A Study on Quality Indicators of Medical Treatment in Diabetes Through Disclosure of Quality Information in National Health Insurance.

Autor: Wu, Ya-Fen, 吳雅芬
Rok vydání: 2015
Druh dokumentu: 學位論文 ; thesis
Popis: 103
Background: The population of average life expectancy continuously increase in Taiwan within the environmental factors of increasingly rich material life and decreasing daily physical activities, which leads the prevalence of diabetes has been increased every year, and hence, towards to vast healthcare costs. According to this phenomenon, the Bureau of National Health Insurance (transformed to National Health Insurance Administration, Ministry of Health and Welfare on July 23rd, 2013) began to implement “The Diabetes Medical Benefit Improvement Project of National Health Insurance” since November 2001. This project attempts to provide more payments to encourage the healthcare providers who have offered better quality of medical treatment among assigned process indicators. Objectives: The aim of this study is to investigate the healthcare quality indicators assigned in the project and evaluate the difference of performance in each indicator under different circumstance, and try to find out the factors which will affect the performance of these healthcare quality indicators from “The Diabetes Medical Benefit Improvement Project of National Health Insurance”, and to explore the factors that affect the execution rate on quality of the four indicators of diabetes. Methods: SPSS20.0 statistic software will be adapted to data management and analyze within collected information in this study, the study on quality indicators of medical treatment in diabetes through disclosure of quality information in National Health Insurance Administration, Ministry of Health and Welfare between 2008 and 2012. The study observed the changes of health care quality indicators in the five years base on one-year unit and observed samples cover all of Taiwan's diabetes. So called diabetes were the patients who diagnosed as diabetes in their major OPD and taking anti-diabetes medicine after the diagnosis. Results: The major findings in this study 1.For the demographic characteristics of diabetes patients, the number of diabetes patients has been increasing from 1,286,846 in 2008 to 1,538,565 in 2012, the ratio of patients distribution were 20% in medical centers, 27% in regional hospitals, 16% in area hospitals, and 37% in clinics. The patient number was from 216,975 in 2008 to 236,925 in 2012 with 8% growth in area hospitals which is the most non-significant growth among all compared to the significant growth in clinics and regional hospitals. The patient number was from 467,209 in 2008 to 570,188 in 2012 with 41% growth in clinics and from 338,911 in 2008 to 421,557in 2012 with 32% growth in regional hospitals. 2.The ratio of major injury with diabetes patients in different categories was also quite different, the highest rate was 19/33% in medical centers, the lowest rate was average of 8.04% in clinics. diabetes patients. 3.From the type of medical institute joined the project, there were 20 medical centers remained the same, more than 80 regional hospitals also maintained. For area hospitals, was from 365 in 2008 decreased to 345 in 2012. Only the number of clinics to join the project was increasing year by year, from 5,419 in 2008 rose to 6,051 in 2012. 4.The highest execution rate is checking glycated hemoglobin, the five-year average rate is 67.13%, the execution rate of fundus examination or fundus photography and urine microalbumin examination is relatively low around 18%. 5.As for the factors affecting the performance differences of diabetes quality indicators through analysis of variance and regression. We found the higher of patients’ average age, major injuries patients ratio, doctor number who joined this project, the better of medical quality index for diabetes patients. Conclusion: The overall execution rate of four quality indicators of diabetes is increasing yearly.
Databáze: Networked Digital Library of Theses & Dissertations
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