A Study on Reducing Incidence Rates and Health-care Costs of Metabolic Syndrome in Taiwan

Taiwanese people are genetically prone to catch metabolic syndrome. The patient number is 2.89 millions now. It kills 4.93 people per hour, and 41,944 people each year，accounting for 29.0% of the total Taiwanese mortality. Each patient spends 31488 NT each year for it at least. Its treatment costs at least 91 billions NT, account for 14.5% of the total Taiwanese health-care cost. If one employee has to ask for a day to leave to the hospital each month, Taiwanese industries have to lose 19.8 billions NT each year.
The clinical course of metabolic syndrome can be improved by diet control and exercise for 45.5%. However, the Taiwanese people and the bureaus have not done their best, as the Japanese. There are many deficiencies in health checking items, population, frequencies, and health promotion mechanism.
The author finds that if the bureaus freely provide the 17,153,322 people aged from 20 to 79 with general health screening including all the 5 items for diagnosis of metabolic syndrome, each costs 700 NT, totally will costs 12,007,325,400 NT. It can detect 2,937,866 patients with metabolic syndrome。The bureaus can further use a 1000 NT-cost case-management follow-up system, totally cost 2,937,866,000 NT, to improve their lifestyles, it can maximally save the health-care fees up to 92,507,524,608 NT. The benefit to cost ratio of total screening plus prevention to save is 6.2. As the Japanese goal to decrease one quarter of the patient numbness, Taiwan can save health-care cost up to 22.75 billions NT, more than the total screening and prevention cost, or 989NT for each Taiwanese person.
To accomplish it, the author recommends the bureaus immediately 【1】include all the 5 items for diagnosis of metabolic syndrome in all health-checking; 【2】freely provide the people aged from 20 to 79 with the checking; 【3】re-design the pay programs with a minor administration fee for each contracted patient and a major values-based wedge for the improved ones; 【4】develop case manager system nationally;【5】 financially encourage the provides to establish patient groups to augment the patients’ behavior change and treatment results;【6】encourage the patients to manage their health by diminish his income tax if he can prove its effect;【7】A company’s fee to improve its employee’s health can be views as cost if it can prove its effect; 【8】use HDL as a single indicator .
In the long run, the author recommends the bureaus 【1】insist to do the right thing even the political resistance to change is huge;【2】improve the quality by reforming the health-care system to compensate the low NHE/GDP ratio;【3】enforce the education to build the people’s better behaviors and the thinking ability.