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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 郭年真(Raymond N. Kuo) | |
dc.contributor.author | Shih-Yun Chen | en |
dc.contributor.author | 陳詩勻 | zh_TW |
dc.date.accessioned | 2021-06-15T16:20:43Z | - |
dc.date.available | 2025-12-31 | |
dc.date.copyright | 2015-09-14 | |
dc.date.issued | 2015 | |
dc.date.submitted | 2015-08-17 | |
dc.identifier.citation | 中文部分
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(2000). Higher incidence of diabetic nephropathy in type 2 than in type 1 diabetes in early-onset diabetes in Japan. Kidney International, 58(1), 302-311. doi: 10.1046/j.1523-1755.2000.00166.x Young, B. A., Lin, E., Von Korff, M., Simon, G., Ciechanowski, P., Ludman, E. J., . . . Katon, W. J. (2008). Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. American Journal of Managed Care, 14(1), 15-24. Young, G. J., Meterko, M., Beckman, H., Baker, E., White, B., Sautter, K. M., . . . Burgess, J. F. (2007). Effects of paying physicians based on their relative performance for quality. Journal of General Internal Medicine, 22(6), 872-876. doi: 10.1007/s11606-007-0185-5 Yu, T. H., Hou, Y. C., & Chung, K. P. (2014). Do low-income coronary artery bypass surgery patients have equal opportunity to access excellent quality of care and enjoy good outcome in Taiwan? Int J Equity Health, 13, 64. doi: 10.1186/s12939-014-0064-8 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/52621 | - |
dc.description.abstract | 研究背景:
糖尿病盛行率持續攀高,且其併發症對病患健康之危害深受重視。然而在全民健保制度下,糖尿病患是否仍存在健康不平等的情形,以及照護品質是否影響糖尿病併發症之發生,仍缺少實證研究之探討。 研究目的: 探討糖尿病患收入、職業類別以及發生糖尿病相關併發症之關係,以及探討糖尿病患之照護過程品質與發生糖尿病相關併發症之關係。 研究方法: 本研究採回溯性研究法,資料來源為國家衛生研究院之2010年百萬抽樣檔,使用2005~2007年新診斷之第二型糖尿病成人個案為對象(9,980人),觀察至2012年底,以Cox迴歸分析探討在控制病人特質後,社經地位(被保險人收入、職業類別)與照護過程品質變項(是否依照指引進行糖化血色素檢驗、空腹血脂、血糖、血清肌酸酐、血清麩胺酸丙酮酸轉氨基酶檢驗、眼睛、微量白蛋白檢查檢驗以及尿液分析之檢查),對糖尿病相關併發症之影響(包含視網膜病變、腎臟病變、神經病變、腦血管病變、心血管病變、周邊血管病變,以及代謝異常)。 研究結果: 在控制病人特性、社經地位與照護過程品質變項後,相較於多數人口(19,200~38,200元),低收入之病患,發生視網膜病變(HR=1.507, p=.013)的危險性高,而次高收入(38,200~63,800元),發生代謝異常的危險性較低(HR=0.348, p=.005);在職業類別方面,發生併發症的危險性無顯著差異。在照護過程品質方面,糖化血色素檢驗(HR=0.326~0.568)、空腹血脂檢驗(HR=0.378~0.865)與微量白蛋白檢驗(HR=0.096~0.745)之達成率越高,發生糖尿病相關併發症的危險性越低;而進行眼睛檢查(HR=1.368~14.299)與尿液分析(HR=1.447~2.472)的病人,發生糖尿病相關併發症的危險性較高,其可能與疾病嚴重程度有關。 結論: 糖尿病相關併發症的發生仍存在社經差異,且照護過程品質與併發症有關。如何透過政策健康的介入,消弭不同社經地位病患間的健康不平等,以及提供照護品質以及降低併發症的發生,是亟需重視之議題。 | zh_TW |
dc.description.provenance | Made available in DSpace on 2021-06-15T16:20:43Z (GMT). No. of bitstreams: 1 ntu-104-R02848014-1.pdf: 6202902 bytes, checksum: bbea02b0163cd4e5f6d32810baf0ea1d (MD5) Previous issue date: 2015 | en |
dc.description.tableofcontents | 致謝 i
摘要 ii Abstract iv 目次 vi 表次 viii 圖次 x 第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的 2 第二章 文獻探討 3 第一節 社會經濟地位 3 第二節 糖尿病相關併發症 9 第三節 糖尿病照護過程品質 19 第四節 相關研究之統計方法 28 第五節 小結 29 第三章 材料與方法 31 第一節 研究對象與資料來源 31 第二節 研究設計與架構 35 第三節 研究假說 37 第四節 研究變項與操作型定義 37 第五節 統計分析方法 44 第四章 研究結果 45 第一節 研究樣本特性 45 第二節 各變項之雙變項分析結果 54 第三節 各併發症之多變項存活分析結果 70 第五章 討論 89 第一節 研究結果討論 89 第二節 假說驗證 96 第三節 研究優點與限制 98 第六章 結論與建議 101 第一節 結論 101 第二節 建議 102 參考文獻 103 | |
dc.language.iso | zh-TW | |
dc.title | 糖尿病患之社經地位、照護過程品質與併發症風險之探討 | zh_TW |
dc.title | The association between socioeconomic status, process of care, and complications of diabetes patients. | en |
dc.type | Thesis | |
dc.date.schoolyear | 103-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 賴美淑(Mei-Shu Lai),陳楚杰(Chu-Chieh Chen) | |
dc.subject.keyword | 糖尿病,併發症,社經地位,照護過程品質,健康不平等, | zh_TW |
dc.subject.keyword | diabetes,complications,socioeconomic status,quality of process care,health inequity, | en |
dc.relation.page | 114 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2015-08-17 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 健康政策與管理研究所 | zh_TW |
顯示於系所單位: | 健康政策與管理研究所 |
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