Objective:
To recognize the difference of patient care offered by primary care family physician, internist and generalist, according to the incidence rate of the acute complications, time to event interval of the chronic complications and the cost of OPD, admission and emergency care.
Method:
The first diagnosed diabetes patients were extracted from the National Health Insurance database, utilizing data from 2001 to 2007 to fit the criteria. Patients with catastrophic illness and who attended to the primary care clinic less than 20% of total OPD visits were excluded. The incidence rate of DM acute complications such as hypoglycemia, NKHS and DKA, and the time to event interval of DM chronic complications such as CAD, stroke, DM nephropathy, DM retinopathy, polyneuropathy and DM peripheral artery disease were investigated. Furthermore, the cost of OPD visit, emergency care and hospital admission was also evaluated.
Result:
The patients cared by primary care family physician tended to get hypoglycemia more frequently, but less likely to get hyperglycemic complications including both DKA and NKHS.The family physician did not recognize the large vessel complications well but can effectively control the diabetic neuropathy and diabetic nephropathy. Compare to those cared by internist, the patients cared by family physician have the lower expense on diabetic related OPD visit, but a little higher on emergency and admission. Totally, the patients cared by family physician have the lowest cost compared to internist and generalist, but without significant difference.
Conclusion:
The cost of OPD visit was significantly lower in patient cared by primary care family physician compared to internist without sacrifice the quality of care. Further study was necessary due to the limitation of the application of secondary database.
| Identifer | oai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0826111-152341 |
| Date | 26 August 2011 |
| Creators | Lin, Chi-wei |
| Contributors | Tsuen-Chiuan Tsai, Ying-Chun Li, Jiun-Ling Wang |
| Publisher | NSYSU |
| Source Sets | NSYSU Electronic Thesis and Dissertation Archive |
| Language | Cholon |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0826111-152341 |
| Rights | user_define, Copyright information available at source archive |
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