糖尿病共同照護疾病管理對生活品質及醫療利用影響之研究─以某區域教學醫院為例; A Study on the Impact of the Diabetes Mellitus Disease Management on Quality of life and Utilization of Health Services - An Example of a Regional Teaching Hospital

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Title:	糖尿病共同照護疾病管理對生活品質及醫療利用影響之研究─以某區域教學醫院為例;A Study on the Impact of the Diabetes Mellitus Disease Management on Quality of life and Utilization of Health Services - An Example of a Regional Teaching Hospital
Authors:	李玉綉;Yuhshiow Lee
Contributors:	中國醫藥大學醫務管理研究所
Keywords:	糖尿病;糖尿病共同照護網;疾病管理;醫療利用;生活品質;Diabetes;diabetes shared care network;disease management;medical care utilization;quality of life (QoL)
Date:	1993
Issue Date:	2009-12-24 10:57:13 (UTC+8)
Abstract:	研究目的︰比較參與糖尿病疾病管理滿一年完成初診、複診兩次及年度複診之個案與未參與糖尿病疾病管理病患在生活品質之影響上與醫療利用上是否有顯著差異。研究方法︰有無參加糖尿病疾病管理之病患於門診就診時，採立意抽樣，面對面問卷訪談各250人，及資料庫分析92年一年間醫療利用情形。研究結果︰一、糖尿病對疾病管理生活品質之影響：有參加照護網比未參加照護網之病患因衛教對生活品質有較正確的認知，亦表示糖尿病對其生活品質負面影響較大。二、有參加疾病管理之病患醫療服務利用每人一年平均除住院費用低於未參加疾病管理外，其他門診、急診、住院次數、住院人日、門診費用均高於未參加疾病管理組，且於統計上有顯著差異。結論：本研究顯示有無參加糖尿病疾病管理對糖尿病生活品質影響及醫療利用均有顯著差異，有參加疾病管理醫療利用每人一年平均除住院費用外，其他各項均高於未參加疾病管理組，但有參加疾病管理組對生活品質有較正確認知，表示其負面影響較大，有無參加疾病管理對糖尿病生活品質項目加權負面影響分數最高為性生活，占第一順位，代表性生活對糖尿病生活品質負面影響最大，可針對此進一步探討，以便在擬定治療計畫時做更周延考量。建議對有無參加疾病管理對生活品質之影響與糖尿病照護品質改善計畫（DQIP）與糖尿病治療滿意度問卷調查（DTSQ）進一步研究，找出相關因素，以協助糖尿病患及其家人改善糖尿病帶來長期對生活品質影響與挑戰。; Objectives. To compare whether there was any significant difference in quality of life and medical care utilization between patients who participated one-year Diabetes Share Care Disease Management (DSCDM) program (including first diagnosis, two follow-up diagnoses and one annual final diagnosis) and patients who didn’t participate in the program. Methods. Purposive sampling and face-to-face in-depth interview were used. 250 patients participating in the DSCDM program and 250 patients without participating in the program were selected Respectively and the data concerning the medical utilization in Year 2003 were analyzed. Results. The influence of diabetes (DSCDM) on the patient’s quality of life: Comparing the patients who participated in the DSCDM program with the patients who didn’t participating in the program, the former had better understanding about the disease impact on quality of life and indicated the disease had negative influence on their quality of life. Pertaining to medical utilization, except “annual average inpatient expenditure”, the patients participating in the DSCDM program had more outpatient visits, emergency visits, inpatient visits, inpatient stays and outpatient expenditures than the patients without participating in the DSCDM program. Each result showed statistic significance. Discussion. The findings of this study showed that there were significant differences in quality of life and medical care utilization between the patients who participated in the DSCDM program and the patients who didn’t participate in the program. In general, those who participated in the DSCDM program had higher medical utilization, understood more about diabetes and felt more negative influence from diabetes. With the survey items been weighted, patients indicated “sex life” was negatively affected by diabetes the most. In view of this, further research on how to address these issues need to be conducted in order to enhance the effectiveness of the DSCDM program. The researcher suggested that more study should be carried out to identify the related factors between the DSCDM program and the patient’s satisfaction from diabetes-related treatments in order to help diabetics and their family cope with the negative impact on quality of life from the disease. Key Words.
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