Economic Burden Of Type 2 Diabetes And Cost Savings Associated With The Hierarchical Medical System

[Purpose] Sustainable,comparative research of economic costs of pain is the basis for the implementation of health policy and planning.Diabetes prevalence increased in most regions of the world in recent years,and has not decreased in any region.Similarly,the prevalence of obesity has nearly doubled since 1980.Diabetes and its complications bring heavy economic burden to patients by increases in direct medical costs,labor loss,decrease of work time and quality of life.There is good evidence that type 2 diabetes can be prevented by adopting a healthy diet,engaging in regular physical activity and maintaining a normal body weight.Early diagnosis,which can be accomplished through relatively inexpensive blood testing,and appropriate treatment help to avoid complications.The research through the field research to calculate economic burden of diabetes mellitus in China in 2016,including the direct economic burden,indirect economic burden and intangible economic burden.The study explores the change of economic burden of type 2 diabetic patients on the influence of hierarchical medical system.Using incomplete information static game model,this study explores mitigation strategy of diabetic patients' economic burden.[Methods] Based on literature review analysis,this study sorted out the theories of economic costs of pain and forulated the technical solution,which helped to provide theoretical support for following research.Using field research,this study calculated economic burden of diabetes mellitus in China in 2016,including the direct economic burden,indirect economic burden and intangible economic burden.Using multiple linear regression method,we analyzed all the influence factors of hospitalization expenses.Two-factor variance analysis was used to analyze patients' out-of pocket cost at medical institutions with different levels.Using classification logistic regression model to explore the influence factors of patients' health.To systematically calculate the health-related quality of life(QOL)based on EQ-5D instrument for diabetic patient.Using incomplete information static game model,this study explores mitigation strategy of diabetic patients' economic burden.[Results](1)this is a serious situation that the economic burden of type 2 diabetes has increased over time in China,and in 2016,the cost reached 10848 yuan,6450 yuan in rural areas,15652 yuan in urban areas.The direct medical cost of type 2 diabetes is 7411 yuan,it is 2.5 times the national average.The RR of type 2 diabetes is 2.29,the economic risk of diabetic patients is higher than the healthy.(2)Unreasonable growth of medical costs aggravated the economic burden of diabetes patients.Both outpatient and inpatient costs have increased.(3)Population aging aggravated the economic burden of diabetes patients.Age is the main influence factors of medical costs,as the growth of the age,medical costs are increasing.(4)Disorderly medical-seeking aggravated the economic burden of diabetes patients.Research showed that 65% of people learn their developing diabetes after disease attack.Only 6% of the patients found disease through community medical examination.(5)Hierarchical medical system helps to reduce economic burden of type 2 diabetes.Case study shows that the medical costs is saved after the implementation of hierarchical medical system.88% of the patients think that the hierarchical medical system helped to save their medical expenses.(6)The hospital would like to transfer patients to community and patients are willing to go to the community to see the doctor,which is an optimal strategy for patients.With this strategy,the economic burden of patients is the smallest,and hospitals' income is the largest.[Conclusions](1)Promote hierarchical medical system and formulate orderly medical-seeking paterm.In terms of willingness,given the willingness of major hospitals to make patient referral down to primary level medical settings,the reform of traditional financial aid mode and the current pricing mechanism of medical services should be carried out at the same time;given the willingness of primary level medical settings to receive referral patients,special subsidies should be established and the gap of performance pay should be widened.(2)Ensure sufficient drug in grassroots medical institutions.Through the full investigation,reasonably determine the amount and type of drug at the grass-roots medical institution.(3)Attaches great importance to health management for the elderly population to achieve healthy ageing.Grass-roots medical institution should strengthen disease screening and early diagnosis and prevention and control work in elderly population.Increase the knowledge publicity of diabetes prevention and control and Optimize the medical insurance system.(4)Strengthen timely diagnosis and appropriate diabetes treatment in community medical institution.the primary health-care services required for early detection and management.(5)Strengthen the regulation of medical behavior,control unreasonable growth of medical expense.Promote the clinical pathway management.Deepen payment method reform.