One More Brick On The Back Of Drowning National Health Care System

Taichung, Taiwan – Patients with diabetes mellitus (DM) have created 4.3 times more medical expenditures, accounting for 11.5% of the Taiwanese total health care cost, in 2001.

While patients with respiratory failure (RF) requiring mechanical ventilation (MV) are associated with significant economic burden (US$22,530 per year), DM was found to be the leading cause of further complications for patients with respiratory failure. Due to the increased requirement of MV and prolonged hospitalization among such a high-risk population, more effective strategies to better manage DM patients are warranted in response to the growing burdens on health care providers and the social  health system worldwide.

Researchers from China Medical University in Taiwan examined the impacts of comorbid diabetes mellitus on medical expenditures among patients with respiratory failure requiring medical ventilation under the implementation of single-payer national health care in Taiwan.

Under the National Health Insurance (NHI) in Taiwan, diabetic patients who are mechanically ventilated due to respiratory failure are more commonly male patients with more severe organ dysfunction.  Such patients consumed significantly more health care resources, with the greatest medical expenditure occurring at the ages of 18-29 years during 2004-2010.

One third of respiratory failure patients were diabetic, while more than three quarters of them were aged 60 years or above. These diabetic RF patients consumed more hospital medical expenditure for respiratory failure care (additional $1,119 versus $1,469) than those non-diabetic RF patients, regardless of discharge status.

“Diabetes is a comorbidity that significantly affects disease status and increases medical expenditures among mechanically ventilated patients due to respiratory failure,” said the study’s corresponding author, Dr. Hsiang-Wen Lin, RPh, MS, PhD, researcher of outcomes research and Associate Professor at the China Medical University’s College of Pharmacy. “Such profound economic burden warrants more aggressive effort to improve current diabetic care, to prevent patients from disease progression (e.g., respiratory failure) or hospitalization. Results from this study could help develop public health strategies to improve diabetes management and alleviate economic and social burdens of health care in our health system.”

The full study, “Economic Burden of Diabetes Mellitus on Respiratory Failure Patients Requiring Mechanical Ventilation during Hospitalizations” is published in Value in Health Regional Issues, Volume 3.


Value in Health Regional Issues (ISSN 2212-1099) is a scientific journal that encourages and enhances the science of pharmacoeconomic/health economic and health outcomes research and its use in health care decisions. The journal is published up to three times a year with one issue focusing on the Asia region, one issue focusing on the Latin America region, and one issue focusing on the Central & Eastern Europe, Western Asia and Africa regions.

The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is a nonprofit, international, educational and scientific organization that strives to increase the efficiency, effectiveness, and fairness of health care resource use to improve health.

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