加入全民健保論值計酬計畫之糖尿病患者接受中西醫療法與照護結果之相關;A Study of the Relationship between the Chinese and Western Medicine and Outcome of Diabetic Care in Patients Admitted to Diabetes Mellitus Quality Improvement Program

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Title:	加入全民健保論值計酬計畫之糖尿病患者接受中西醫療法與照護結果之相關;A Study of the Relationship between the Chinese and Western Medicine and Outcome of Diabetic Care in Patients Admitted to Diabetes Mellitus Quality Improvement Program
Authors:	顏聖致;Sheng-Chih Yen
Contributors:	中國醫藥大學：中國醫學研究所碩士班
Keywords:	糖尿病;論質計酬計畫;合併中西醫治療;Diabetes Mellitus;quilty improvement program
Date:	2009-07-22
Issue Date:	2009-08-10 16:01:05 (UTC+8)
Abstract:	加入全民健保論值計酬計畫之糖尿病患者接受中西醫療法與照護結果之相關指導教授：林昭庚　教　授共同指導教授：李采娟　教授研究生：顏聖致中國醫藥大學中國醫學研究所中文摘要中央健康保險局於2001年起開始實施「全民健保糖尿病論質計酬計劃」，將糖尿病病患納入共同照護模式下管理，以病患照護的成效為健保局支付費用的依據。本文之研究目為探討加入論質計酬計劃之糖尿病病患選擇合併中西醫治療方式的影響因素，常使用的方劑，及探討合併中西醫治療與照護結果的相關性。本研究為單一族群回溯性追蹤研究，對象為在2001年11月01日到2003年05月20日加入論質計酬計劃中的糖尿病病患為研究對象。以患者加入此項試辦計畫時的各項狀態作為基準；在經過一年管理計畫後，記錄其照護結果。此外，根據安德森的健康行為模式作為研究架構，嘗試探討人口學因子、家族史和健康行為、糖尿病相關變項、共病、併發症與是否合併中西醫治療之間的相關性，再進一步探討上述所有變項與照護結果間的相關。本研究發現，有無合併中西醫治療的研究對象與其糖化血色素改變量無差異。但若進一步由複迴歸分析，則評估合併中西醫治療對於糖化血色素改變量之效果時，使用竹葉石膏湯的糖尿病患者之糖化血色素下降改變較大。反之，使用白虎湯比未曾使用此方劑的人之糖化血色素下降改變較小。關鍵字：糖尿病、論質計酬計畫、合併中西醫治療英文摘要 A Study of the Relationship between the Chinese and Western Medicine and Outcome of Diabetic Care in Patients Admitted to Diabetes Mellitus Quality Improvement Program Sheng-Chih Yen Abstract Diabetes mellitus quilty improvement program was launched in 2001, incorporating all patients into the program which maganged the medical care of patients. The purpose of this study is to discuss the factors that patients chose the intergrated Chinese and Western medicine, the frequently used prescriptions, and the outcome of the patients while used different medical care. The subjects were admitted to the program from 2001 to 2003. The baseline of their data was set up when they joined the program, while the endpoint of theirs was recorded after one-year period. The research fram, discussing the relationship between the Chinese and Western medicine and the outcome, is on the basis of the model of health behavior invented by R. M. Andersen. The findings of this paper shows the relationship between the HbA1c and the Chinese and Western medicne is not significant; however, patients who used Zhu-Ye Shi-Gao Tang got the larger decline of HbA1c compared with others, while patients using Bai-Hu Tang got the lower decline of HbA1c. Keywords: Diabetes Mellitus, quilty improvement program.
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