第六章 結果與建議
第二節 建議
一、預防糖尿病併發症的努力，常會忽略了病況及其治療對病患當前 生活品質的影響，本次研究有關口服降血糖藥物與規律運動對生 活品質影響有統計上意義，建議進一步糖尿病治療滿意度問卷調 查(Diabetes Treatment Satisfaction Questionnaire DTSQ)以了解糖 尿病對生活品質之影響是否與治療滿意度有直接相關。另可針對 本研究生活品質影響之調查加權分數負數高，負面影響大之生活 品質各項加以探討改善，如本研究以第五項性生活平均值-3.5 為 最高，代表性生活對糖尿病生活品質負面影響最大，可針對此進 一步探討以便在治療計畫擬定時做更周延的考量，改善糖尿病患 生活品質，使病人活的久也活的好。
二、本研究以有無參加糖尿病疾病管理生活品質及醫療服務利用影響 之差異為研究重點，建議未來可針對有無參加糖尿病疾病管理醫 療、衛教、管理三方面體系與糖尿病照護品質改善計畫（Diabetes Quality Improvement Project，DQIP）及糖尿病治療滿意度調查
（Diabetes Treatment Satisfaction Questionnaire，DTSQ）進一步 研究，以深入了解影響糖尿病生活品質及治療滿意度之相關因 素，協助病患及其家人適應糖尿病所帶來長期對生活品質影響與 挑戰。
三、『全民健康保險糖尿病醫療給付改善方案試辦計畫』之實施，對 參與糖尿病共同照護網之個案有一定的品質監測且初診、複診、
檢查亦有完整照護標準，透過醫療院所有效整合醫療團隊，提供 兼具連續性、完整性的照護服務，使參加疾病管理糖尿病患者得 到合宜的照護與有效的利用醫療資源，糖尿病照護團隊的照護品 質能與全民健保支付制度扣連，由付費者來推動，能有效的改變 醫療院所的照護行為，建議中央健康保險局可將此管理模式推展 到其他慢性病，使每位慢性病患皆可受到完整照護品質。
研究限制
一、研究對象對糖尿病生活品質影響調查之限制
糖尿病為慢性疾病，疾病管理需長期管理方可分析出管理上 的成效，本研究對象以參與糖尿病照護網滿一年完成初診、複診 兩次及年度總評為對象，在整個研究糖尿病對生活品質之影響雖 初見成效，但因為期限較短，無法實證推估是否因糖尿病疾病管 理所帶來的影響，可考慮進行長期連續性管理成效評估，並擴大 樣本數範圍，以增加研究結果之外推性。
二、醫療利用方面
(一) 醫療服務利用與醫療費用資料選取︰
本研究針對研究對象醫療服務利用及醫療費用資料庫分 析乃侷限某區域教學醫院之數據，又院外醫療利用就醫情況是 透過問卷調查由病患自行回答，在協助驗證上仍顯不足，對整 個醫療服務利用及醫療費用的推估上顯較薄弱。
(二) 本研究未將有無參與糖尿病疾病管理門診、急診、住院、用藥 情形及用藥費用醫療資源耗用情形如每日藥費、每次藥費、給 藥日數、用藥總費用等加以分析無法比較有無參與糖尿病疾病 管理用藥醫療資源耗用之差異，是否因參加糖尿病疾病管理而 減少用藥醫療資源之耗用。
三、本研究因時間較緊迫未進行糖尿病之疾病管理收案前之調查，以 作為疾病管理前後之分析比較，在評價整個參與與未參與糖尿病 照護網疾病管理成效，顯有不足之遺憾。
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