Association between Personal Health Care Management and Health Care Utilization among Taiwanese Diabetes

Background: Previous studies demonstrated that adults with diabetes were more likely to report fair or poor health than people without diabetes. Self-rated health, although subjective assessment of health, is particularly important because evidence has shown that it was associated with subsequent health care utilization. From the health care management perspective, for people with diabetes it remains unclear whether (1) health promotion behaviors, such as not smoking, regular physical activity, and (2) health services management, such as retinopathy check-up, enhance self-rated health, and thereby reduce their health care utilization. Objective: The objectives of this study are shown as followed. First year: To investigate self-rated health status and its associated factors among Taiwanese diabetes. Moreover, we like to explore the impacts of health care management on self-rated health among Taiwanese diabetes. Second year: To examine the association between self-rated health status and health care utilization among Taiwanese diabetes. Moreover, we like to explore the impacts of health care management on health care utilization among Taiwanese diabetes. Method: This study will use theoretical model of health services utilization to examine the associations among health care management, self-rated health status, and health care utilization. The study population included participants in the National Health Interview Survey (NHIS) in Taiwan in 2001. Those individuals aged 18 and above with diabetes confirmed by physicians will be included in this study (n = 797). Of the potential participants, those who with claims data from the Bureau of National Health Insurance could be obtained from the claim data during 2002-2005, will be eligible for analysis in the present study. Statistical analysis: Summary distributions of the dependent variables and independent variables will be estimated. Logistic regression analysis will be performed to assess the association between self- rated positive health status and its associated factors. The odds ratios (OR) and 95% confidence interval (CI) of self- rated positive health status were performed. Poisson regression analysis will be used to estimate the parameters specified in the health care utilization model. The Multilevel modeling approach will be used.

Project ID:PF9801-1818
External Project ID:NSC97-2410-H182-009-MY2