Costs of Temporary and Permanent Disability Induced by Diabetes

Olivera, Ercilia M; Duhalde, Esteban Péerez; Gagliardino, Juan José

doi:10.2337/diacare.14.7.593

Cited by 35 publications

(18 citation statements)

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“…Similar findings were reported other researchers in university employees in Argentina during 1984–1986, who reported retinal lesions as the most frequent cause of diabetes-induced disability and average work production loss per patient of 11 years [21]. …”

Section: Discussionsupporting

confidence: 90%

Survival rates and worker compensation expenses in a national cohort of Mexican workers with permanent occupational disability caused by diabetes

et al. 2016

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BackgroundPermanent occupational disability is one of the most severe consequences of diabetes that impedes the performance of usual working activities among economically active individuals. Survival rates and worker compensation expenses have not previously been examined among Mexican workers. We aimed to describe the worker compensation expenses derived from pension payments and also to examine the survival rates and characteristics associated with all-cause mortality, in a cohort of 34,014 Mexican workers with permanent occupational disability caused by diabetes during the years 2000–2013 at the Mexican Institute of Social Security.MethodsA cross-sectional analysis study was conducted using national administrative records data from the entire country, regarding permanent occupational disability medical certification, pension payment and vital status. Survival rates were estimated using the Kaplan–Meier method. Multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HR) and 95 % confidence intervals (95 % CI) in order to assess the cohort characteristics and all-cause mortality risk. Total expenses derived from pension payments for the period were accounted for in U.S. dollars (USD, 2013).ResultsThere were 12,917 deaths in 142,725.1 person-years. Median survival time was 7.26 years. After multivariate adjusted analysis, males (HR, 1.39; 95 % CI, 1.29–1.50), agricultural, forestry, and fishery workers (HR, 1.41; 95 % CI, 1.15–1.73) and renal complications (HR, 3.49; 95 % CI, 3.18–3.83) had the highest association with all-cause mortality. The all-period expenses derived from pension payments amounted to $777.78 million USD (2013), and showed a sustained increment: from $58.28 million USD in 2000 to $111.62 million USD in 2013 (percentage increase of 91.5 %).ConclusionsMexican workers with permanent occupational disability caused by diabetes had a median survival of 7.26 years, and those with renal complications showed the lowest survival in the cohort. Expenses derived from pension payments amounted to $ 777 million USD and showed an important increase from 2000 to 2013.

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Section: Discussionsupporting

confidence: 90%

Survival rates and worker compensation expenses in a national cohort of Mexican workers with permanent occupational disability caused by diabetes

et al. 2016

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“…1 Previous work has shown that unemployment is a particular problem for people with diabetes, 2,3 and in terms of health and social outcomes, this may have serious consequences. 4,5 Unemployment does not only mean loss of income but can also result in loss of social status for individuals, can affect personal attachments, and is associated with other factors such as poor diet and housing. 6 It has also been demonstrated that unemployment is a good marker of both material and social deprivation and is highly correlated with hospital admission rates.…”

Section: Introductionmentioning

confidence: 99%

Social deprivation and mortality in adults with diabetes mellitus

1998

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To investigate the relationship between measures of social deprivation and mortality in adults with diabetes, data from 2104 randomly selected adults (> 16 years of age) with Type 1 and Type 2 diabetes mellitus from 8 hospital out-patient departments were analysed. A total of 38% of subjects had Type 1 (diagnosed before the age of 36 years and treated with insulin), 55% were male and 85% Caucasian. During a follow-up period (mean (SD) of 8.4 (0.9) years), 293 (14%) of the subjects died, the most commonly recorded cause of death being cardiovascular disease. Duration adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated separately for Type 1 and Type 2 subjects. The mortality rates for men were higher than for women (Type 1: OR 1.27, CI 0.61-2.62; Type 2: OR 1.79, CI 1.27-2.52); were higher for those of lower vs higher social class (Type 1: OR 1.34, CI 0.61-2.96; Type 2: OR 2.0, CI 1.41-2.85); and were higher for those who left school before 16 years of age compared to those who left school at or after 16 years of age (Type 1: OR 3.98, CI 1.96-8.06; Type 2: OR 2.86, CI 1.93-4.25). Subjects who were unemployed had a higher mortality rate than those employed at the time of the study (Type 1: OR 3.10, CI 1.67-5.79; Type 2: OR 2.88, CI 2.12-3.91) and those living in council housing had a greater mortality than those who were living in other types of housing (Type 1: OR 2.57, CI 1.35-4.91, Type 2: OR 2.76, CI 2.05-3.73). Also for both Type 1 and Type 2 subjects mortality was significantly higher in those subjects who had a least one diabetic complication at baseline and reported one or more hospital admissions in the previous year and in Type 2 subjects with poor glycaemic control. After adjusting for duration of diabetes, hospital admissions, and the presence of diabetic complications, being unemployed, male, in poor glycaemic control (Type 2 only), and less educated were significant risk factors for mortality (p<0.001). These results suggest that there are important indicators of social deprivation which predict mortality over and above diabetic health status itself. Locally targeted action will be required if these inequalities in health experienced by people with diabetes are to be reduced.

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“…Improvement in diabetes control has the potential to reduce direct costs involved in the treatment of complications. [21] Strict glycemic and blood pressure control can reduce the incidence and slow the progression of DN. [22] Improvement in diabetes control, early diagnosis of DN, and treatment has the potential to reduce the direct cost involved in treatment of DN.…”

Section: Discussionmentioning

confidence: 99%

Pharmacoeconomic evaluation of diabetic nephropathic patients attending nephrology department in a tertiary care hospital

José

Jose

Devi

et al. 2017

Journal of Postgraduate Medicine

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Aims:To evaluate the cost of pharmacotherapy and its determinants in diabetic nephropathy (DN) in the nephrology department of a tertiary care hospital.Materials and Methods:A prospective observational study was conducted among adult patients visiting nephrology outpatient department (February–July 2015). Data on demography, investigations, and medications prescribed, direct cost and indirect costs were analyzed. We used Chi-squared test for categorical variables and multivariate linear regression analysis to identify determinants of cost of pharmacotherapy and total cost.Results:Of 100 patients, 50 were above 60 years and 75 were male. Ninety-seven patients had hypertension, which was the most common comorbidity. The majority (60 patients) belonged to Stage 5 DN and 59 patients were on dialysis. The mean number of drugs per patient was 7.60 ± 2.44. The total monthly cost per patient amounted to INR 24,203.27 with total direct cost of INR 21,013.90 (87%) and indirect cost of INR 3189.30 (13%). The monthly cost of dialysis and pharmacotherapy per patient were INR 9060.00 (37%) and INR 2535.98 (11%), respectively. Stage of DN (unstandardized coefficient, B = 7553.96, 95% confidence interval [CI] [6175.09–8932.82], P < 0.001) was a significant determinant of total cost. Number of drugs (B = 636.694, 95% CI [335.670–937.718], P < 0.001) and stage of DN (B = 852.986, 95% CI [297.043–1408.928], P = 0.003) were predictors of cost of pharmacotherapy.Conclusion:Stage of DN and number of drugs prescribed were major determinants of cost of pharmacotherapy.

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Costs of Temporary and Permanent Disability Induced by Diabetes

Cited by 35 publications

References 0 publications

Survival rates and worker compensation expenses in a national cohort of Mexican workers with permanent occupational disability caused by diabetes

Survival rates and worker compensation expenses in a national cohort of Mexican workers with permanent occupational disability caused by diabetes

Social deprivation and mortality in adults with diabetes mellitus

Pharmacoeconomic evaluation of diabetic nephropathic patients attending nephrology department in a tertiary care hospital

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