Psychiatry Investig.
2017 Nov;14(6):770-778. 10.4306/pi.2017.14.6.770.
Health Care Utilization and Expenditures of Patients with Diabetes Comorbid with Depression Disorder: A National Population-Based Cohort Study
- Affiliations
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- 1Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- 2Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. chua.lin@msa.hinet.net
- 3Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
- 4Department of Healthcare Administration and Medical Informatics, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
- 5Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- 6Division of Secretary, Kaohsiung Medical University Hospital, Kaohsiung Medical, Kaohsiung, Taiwan.
- 7Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
- KMID: 2402403
- DOI: http://doi.org/10.4306/pi.2017.14.6.770
Abstract
OBJECTIVE
The study investigated to compare health care utilization and expenditures between diabetic patients with and without depression in Taiwan.
METHODS
Health care utilization and expenditure among diabetic patients with and without depression disorder during 2000 and 2004 were examined using Taiwan's population-based National Health Insurance claims database. Health care utilization included outpatient visits and the use of inpatient services, and health expenditures were outpatient, inpatient, and total medical expenditures. Moreover, general estimation equation models were used for analyzing the factors associated with outpatient visits and expenditures. Multiple logistic regression analysis was applied for identifying the factors associated with hospitalization.
RESULTS
The average annual outpatient visits and annual total medical expenditures in the study period were 44.23-52.20; NT$87,496-133,077 and 30.75-32.92; NT$64,411-80,955 for diabetic patients with and without depression. After adjustment for covariates, our results revealed that gender and complication were associated with out-patient visits. Moreover, the time factor was associated with the total medical expenditure, and residential urbanization and complication factors were associated with hospitalization.
CONCLUSION
Health care utilization and expenditures for diabetic patients with depression were significantly higher than those without depression. Sex, complications, time, and urbanization are the factors associated with health care utilization and expenditures.
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