Comorbidities, quality of life and patients' willingness to pay for a cure for type 2 diabetes in Taiwan.
OBJECTIVE
Diabetes is one of the leading causes of death in Taiwan. However, to date,no study has investigated the patient profile in this country.Therefore,this study aimed to analyse health condition,health-related quality of life and associated financial burden of people with diabetes in Taiwan.


METHODS
A cross-sectional survey was conducted using face-to-face interviews with patients with diabetes aged 18 years and over from four hospitals in northern Taiwan. A hypothetical scenario was designed to ascertain subjects' willingness to pay for a cure for diabetes. Ethical approval and consent were obtained from the patients and hospital ethics boards.


METHODS
A double-bounded dichotomous contingent valuation method and maximum log- likelihood model were employed to evaluate the cost of the disease in Taiwan. Anchoring effect .EQ-5D was employed to assess patients' health-related quality of life.


RESULTS
The main comorbidities reported were hypertension(52.2%),cataract(34.3%)and loss of sight(24.3%).The total cost of disease borne by each patient with diabetes is US$3065.7 per year.The total cost of diabetes to society is approximately US$2.96 billion, equivalent to approximately 0.8% of the gross domestic product of Taiwan. The Bureau of National Health Insurance alleviates approximately one-third of the burden for patients.


CONCLUSIONS
The presence of specific comorbidities for patients with diabetes does not have a significant impact on their willingness to pay for a cure. However, body mass index, health- related quality of life and ability to decrease blood glucose level were significantly associated with willingness to pay. With ever-increasing health expenditures around the world,cost containment should start with preventive approaches. Health policies regarding the prevention of diabetes should focus on the promotion of life quality and fitness of the patients.
Chang
K
K
Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan, Republic of China. koyin@kchang.net
D000328:Adult; D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000191:economics / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000628:therapy; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013624:Taiwan