Analysis And Cross-sectional Study On Diabetics With Medical Insurance

Objective: To collect baseline data of current status,prevention and therapy and disease burden of diabetics with medical insurance in China. To find risk factors and unsettled problems. To offer suggestions and reference for chronic disease management and medical insurance system construction.Methods: Questionnaire investigation. Total subjects 1704, including Beijing 612, Wuhan 489 and Guangzhou 593. Collect diabetics'related data from insurance institution and hospitals. Data checked and managed in Epidata 13.0, use SPSS13.0 for analysis. Main statistics in the thesis as follows: descriptive analysis,rank sum test,chi-square test and multiple regression analysis.Result:1. Male 666 account for 39.32%, female 1028 account for 60.68% respectively. Male average age 65.68士11.34, female average age 66.22士10.37. The ratio male/female is 0.65. Subjects whose age above 60 accounts for 71.77%.2. Education background: elementary graduates is 33.68%, primary middle school graduates is 37.73%, high middle school graduates is 20.78% and college graduates is 7.75%. Occupation: worker is 48.15%, staffer is 7.92%, teacher is 1.15% and others is 42.71%. Type of insurance: worker insurance is 81.01%, residents insurance is 9.32%, civil servant insurance is 0.59% and retiree insurance is 9.08%. 3. Average BMI value is 25.0±3.7. Smoker account for 15.82% and non-smoker is 84.18%. Drinker is 8.85% and non-drinker is 91.15%. Exerciser is 74.29% and non-exerciser is 25.6%. Dieter is 89.22% and non-dieter is 10.78%.4. About 26.71% subjects therapy in primary hospital, 40.04% in secondary hospital and 33.25% in third grade hospital. An average cost is 5794.34±4502.14 Yuan in primary hospital, 4680.08±5901.37 Yuan in secondary hospital and 7341.94±9597.64 Yuan in third grade hospital.5. The average value of fasting blood glucose is 12.8 mmol/L,postprandial blood glucose is 16.7 mmol/L,the surpass rate is 82.7% and 20.5% respectively. The average blood glucose monitor frequency is once a month.6. Complication proportion is 35%, non-complication proportion is 65%. Diabetics with one complication account for 22.4%, diabetics with two complications account for 8.63%, diabetics with three complications account for 2.64%, diabetics with four complications account for 1.17%, five or more than five complications account for 0.12%. Diabetics with complication cost about 3529.8 Yuan more than that without complication.7. Main medicine as follows: Metformin (29.3%), Acarbose (16%), Novolin (7.6%), Diamicron (5.1%) and insulin (4.7%).8. The average time going to hospital is 14.3 in 2007, 95%CI is (13.3,15.2). The average total cost is 6337 Yuan, including examine fee account for 11.90%, medicine fee account for 71.70%, therapy fee account for 10.41%, and other fee account for 2.70%. The average claim rate is 63%. Average family income is 3515±2581 Yuan, 95%CI(3392,3639). Average cost of diabetic's medicine in 2007is 4113±6181 Yuan.9. The costs influential factors including costs of diabetic's medicine, times to out-patient, complications, claim rate, occupation, hospital level and sex.10. Satisfaction rate of community health service is 92.9%. The rate of making use of community healthy service is 86.5%. Among primary hospitals, the rate of offering healthy education is 95.6%, the rate of offering healthy guidance is 93.8%, the rate of home service offering is 46.9% and the rate of Preferential treatment is 72.5%.11. The ratio of diabetics with insurance have commercial medical insurance or medical subsidy is about 10.3%.Conclusion:1. Female more than male, senior (older than 60 years) account for the majority.2. Average literature level of subjects is relatively low. The proportion of worker and work insurance is relatively large.3. The proportion of medicine cost account for the majority expenditure. Main medicines are Metformin, Acarbose, Novolin, Diamicron and insulin. This indicates that the key process for controlling costs is the medicine costs control.4. The frequency of blood monitoring is lower as expected. The majorities have a good lifestyle, however, BMI mean surpasses normal value and has a high abnormal blood glucose rate, these indicate behavior and medical control of blood glucose is skeptical.5. The proportion of diabetics who therapy in primary hospital is low, there's a large cost differences among hospitals different level.6. Main risk factors of medicine expenditure are complication, hospitalized times, medical cost, claim rate, hospital level, sex and occupation.7. The construction of community health system is successful. The area of commercial medical insurance and medical subsidies have a large developing space, just a small rate of diabetics with social medical insurance has either commercial insurance or medical subsidy.