由於盛行率和發生率的逐年增加，糖尿病已成為現階段主要的公共衛生課題。因糖尿病患者常會伴隨相關併發症，包括大血管病變(如心臟血管疾病、腦血管疾病、週邊血管疾病)、微血管病變(如視網膜病變、腎臟病變)及末梢神經病變。依流行病學三段五級的觀念，如果未能透過有效的篩檢和完整的治療模式，許多民眾在未被正確診斷和適當治療的情況下，容易造成相關併發症的發生及社會成本的增加。
此研究希望能從嘉義地區一家區域教學醫院的一般門診及糖尿病專科門診對於糖尿病病人照護的數量、方式、責任和品質著眼來探討醫院內的糖尿病照護現況,並藉此一研究來了解與現行糖尿病照護標準的差異，依此可以改善照護的過程和品質，並且可以提供在機構內評量照護負責度和品質的測量方法，以做為品質改善計畫的參考。
本研究顯示專科照護以HbA1c、血糖、尿液平均年檢查次數而言比一般科的檢驗平均次數多，且在統計學上達顯著差異;在年度受檢比例上則顯示專科照護負責度的表現在HbA1c、血脂肪、血壓及尿液的年度檢查比例比一般科比例多，在統計學上達顯著差異，專科照護已達到美國國家的水平(PRP研究)，甚至超越(分別為99%Vs.87%; 73%Vs.47%; 94%Vs.92%; 68%Vs.54%)，一般科照護除了血壓方面(80.7%Vs.92%)接近先進國家的水平外，其餘項目皆需要多加補強。在眼睛、足部、神經檢查的比例在兩科皆低於建議標準；在腎臟、血脂的檢驗方面則尚可符合標準；在血壓、尿液的測量方面專科的照護是合於標準但在一般科對於尿液檢驗部份則有待加強。整體而言專科照護對於病人照護負責度的表現較優。
在醫療照護結果品質改善部分中，在實驗室檢查追蹤表上可見，HbAlc、膽固醇、腎功能(Cr.)控制在不良的範圍者以一般科較多，且有統計上之顯著差異；專科病患住院平均次數以及住院比例明顯較一般科少(0.14Vs.0.41次/年); 糖尿病護照發放使用也較一般科顯著良好(34.0%Vs.4.6%)。
醫院管理機構以及醫療人員對於糖尿病照護之負責度都應採用以證據為基礎的計劃，提高對糖尿病高品質照護的機會，像美國糖尿病協會已發展出一套臨床建議，可幫助每個地區取得一致性的照護負責度準則以及持續性的品質指標改善計劃。雖然負責度與照護品質不一定成正相關，但良好的負責度卻是照護品質不可缺少的要件。

第一章 前言
研究緣起與動機
第二章 研究目的
第三章 文獻探討
第一節 糖尿病的流行病學
第二節 醫療照護與慢性併發症的實証醫學相關研究
第三節 糖尿病的醫療照護標準
第四節 糖尿病負責度(ACCOUNTABILITY) 的定義
第五節 糖尿病照護有關負責度之發展
第六節 糖尿病照護品質與負責度表現之評量
第七節 糖尿病照護品質的評估研究
第四章 研究方法
第一節 研究架構
第二節 研究基本假設
第三節 研究對象資料來源及處理
第四節 研究變項與操作
第五節 統計及分析方法
第五章 研究結果
第六章 討論
第一節 研究限制
第二節 研究結果之討論
第七章 結論與建議
第八章 參考文獻
第九章 表格與圖表

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