Economic Burden in Chinese Patients with Diabetes Mellitus Using Electronic Insurance Claims Data

Huang, Yunyu; Vemer, Pepijn; Zhu, Jingjing; Postma, Maarten J.; Chen, Wen

doi:10.1371/journal.pone.0159297

Cited by 43 publications

(43 citation statements)

References 18 publications

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“…The primary driver (> 50%) of costs were drug costs, which was similar to our analysis [17]. Patients with diabetes were reported to have total annual medical costs of ¥19,600 and diabetes-related costs of ¥13,100, which was closely correlated with our estimated annual direct cost of ¥17,377 for FM patients [18].…”

Section: Discussionsupporting

confidence: 78%

Using a Physician Survey to Estimate the Economic Burden of Fibromyalgia in China

Furnback¹,

Chen²,

Li³

et al. 2020

Preprint

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Background: Fibromyalgia (FM) is a chronic pain disorder with a global prevalence estimated to be between 2 and 3%. In addition to the chronic pain incurred by patients, FM is commonly associated with comorbidities and complications such as depression, anxiety, and sleep disturbances. This study estimates the economic burden of patients with FM in China using a physician survey. Methods: A burden of illness model was constructed using a micro-costing approach to estimate the direct cost associated with FM patients in China. FM-related comorbidities of anxiety, depression, and sleep disturbance were included in the model. Treatment utilization and costs for FM and FM-related comorbidities were included as well as FM-related healthcare resource utilization (physician visits, hospitalizations, blood tests, and radiologic tests). FM treatments included nonsteroidal anti-inflammatory drugs, pregabalin, duloxetine, amitriptyline, tramadol, Chinese medicine, physiotherapy, and acupuncture. The model leveraged the results of a physician survey, which targeted 6 rheumatologists and pain experts each with 5-10 FM patients per month in China. All costs are presented in Renminbi (¥) using spot exchange rates as of May 1, 2020.Results: From the physician survey, the prevalence rate of FM in China was estimated to be 2.8% with 75.8% as female. The economic model estimated the annual per patient direct medical cost of FM to be ¥17,377. Within these costs, FM-medication and treatment costs (¥11,216), healthcare resource utilization (¥4,297), and costs for medications treating FM-related comorbidities (¥1,863) were the highest contributors. Healthcare resource utilization costs were driven by physician visits (¥2,787) followed by radiographic tests (¥808), blood tests (¥508), and hospitalizations (¥194). Conclusion: The prevalence and gender distribution of FM patients in China is similar to those of other countries. The economic model estimates patients with fibromyalgia in China to incur significant economic costs.

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Section: Discussionsupporting

confidence: 78%

Using a Physician Survey to Estimate the Economic Burden of Fibromyalgia in China

Furnback¹,

Chen²,

Li³

et al. 2020

Preprint

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“…Moreover, direct medical expenses for patients with diabetes and complications are higher than those of patients without complications, and they increase with increases in the number of complications [2,8]. From 2009 to 2011, there was an increasing trend in diabetes-related medical costs in China, from USD 1655 to USD 1857 [8]. Indirect medical costs, such as transportation, and loss in labor productivity due to health conditions can also be a huge financial burden on patients.…”

Section: Introductionmentioning

confidence: 99%

EQ-5D-3L Decrements by Diabetes Complications and Comorbidities in China

Zhang

Chen

et al. 2020

Diabetes Ther

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Introduction: Patients with type 2 diabetes have lower quality of life, which is further impaired by diabetes complications and comorbidities. This study aims to evaluate the impact of diabetes complications and comorbidities on EuroQol Five-Dimension Three-Level (EQ-5D-3L) scores among patients with type 2 diabetes with ongoing oral drug treatments in China. Methods: This retrospective cross-sectional analysis included 9570 patients with type 2 diabetes on oral drug treatments, who were enrolled from 75 hospitals in nine cities in China. Patient characteristics, including demographic data, health conditions, oral treatment history, and health insurance coverage, were collected through self-reported questionnaires. Health utility was measured by the EQ-5D-3L scale in the questionnaire and a Chinese version of the EQ-5D-3L scoring weights was applied in the analysis. The associations between complications and health utility were assessed using linear regression. Results: A total of 7081 patients with complete survey data were included in the analytic sample; 3479 (49.13%) patients were female. The mean age was 59.6 years old, with a standard deviation (SD) of 12.64. The average duration with type 2 diabetes was 7.91 (SD = 6.22) years. A total of 5189 (73.28%) patients reported complications. Hypertension (51.25%) and hyperlipidemia (28.90%) were the most common complications. Other complications reported by patients included cardiovascular disease, stroke, retinopathy, nephropathy, diabetic foot, and hypoglycemia. On average, each patient had 1.54 complications. All complications and comorbidities decreased the EQ-5D-3L score. Among patients with complications, the worst effect on EQ-5D-3L score was caused by diabetic foot, decreasing by 0.118 (p \ 0.001), followed by stroke (decreasing by 0.101, p \ 0.001) and nephropathy (decreasing by 0.058, p \ 0.001). Conclusion: The diabetes complications and comorbidities among patients with type 2 diabetes were associated with poor health utility scores, especially for those with diabetic foot, stroke, and nephropathy. Key Summary PointsSeventy-three percent of the Chinese patients with type 2 diabetes surveyed had at least one diabetes complication.Increased numbers of diabetes complications are associated with worse EQ-5D utility index and EQ-5D VAS score.Cardiovascular disease, stroke, retinopathy, nephropathy, diabetic foot, and symptomatic hypoglycemia event were associated with EQ-5D disutility of 0.007-0.118.Duration of type 2 diabetes for 10 years or longer had lower EQ-5D utility by 0.014.

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“…Although guidelines on data collection in registries exist, data quality varies, for example in the cancer registry 40. Researchers who have used the health insurance data indicated a lack of standardized, reliable, and systematic coding of diagnoses and prescriptions 64. China’s health care quality management and control systems need further improvement 12.…”

Section: Discussionmentioning

confidence: 99%

Chinese health care system and clinical epidemiology

Sun¹,

Gregersen²,

Yuan³

2017

CLEP

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China has gone through a comprehensive health care insurance reform since 2003 and achieved universal health insurance coverage in 2011. The new health care insurance system provides China with a huge opportunity for the development of health care and medical research when its rich medical resources are fully unfolded. In this study, we review the Chinese health care system and its implication for medical research, especially within clinical epidemiology. First, we briefly review the population register system, the distribution of the urban and rural population in China, and the development of the Chinese health care system after 1949. In the following sections, we describe the current Chinese health care delivery system and the current health insurance system. We then focus on the construction of the Chinese health information system as well as several existing registers and research projects on health data. Finally, we discuss the opportunities and challenges of the health care system in regard to clinical epidemiology research. China now has three main insurance schemes. The Urban Employee Basic Medical Insurance (UEBMI) covers urban employees and retired employees. The Urban Residence Basic Medical Insurance (URBMI) covers urban residents, including children, students, elderly people without previous employment, and unemployed people. The New Rural Cooperative Medical Scheme (NRCMS) covers rural residents. The Chinese Government has made efforts to build up health information data, including electronic medical records. The establishment of universal health care insurance with linkage to medical records will provide potentially huge research opportunities in the future. However, constructing a complete register system at a nationwide level is challenging. In the future, China will demand increased capacity of researchers and data managers, in particular within clinical epidemiology, to explore the rich resources.

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Economic Burden in Chinese Patients with Diabetes Mellitus Using Electronic Insurance Claims Data

Cited by 43 publications

References 18 publications

Using a Physician Survey to Estimate the Economic Burden of Fibromyalgia in China

Using a Physician Survey to Estimate the Economic Burden of Fibromyalgia in China

EQ-5D-3L Decrements by Diabetes Complications and Comorbidities in China

Chinese health care system and clinical epidemiology

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