A retrospective observational population‐based study to assess the prevalence and burden of illness of type 2 diabetes with an estimated glomerular filtration rate < 90 mL/min/1.73 m² in Ontario, Canada

Abstract

Aim To better understand the healthcare burden of people with type 2 diabetes (T2D) and estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 in Ontario, Canada. Materials and Methods We used administrative data to evaluate the prevalence of T2D, eGFR < 90 mL/min/1.73 m2 and adverse cardiovascular co‐morbidities in individuals aged ≥ 30 years living in Ontario, Canada. We also examined incremental healthcare costs and healthcare resource utilization (HCRU) for these patients with specific incident cardiovascular and renal outcomes, in comparison with controls without these outcomes. Results While the prevalence of T2D in the general population aged ≥ 30 years in Ontario increased by 1.8% over a 5‐year period (2011‐2012 to 2015‐2016), the prevalence of eGFR < 90 mL/min/1.73 m2 among people with T2D increased by 35%. In comparison with corresponding controls without these outcomes, the per patient average total costs (Canadian dollars) over a 2‐year analysis period were higher for patients with cardiovascular disease/chronic kidney disease related death ($69 827; n = 32 407), doubling of serum creatinine ($52 260; n = 22 825), those who started dialysis ($150 627; n = 3499) or received a kidney transplant ($50 664; n = 651). Similarly, HCRU was significantly greater for patients with these incident outcomes. Conclusions This real‐world retrospective study highlights an increasing prevalence of T2D, eGFR < 90 mL/min/1.73 m2, and the substantially higher healthcare costs and HCRU when these patients have adverse cardiovascular and renal outcomes. The existence of such a large economic burden underpins the importance of preventing these diabetes‐related complications.

Humanistic and Economic Burden of Patients with Cardiorenal Metabolic Conditions: A Systematic Review

“…As shown in Fig. 1A, B, ten of the cost studies were conducted in the US [ 22 , 24 – 32 ], with one from Canada [ 33 ], Hong Kong [ 34 ], and Malaysia [ 35 ]. No European studies reported cost data; 9/10 US studies were retrospective cohort studies, with one Markov model study [ 31 ].…”

“…No European studies reported cost data; 9/10 US studies were retrospective cohort studies, with one Markov model study [ 31 ]. Similarly, eight of the HCRU studies were conducted in the US [ 21 , 22 , 27 , 29 – 31 , 36 , 37 ] with one from Canada [ 33 ]; four were from Europe (one from the UK [ 12 ] and Spain [ 38 ], and two from Sweden [ 39 , 40 ]); and one study involved multiple countries across Europe, Australia, and Asia [ 41 ] (Fig. 1 B).…”

Comparative Analysis of Burden of Topmost Disorders Requiring Rehabilitation Services – a Systematic Review and Meta-analysis

“…The low proportion of included studies compared to the total initial studies could be a reflection of the well-defined inclusion criteria based on the WHO criteria of GBD. The inclusion of several highquality studies in the review, [13][14][15][16][17][20][21][22][23][24][25][26][27][28][29]30,[34][35][36][50][51][52][53][78][79][80][98][99][100][101][111][112][113]119 would mean that the outcome of this review can be relied upon to make policies on rehabilitation in the selected conditions, especially the neurological conditions. A major observation is the very few high-quality publication on diarrhoea and low back pain.…”