 2013, we retrieved a total of 919 patients who participated in the DSCP with the first hospitalisation for an infectious disease as the study cohort and 9190 propensity score-matched patients with type 2 diabetes who did not participate as the comparison.The efficacy of DSCP was evaluated via the following comparisons between the DSCP and non-DSCP cohorts: hospital mortality, 1-year medical cost prior to and during the hospitalisation, and complications, such as receiving mechanical ventilation and intensive care unit admission. The ratio (OR) for hospital mortality of the DSCP participants was calculated by logistical regression. Further stratification analyses were conducted to examine which group of patients with type 2 diabetes benefited the most from the DSCP during hospitalisation for infectious diseases.ResultsThe DSCP cohort had a lower hospital mortality rate than the non-DSCP participants (2.18% vs 4.82%, pConclusionParticipation in the DSCP was associated with a lower risk of hospital mortality for infectious diseases. |
Databáze: | OpenAIRE |
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