糖尿病醫療給付改善方案、照護過程品質與可避免住院之相關性探討

蔡茜如

doi:10.6342/NTU.2014.02265

3.232.96.22，Hello！

Close
Search Quick Search Advanced Search Publication Search	Personal Service Member Login Searching History Use Bonus Card SYMSKAN
Browse Browse by University of Graduate Thesis Browse by Pinyin of Graduate Thesis Browse by Conference Proceedings Topic Browse by Conference Proceedings Publisher Browse by Pinyin of Conference Proceedings Browse by eBook Category Browse by eBook Topic Browse by eBook Publisher
Customer Services Authorize Airiti Recommend a Journal

Search Symbol (Half-width)	Description of Search Symbols
Space	"AND" indicates the intertwining of key terms used in a search
Double Quotation Marks ("") ( " " )	Double quotation marks indicate the beginning and end of a phrase, and the search will only include terms that appear in the same order of those within the quotations. Example: "image process" ： " image process "
?	Indicates a variable letter. Entering two ? will indicate two variable letters, and so on. Example: "Appl?", search results will yield apple, apply… e , appl y … ( (often used to English word searches) )
*	Indicates an unlimited number of variable letters to follow, from 1~n. Example: Enter "appl*", search results will yield apple, apples, apply, applied, application…(often used in English word searches) e , appl es , appl y , appl ied , appl ication … ( (often used to English word searches) )
AND、OR、NOT	Boolean logic combinations of key words is a skill used to expand or refine search parameters. (1) AND (1) AND: Refines search parameters (2) OR (2) OR: Expands search parameters (3) NOT: Excludes irrelevant parameters

DOI stands for Digital Object Identifier （ D igital O bject I dentifier ） ,
and is the unique identifier for objects on the internet. It can be used to create persistent link and to cite articles.

Using DOI as a persistent link

To create a persistent link, add「http://dx.doi.org/」「 http://dx.doi.org/ 」 before a DOI.
For instance, if the DOI of an article is 10.5297/ser.1201.002 , you can link persistently to the article by entering the following link in your browser: http://dx.doi.org/ 10.5297/ser.1201.002 。
The DOI link will always direct you to the most updated article page no matter how the publisher changes the document's position, avoiding errors when engaging in important research.

Cite a document with DOI

When citing references, you should also cite the DOI if the article has one. If your citation guideline does not include DOIs, you may cite the DOI link.

DOIs allow accurate citations, improve academic contents connections, and allow users to gain better experience across different platforms. Currently, there are more than 70 million DOIs registered for academic contents. If you want to understand more about DOI, please visit airiti DOI Registration （ doi.airiti.com ）。

Data Source

Health & Medical Care > Health Promotion & Hygiene
College of Public Health > Graduate Institute of Health Policy and Management
Social Sciences > Politics

Bibliography Management Tool

Related Links

Report an Issue

Search in Library

Full-Text will be available on 2024/08/20 Authorization notice of subscription

糖尿病醫療給付改善方案、照護過程品質與可避免住院之相關性探討

Association Between A Pay-for-Performance Program, Process Quality and Avoidable Hospitalizations for Diabetes Care

蔡茜如 , Masters　　Advisor：鍾國彪　　

繁體中文 DOI： 10.6342/NTU.2014.02265

糖尿病論質計酬；照護過程品質；可避免住院；多層次分析； pay-for-performance ； process quality ； avoidable hospitalizations ； multilevel analysis

Abstract │ Reference (79) │ Times Cited (1) │ Altmetrics

Abstract 〈TOP〉

Parallel Abstract 〈TOP〉

Background: The diabetes-related complications can be prevented from getting worse by quality of ambulatory care and proper treatment. Therefore, more and more studies are using avoidable hospitalizations as the measurement to evaluate the quality and the accessibility of primary care. However, a number of studies have examined the impacts of pay for performance programs on the process quality and healthcare utilization, but little is known about the quality measurement of outcome.

Objective: The study aimed to examine the association between a pay-for-performance program, process quality and avoidable hospitalizations for diabetes care. And to examine the effect of cross-level interaction between patient-level and physician-level on process quality.

Methods: A longitudinal cohort study with 3-year follow-up. New-onset diabetes patient were selected in 2004-2005 form National Health Insurance Research Database. Using generalized estimating equations to examine the association between the pay-for-performance program, process quality and avoidable hospitalizations for diabetes care after adjustment for the characteristics of patients. Furthermore, to examine weather process quality may mediate the relationship between the pay-for-performance program and avoidable hospitalizations. Finally, by using multilevel analysis, to examine the effect of cross-level interaction between patient-level and physician-level on process quality.

Results: Patients who participated in the pay-for-performance program have a lower probability of avoidable hospitalizations and have a better process quality of care. The patients who had a better process quality of care may also have a lower probability of avoidable hospitalizations. Patients’ quality of care on process may be influenced by primary care physicians' gender, age, specialist and hospital. Primary care physicians' specialist and hospital also have cross-level interaction on participating in the pay-for-performance.

Conclusions: Participating in the pay-for-performance program is an effective way to improve the process quality and to reduce the probability of avoidable hospitalizations for diabetes care. Had a better process quality may also reduce the probability of avoidable hospitalizations. Patients’ quality of care on process may be influenced by primary care physicians' characteristics. In order to evaluate the effect of policy more deeply, further researches could quantify the severity of avoidable hospitalizations, like times, costs, etc.

Reference ( 79 ) 〈TOP〉

Agabiti, N., Pirani, M., Schifano, P., Cesaroni, G., Davoli, M., Bisanti, L., . . . Marinacci, C. (2009). Income level and chronic ambulatory care sensitive conditions in adults: a multicity population-based study in Italy. BMC public health, 9(1), 457.
連結：
Amer Diabet, A. (2013). Standards of Medical Care in Diabetes-2013. Diabetes Care, 36, S11-S66. doi: 10.2337/dc13-S011
連結：
Association, A. D. (2000). Standards of medical care for patients with diabetes mellitus. American Diabetes Association. Tenn Med, 93(11), 419-429.
連結：
Billings, J., Anderson, G. M., & Newman, L. S. (1996). Recent findings on preventable hospitalizations. Health Affairs, 15(3), 239-249. doi: 10.1377/hlthaff.15.3.239
連結：
Billings, J., Zeitel, L., Lukomnik, J., Carey, T. S., Blank, A. E., & Newman, L. (1993). Impact of socioeconomic status on hospital use in New York City. Health Aff (Millwood), 12(1), 162-173.
連結：

Times Cited (1) 〈TOP〉

莊媤戎(2017)。糖尿病照護可近性、過程與死亡率之相關性探討：區位研究。中國醫藥大學醫務管理學系碩士班學位論文。2017。1-80。

Altmetrics

〈TOP〉

E-mail ：

When an article is available to download, a notice will be sent to your mailbox address.

E-mail ：