Exploring Variation in Outcome of Diabetic Nephropathy Care among Different Medical Specialties
| Autor: | Ting-Yi Wu, 吳亭儀 |
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| Rok vydání: | 2015 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 103 Background and purpose: Diabetes is one of the most important chronic diseases in the world. Additionally, diabetes is one of the leading causes of ESRD. In conclusion, diabetes cannot only worsen the condition of a patient with kidney diseases but also increase the patient’s mortality. However, as departments of hospitals becomes more specialized, each specialist may utilize different treatments. The purpose of this research is to examine the effect of various treatments utilized by different specialists on the development of Type 2 Diabetes Mellitus to Diabetic Nephropathy. Methods: This research is a secondary research. We obtained the data of diabetic patients from National Health Insurance Research Database. This research focused on patients who start suffering from Type 2 Diabetes Mellitus in 2004. We observed the effect of various treatments on the incidence of nephropathy seven years after the occurrence of diabetes. Results:(1) Most patients visit Medical Department (49.0%) while only 11.2% visit Endocrinology.9.6% of all the patients suffer from Diabetic Nephropathy, only 6.3% of them make an examination every year, and 30.8% of them take ACEI and ARB. (2) Patients who take ACEI and ARB medication and make more ACR inspections have a higher probability to suffer from diabetic nephropathy. Patients, who visit Endocrinology, make ACR inspections most constantly. Furthermore, patients from Medical Department take ACEI and ARB medication most constantly. Finally, patients who visit Endocrinology have the highest probability to suffer from diabetic nephropathy. Conclusion: Each specialist provides different treatments to patients. By providing educational and training programs to each specialist, it might reduce the difference of treatments given by each specialties and improve the quality of care. Additionally, it is very essential to make ACR examinations periodically for early detection and diagnosis. However, only few specialists require patients to make the examinations. Consequently, to reduce the chance for diabetic patients to undergo kidney dialysis, it should implement a policy that forces patients, who are predispose to nephropathy, to take the examination regularly. This research is to examine the outcome of incidence of nephropathy seven years after the occurrence of diabetes, it might couldn''t forecast completed. Finally, it is recommended to use longer time to examine the outcome of incidence of end-stage renal disease or taken hemodialysis as outcome. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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