以七年全民健保世代資料分析台灣地區糖尿病病患之用藥情形

Analysis of Diabetes Mellitus Patients Medication in Taiwan from 7 years Cohort Data of NHI

賴昭男(Chao-Nan Lai) ； 顏銘傭(Ming-Yung Yen) ； 高東煒(Tung-Wei Kao) ； 羅慶徽(Ching-Hui Loh) ； 方文輝(Saou-Hsing Liou) ； 周稚傑(Chih-Chieh Chou)

《中華職業醫學雜誌》 17卷1期 (2010/01) Pp. 45-58

https://doi.org/10.30027/CJOM.201001.0006

摘要

目標：日亦嚴重的糖尿病是最常見的慢性病之一，而且對醫療及社會資源的影響非常巨大。因此，本研究欲利用全民健保資料庫來了解現今台灣地區糖尿病用藥的情況並加以分析。
方法：本研究選取2000年至2006年全民健康保險資料庫之一百萬人系統抽樣歸人檔資料為主體，為二次資料分析。研究對象為糖尿病患，依相關之變項進行描述性分析，並進一步分析每年糖尿病患之用藥變化情形。
結果：台灣地區糖尿病之盛行率在2000年為百分之二點二，在2006盛行率已增加百分之為百分之四點三。其發生率以每年0.55%快速增加。處方開立用藥使用情形，sulfonylureas和biguanides一直高居前二名，TZD之用量上升快速，並於2003年後，超越insulin，排名第三。而從費用比例來看，糖尿病藥費佔所有糖尿病患藥費從2000年之35%上升至2006年之43%。其中TZD的上升更是快速，並於2003年後，超越biguanides，排名第二，但sulfonylureas仍是維持第一名。
結論：做為一個現代的醫師，應不斷的吸收新知、了解每種藥物的特性並對病人不同的狀況，做出最合宜的處方，並考量社會資源分配，才能真正造福病人。

關鍵字

糖尿病 ； 糖尿病藥物 ； 全民健康保險 ； 醫療資源

並列摘要

Objectives: Diabetes mellitus is one of the most common chronic diseases and it has a huge economic burden on the society. We still have a lot to improve in terms of the care we provide diabetic patients. This study explores the medication patterns of diabetes mellitus in Taiwan from the sampling cohort data of National Health Insurance.
Methods: The research data is a randomized, systemic sampling cohort data of one million beneficiaries for National Health Insurance (NHI) from 2000 to 2006. This is also a secondary data analysis. We performed descriptive and statistical analysis of the prescriptive frequency and cost of anti-diabetic agents.
Results: The prevalence of diabetes mellitus in Taiwan was 2.2% in 2000, and nearly doubled during this study period in Taiwan, which increased to 4.3% in 2006. The incidence of newly treated diabetes is more than 0.55% per year. The prescriptive frequency showed that sulfonylureas and biguanides were always the top two anti-diabetic medications. TZD rose fast, and it surmounted insulin, ranking third, after 2003. Considering the proportion of medical expenses, the proportional costs for anti-diabetic medicines increased from 35% in 2000 to 43% in 2006 for all medication cost of diabetic patients. The fast rising cost of TZD is surprising, and it surmounted biguanides, ranking second, after 2003. Sulfonylurea still maintains the first place.
Conclusions: Being a modern physician, every one should update medical knowledge frequently, understand characteristics of medicines, and consider the unique condition of each patient. Then, we can prescribe the most suitable treatments. In addition, we should also consider allocation of social resources to the most needed patients.

並列關鍵字

anti-diabetic agents ； diabetes mellitus ； health expenditure ； national health insurance