Please use this identifier to cite or link to this item: https://ah.nccu.edu.tw/handle/140.119/136857


Title: 以健保資料庫探討臺灣高齡人口第二型糖尿病與其併發症
Using National Health Insurance Database to Explore Taiwan Elderly’s Type II Diabetes and its Complications
Authors: 許育嘉
Shiu, Yu-Jia
Contributors: 楊曉文
余清祥

Yang, Sheau-Wen
Yue, Ching-Syang

許育嘉
Shiu, Yu-Jia
Keywords: 人口老化
第二型糖尿病
併發症
醫療利用
全民健保資料
Population Aging
Type 2 Diabetes
Complications
Health Care Utilization
National Health Insurance
Date: 2021
Issue Date: 2021-09-02 16:01:58 (UTC+8)
Abstract: 由於生活飲食習慣的改變,加上缺乏足夠的定期運動,國人罹患糖尿病的比例有越來越高的趨勢,尤其是佔比超過九成的第二型糖尿病,隨著年齡增加,罹病機率愈大。糖尿病患者屬於代謝症候群的一員,可視為健康的危險訊號,糖尿病患者通常容易罹患心血管疾病,死亡率也高於一般國民,近年我國代謝症候群相關死亡率甚至超過癌症,可謂可怕的隱形殺手,對國家發展、個人生活造成重大威脅。台灣糖尿病盛行率高於世界平均,尤其是高齡者情況更加嚴重,由於糖尿病屬於慢性疾病,需要長期治療及觀察,預計相關醫療支出及影響將隨著人口老化而加劇。有鑑於此,本文以第二型糖尿病為研究目標,推估第二型糖尿病病患及醫療利用的變化趨勢,提供政府及保險公司因應的參考。
本文以台灣高齡人口為研究對象,探討第二型糖尿病罹病趨勢與其併發症,並分析患者的門診、住院等醫療利用,使用全民健保資料庫的2005年百萬老年人抽樣資料,資料期間為2005~2013年。由於糖尿病至今仍無一致的認定標準,基於慢性病有持續就醫的需求,本文採用門診與住院紀錄作為判斷是否罹患糖尿病的標準。資料分析顯示第二型糖尿病高齡患者的盛行率與發生率皆逐年上升,而死亡率則呈現下降的趨勢;無論是門診或住院的醫療利用,糖尿病患者明顯高於非糖尿病患者,且糖尿病高齡患者的門診醫療使用在近年有上升趨勢。另外,本文亦探討第二型糖尿病併發症帶來的影響,發現心血管病變、洗腎、神經病變、眼部病變會增加第二型糖尿病高齡患者的門診次數,且患有洗腎需求的第二型糖尿病高齡患者其平均門診金額會大幅上升。
Due to the changes in dietary habits and the absence of sufficient physical activity, an increasing proportion of the population has become susceptible to diabetes, particularly type 2 diabetes, which accounts for over 90% of the disease, with increasing incidence with age. Diabetes is a member of the Metabolic Syndrome Family, regarded as a health risk signal. Patients with diabetes are commonly predisposed to cardiovascular diseases. They have a higher mortality rate when compared to the general population, which has even surpassed cancer in recent years, making it a formidable covert killer that poses a significant threat to national development and personal life. In Taiwan, the prevalence of diabetes exceeds the world average, particularly among the elderly. Furthermore, as diabetes is a chronic disease requiring long-term treatment and observation, it is expected that the related medical expenses and impacts would intensify as the population ages. In consideration of these factors, this study addresses type 2 diabetes to estimate the trend of the changing number of diabetic patients and their medical utilization in order to provide a reference for the government and insurance companies.
In this study, we analyzed the trend of type 2 diabetes and its complications among the Taiwanese elderly population, as well as the outpatient and inpatient medical utilization based on the National Health Insurance Database's 2005 population-based sample records of one million elderly people, covering the period between 2005 and 2013. Due to the fact that there are no consensus criteria for diabetes, this study considers outpatient records and inpatient records as a criterion for determining diabetes in view of the demand for continuous medical care for chronic diseases. The prevalence and incidence of type 2 diabetes in elderly patients have been increasing year after year, while mortality rates have been decreasing; the use of outpatient and inpatient medical care for diabetic patients were significantly higher than that for non-diabetic patients, while the utilization of outpatient medical care for diabetic elderly patients has been on the rise in recent years. In addition, this study also examined the impact of type 2 diabetes complications and found that cardiovascular diseases, renal and neuropathy, as well as ophthalmic pathologies increased the number of outpatient visits for elderly patients with type 2 diabetes, whereas the average amount of outpatient visits and costs for elderly patients with type 2 diabetes who require renal dialysis increased significantly.
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Description: 碩士
國立政治大學
風險管理與保險學系
106358013
Source URI: http://thesis.lib.nccu.edu.tw/record/#G0106358013
Data Type: thesis
Appears in Collections:[風險管理與保險學系 ] 學位論文

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