title: Healthcare Utilization and Expenditures for Persons with Diabetes Comorbid with Mental Illnesses.
abstract: The aim of this study was to investigate healthcare utilization and expenditure for patients with diabetes comorbid with and without mental illnesses in Taiwan. People with diabetes comorbid with and without mental illnesses in 2000 were identified and followed up to 2004 to explore the healthcare utilization and expenditure. Healthcare utilization included outpatient visits and use of hospital inpatient services, and expenditure included outpatient, inpatient and total medical expenditure. General estimation equation models were used to explore the factors associated with outpatient visits and expenditure. To identify the factors associated with hospitalization, multiple logistic regressions were applied. The average number of annual outpatient visits of the patients with mental illnesses ranged from 37.01 to 41.91, and 28.83 to 31.79 times for the patients without mental illnesses from 2000 to 2004. The average annual total expenditure for patients with mental illnesses during this period ranged from NT$77,123-NT$90,790, and NT$60,793- NT$84,984 for those without mental illnesses. After controlling for covariates, the results indicated that gender, age, mental illness and time factor were associated with outpatient visits. Gender, age, and time factor were associated with total expenditure. Age and mental illness were associated with hospitalization in logistic regression. The healthcare utilization and expenditure for patients with mental illnesses was significantly higher than for patients without mental illnesses. The factors associated with healthcare utilization and expenditure included gender, age, mental illness and time trends.
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung, 807, Taiwan.
authors.forename: Chen-Hsiang
authors.initials: CH
authors.lastname: Su
authors.affiliation: Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung, 807, Taiwan.
authors.forename: Herng-Chia
authors.initials: HC
authors.lastname: Chiu
authors.affiliation: Department of Public Health, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung, 807, Taiwan.
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Hsieh
authors.affiliation: Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, 68, Zhonghua 3rd Road, Qianjin District, Kaohsiung, 801, Taiwan.
authors.forename: Ju-Yu
authors.initials: JY
authors.lastname: Yen
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung, 807, Taiwan.
authors.forename: Mei-Hsuan
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Division of Secretary, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung, 807, Taiwan.
authors.forename: Chih-Yi
authors.initials: CY
authors.lastname: Li
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung, 807, Taiwan.|Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung, 807, Taiwan.
authors.forename: Kao-Ping
authors.initials: KP
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung, 807, Taiwan. d810100@cc.kmu.edu.tw.|Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung, 807, Taiwan. d810100@cc.kmu.edu.tw.
authors.forename: Chun-Jen
authors.initials: CJ
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics* / Q000706:statistics & numerical data; D015897:Comorbidity; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000191:economics* / Q000453:epidemiology; D005260:Female; D005102:Health Expenditures; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D013624:Taiwan
keywords: Diabetes; Expenditure; Healthcare utilization; Mental illness