Patient-Level Estimates of the Cost of Complications in Diabetes in a Managed-Care Population
| Autor: | Nirmala Sandhu, David K. McCulloch, Scott D. Ramsey, David K. Blough, Katherine M. Newton, Edward H. Wagner |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Adolescent Cost effectiveness Population Diabetes Complications Diabetes mellitus Diabetes Mellitus Humans Medicine education Stroke Aged Retrospective Studies Pharmacology education.field_of_study business.industry Health Policy Incidence (epidemiology) Managed Care Programs Age Factors Public Health Environmental and Occupational Health Type 2 Diabetes Mellitus Retrospective cohort study Middle Aged medicine.disease Diabetic foot Surgery Costs and Cost Analysis Female business |
| Zdroj: | PharmacoEconomics. 16:285-295 |
| ISSN: | 1170-7690 |
| DOI: | 10.2165/00019053-199916030-00005 |
| Popis: | Objective: To develop incidence-based estimates of the cost of several diabetes-related complications. Design and setting: This was a retrospective cohort study in a large health maintenance organisation. A total of 8905 patients with type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes mellitus and 36 520 age- and gender-matched controls without diabetes were observed from 1992 to 1995. Incidence rates of 6 major diabetes-related complications were computed for both populations. Annual health expenditures in the first and second year following diagnosis were computed for each complication. For comparison, annual costswere derived for individuals without diabetes or the complication of interest. Main outcome measures and results: Over 3 years of observation, incidence rates for the groups with and without diabetes were as follows: myocardial infarction 9.0 versus 3.2%; stroke 8.7 versus 3.8%; hypertension 26.2 versus 16.9%; end-stage renal disease 5.9 versus 1.4%; foot ulcer 7.9 versus 1.1%; and eye disease 44.3 versus 2.8%. Expressed as a multiple of the average annual cost of care for those without diabetes [$US3400/year (1995 dollars) for those over 65 years of age] and the related complication of interest, excess expenditures for those with diabetes were as follows for the first year following diagnosis: no complications 1.59; myocardial infarction 4.1; stroke 3.5; hypertension 2.56; end-stage renal disease 4.32; foot ulcer 4.0; and eye disease 2.46. For younger cohorts (less prevalent in the sample), incremental costs for each complication were generally greater than in the older group. Conclusions: The high incidences and costs may support the value of aggressive early intervention for patients with diabetes. These data will be useful for pharmacoeconomic modelling of the cost effectiveness of new and existing therapies for this condition. |
| Databáze: | OpenAIRE |
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