The Estimation and Application of the Morbidity Rates of Diabetes, Hyperlipidemia,and Hypertension

[[abstract]]我國自民國 82 年邁入高齡化社會以來，65 歲以上老年人口所占比例持續上升。根據衛生福利部表示，台灣有 75%的老年人罹患至少一種慢性病，且有一半以上的老年人同時罹患兩種或更多的慢性病，可以看出慢性疾病對老年人口健康的影響甚大。並且，由衛生署 2003 年公佈的十大死因資料，代謝症候群相關的死亡率占十大死因約 35.7％，且與三高有關的死亡比例高達 27％，可見三高疾病對國人的影響相當大。 本文採用全民健康保險資料庫2005年百萬抽樣歸人檔，探討國人之三高疾病，並計算其門診發生率、住院發生率等。我們使用Lee-Carter模型、Renshaw and Haberman模型與Age-Period-Cohort模型三種隨機模型配適醫療發生率，結果顯示三種模型配適效果均不錯，最後我們使用Lee-Carter模型進行發生率的預測並應用在終身醫療健康保險商品設計，提供給各保險公司參考。本文也計算糖尿病患者隨著患病時間增加併發其他慢性病的機率，亦可提供保險公司的核保及國人疾病預防之參考。 Taiwan has been an aging society since 1993, and the proportion of the elderly over the age of 65 is continuously rising. According to the statistics of the Ministry of Health and Welfare, there are 75% of Taiwan’s elderly person have at least one chronic disease and more than half of them have two or more chronic diseases at the same time. Among the ten leading causes of death announced by the Ministry of Health and Welfare in 2003, Metabolic syndrome-related mortality accounted for about 35.7%, and the Diabetes, Hyperlipidemia, Hypertension is 27%. It shows that the health of the elderly will be affected by chronic diseases. In this study, we calculate incidence rates, prevalence rates and hospitalization rates of Diabetes, Hyperlipidemia, Hypertension patients from 2003 to 2013.The data are from longitudinal health insurance database 2005 (LHID2005). We also used Lee-Carter, Renshaw and Haberman, and Age-Period-Cohort models to fit the morbidity rates and apply them to design a whole life medical policy.We also calculate the probability of diabetes mellitus patients getting other chronic diseases. It also provides the reference for insurance company's underwriting and disease prevention