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, 19 (1), 890

Effects of Health-Information-Based Diabetes Shared Care Program Participation on Preventable Hospitalizations in Taiwan

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Effects of Health-Information-Based Diabetes Shared Care Program Participation on Preventable Hospitalizations in Taiwan

Yia-Wun Liang et al. BMC Health Serv Res.

Abstract

Background: Taiwan's Diabetes Shared Care Program has been implemented since 2012, and the health information system plays a vital role in supporting most services of this program. However, little is known regarding the effectiveness of this information-based program. Therefore, this study investigated the effects of the participation of the Diabetes Shared Care Program on preventable hospitalizations.

Methods: This longitudinal study examined the data of health-care claims from 2011 to 2014 obtained from the diabetes mellitus health database. Patients with diabetes aged ≥18 years were included. Preventable hospitalizations were identified on the basis of prevention quality indicators developed for administrative data by the US Agency for Healthcare Research and Quality. A multilevel logistic regression was performed to examine the effects of the participation of the Diabetes Shared Care Program on preventable hospitalizations after adjustment for other variables. Analyses were conducted in late 2018.

Results: A medium level of participation (p = 0.05), age between 40 and 64 years(p < 0.0001), and absence of a catastrophic illness(p < 0.0001) were associated with a lower probability of having a preventable hospitalization. Male sex(p < 0.0001), age ≥ 65 years(p = 0.0203), low income level(p < 0.0001), living in the Southern division(p = 0.0106), and presence of many comorbidities(p < 0.0001) were associated with a higher probability of having a preventable hospitalization after adjustment for characteristics at the individual and county levels.

Conclusions: The health information system records patients' medical history, monitors quality of care, schedules patient follow-ups, and reminds case managers to provide timely health education. This health-information-based Diabetes Shared Care Program is associated with better quality care of ambulatory, so it should be promoted on a broader scale.

Keywords: Diabetes shared care program; Health information system; Participation; Preventable hospitalizations.

Conflict of interest statement

The authors declare that they have no competing interest. No financial disclosures were reported by the authors of this paper.

Figures

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Fig. 1
Time flow of the study

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References

    1. Health Promotion Administration. Statistical yearbook of health promotion 2016. Taiwan: The Health Promotion Administration Ministry of Health and Welfare; 2018.
    1. National Health Insurance Administration. The top 20 diseases of the National Health Insurance program expenditures. https://www.nhi.gov.tw/DL.aspx?sitessn=292&u=LzAwMS9VcGxvYWQvMjkyL3JlbGZpbGUvMC8yNjMxNi8yMDE35bm05ZyL5Lq65YWo5rCR5YGl5bq35L%2Bd6Zqq5bCx6Yar55a%2B55eF6LOH6KiKLTEwNzA5MDYucGRm&n=MjAxN%2BW5tOWci%2BS6uuWFqOawkeWBpeW6t%2BS%2FnemaquWwsemGq%2BeWvueXheizh%2Bioii0xMDcwOTA2LnBkZg%3D%3D&ico%20=.pdf. Accessed 5 Dec 2018.
    1. Tan EC, Pwu RF, Chen DR, et al. Is a diabetes pay-for-performance program cost-effective under the National Health Insurance in Taiwan? Qual Life Res. 2014;23:687–696. doi: 10.1007/s11136-013-0502-x. - DOI - PubMed
    1. National Health Insurance Administration, Ministry of Health and Welfare. 2016-2017 national health insurance annual report. Taiwan: National Health Insurance Administration, Ministry of Health and Welfare; 2018.
    1. Lee TT, Cheng SH, Chen CC, et al. A pay-for-performance program for diabetes care in Taiwan: a preliminary assessment. Am J Manag Care. 2010;16(1):65–69. - PubMed
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