糖尿病作为最常见的慢性疾病之一,疾病负担沉重。但我国糖尿病门诊保障整体尚不完善,对糖尿病管理的激励有限,不利于保障糖尿病患者的健康水平。我国台湾地区糖尿病照护模式已开展较长时间,可有效激励医护人员开展糖尿病管理。本文系统阐述该模式的实施细节,包括医疗服务提供方资质认证、患者入组与管理、按绩效付费考核指标等,为大陆地区完善糖尿病慢病管理与激励约束提供政策建议。
Abstract
As one of the most common chronic diseases, diabetes brings heavy burden to the whole society. However, the healthcare security of diabetes outpatient still need to be improved, and the incentives for diabetes management are limited, which is not conducive to guarantee the health of patients. Diabetes care mode in Taiwan Province has been developed for a long time, which can effectively motivate medical staffs to promote diabetes management. This article systematically elaborates the implementation details of the mode, including qualification certification of medical providers, patient enrollment and management, indicators of pay for performance, etc., in order to provide suggestions for the improvement of diabetes management in China's mainland.
关键词
台湾地区 /
糖尿病照护 /
按绩效付费
Key words
Taiwan Province /
diabetes care /
pay for performance
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参考文献
[1] Wang L, Gao P, Zhang M, et al.Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013[J]. JAMA, 2017, 317(24):2515-2523.
[2] 国家卫生健康委员会.中国卫生健康统计年鉴2020 [M]. 中国协和医科大学出版社, 2020.
[3] Department of Health, the Executive Yuan, ROC, Health and Vital Statistics, 1986-1998 Republic of China, Taipei, 1999.
[4] 黄萍. 上海和台湾糖尿病防治管理服务模式对比研究[J]. 中国全科医学, 2018, 21(26):5.
[5] Lee I-Te,Hsu Chih-Cheng,Sheu Wayne Huey-Herng,Su Shih-Li,Wu Yi-Ling,Lin Shih-Yi. Pay-for-performance for shared care of diabetes in Taiwan.[J]. Journal of the Formosan Medical Association = Taiwan yi zhi,2019,118 Suppl 2.
[6] Chiou S T, Lin H D, Yu N C, et al An initial assessment of the feasibility and effectiveness of implementing diabetes shared care system in Taiwan--some experiences from I-Lan County[J] Diabetes Research & Clinical Practice, 2001, 54(2):67-73.
[7] SHEEN Y J, KUNG P T, KUO W Y, et al.2018. Impact of the pay-for-performance program on lower extremity amputations in patients with diabetes in Taiwan[J]. Medicine (Baltimore), 97(41): e12759.
[8] PETERSEN L A, RAMOS K S, PIETZ K, et al.2017. Impact of a Pay-for-Performance Program on Care for Black Patients with Hypertension: Important Answers in the Era of the Affordable Care Act[J]. Health Serv Res, 52(3): 1138-1155.
[9] HSIEH H M, CHIU H C, LIN Y T, et al.2017. A diabetes pay-for-performance program and the competing causes of death among cancer survivors with type 2 diabetes in Taiwan[J]. Int J Qual Health Care, 29(4): 512-520.
[10] Kornelius E, Chiou J Y, Yang Y S, et al The Diabetes Shared Care Program and Risks of Cardiovascular Events in Type 2 Diabetes[J] American Journal of Medicine, 2015, 128(9):977-985e3.
[11] Holman R R, Paul S K, Bethel M A, et al 10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes[J] New England Journal of Medicine, 2008, 359(15):1577-1589.
[12] Tang PL, Yuan WL, Tseng HF Clinical follow-up study on diabetes patients participating in a health management plan[J] Journal of Nursing Research Jnr, 2005, 13(4):253-262.
