Excess costs of medical care 1 and 8 years after diagnosis of diabetes: estimates from young and middle-aged incidence cohorts in Sweden

Jonsson, Pia Maria; Marké, Lars-Åke; Nyström, Lennarth; Wall, Stig; Östman, Jan

doi:10.1016/s0168-8227(00)00161-3

Cited by 21 publications

(25 citation statements)

References 18 publications

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“…Correspondingly, US studies place the cost ratio of elderly diabetic patients well below that of young diabetic patients [1]. In a Swedish study, which included only young or middle-aged subjects, the cost ratio was 4.8 [21].…”

Section: Discussionmentioning

confidence: 99%

The cost burden of diabetes mellitus: the evidence from Germany—the CoDiM Study

et al. 2006

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Section: Discussionmentioning

confidence: 99%

The cost burden of diabetes mellitus: the evidence from Germany—the CoDiM Study

et al. 2006

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“…According to Bjork (13), three times the health care resources were being spent on diabetes complications than on diabetes control. Jö nsson et al (14) made an important observation that young adults diagnosed with diabetes between ages 15 and 34 years spent larger amounts on diabetes care, which decreased in subsequent years. A second phase of high cost might result with the onset of complications.…”

Section: Statistical Analysesmentioning

confidence: 99%

Increasing Expenditure on Health Care Incurred by Diabetic Subjects in a Developing Country

et al. 2007

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OBJECTIVE— This study aimed to assess the direct cost incurred by diabetic subjects who were in different income groups in urban and rural India, as well as to examine the changing trends of costs in the urban setting from 1998 to 2005. RESEARCH DESIGN AND METHODS— A total of 556 diabetic subjects from various urban and rural regions of seven Indian states were enrolled. A brief uniform coded questionnaire (24 items) on direct cost was used. RESULTS— Annual family income was higher in urban subjects (rupees [Rs] 100,000 or $2,273) than in the rural subjects (Rs 36,000 or $818) (P < 0.001). Total median expenditure on health care was Rs 10,000 ($227) in urban and Rs 6,260 ($142) in rural (P < 0.001) subjects. Treatment costs increased with duration of diabetes, presence of complications, hospitalization, surgery, insulin therapy, and urban setting. Lower-income groups spent a higher proportion of their income on diabetes care (urban poor 34% and rural poor 27%). After accounting for inflation, a secular increase of 113% was observed in the total expenses between 1998 and 2005 in the urban population. The highest increase in percentage of household income devoted to diabetes care was in the lowest economic group (34% of income in 1998 vs. 24.5% in 2005) (P < 0.01). There was a significant improvement in urban subjects in medical reimbursement from 2% (1998) to 21.3% (2005). CONCLUSIONS— Urban and rural diabetic subjects spend a large percentage of income on diabetes management. The economic burden on urban families in developing countries is rising, and the total direct cost has doubled from 1998 to 2005.

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“…Many studies have described the economic impact diabetes has on the health system and society (3)(4)(5)(6) and have compared the health care utilization of patients with and without diabetes (7)(8)(9)(10). Only a few studies have assessed the relationship between patient characteristics, complications, and costs using patientlevel data (11)(12)(13)(14)(15)(16) and most have examined the relationship for aggregated end points (12,13,15,16).…”

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confidence: 99%

The Direct Medical Cost of Type 2 Diabetes

et al. 2003

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OBJECTIVE -To describe the direct medical costs associated with type 2 diabetes, as well as its treatments, complications, and comorbidities.RESEARCH DESIGN AND METHODS -We studied a random sample of 1,364 subjects with type 2 diabetes who were members of a Michigan health maintenance organization. Demographic characteristics, duration of diabetes, diabetes treatments, glycemic control, complications, and comorbidities were assessed by surveys and medical chart reviews. Annual resource utilization and costs were assessed using health insurance claims. The log-transformed annual direct medical costs were fitted by multiple linear regression to indicator variables for demographics, treatments, glycemic control, complications, and comorbidities.RESULTS -The median annual direct medical costs for subjects with diet-controlled type 2 diabetes, BMI 30 kg/m 2 , and no microvascular, neuropathic, or cardiovascular complications were $1,700 for white men and $2,100 for white women. A 10-kg/m 2 increase in BMI, treatment with oral antidiabetic or antihypertensive agents, diabetic kidney disease, cerebrovascular disease, and peripheral vascular disease were each associated with 10 -30% increases in cost. Insulin treatment, angina, and MI were each associated with 60 -90% increases in cost. Dialysis was associated with an 11-fold increase in cost. T he worldwide prevalence of diabetes is increasing (1), as is the demand for and cost of medical care (2). Many studies have described the economic impact diabetes has on the health system and society (3-6) and have compared the health care utilization of patients with and without diabetes (7-10). Only a few studies have assessed the relationship between patient characteristics, complications, and costs using patientlevel data (11-16) and most have examined the relationship for aggregated end points (12,13,15,16). The purpose of this study was to describe the relationship between direct medical costs and individual demographic characteristics, treatments, glycemic control, complications, cardiovascular risk factors, and comorbidities in patients with type 2 diabetes. CONCLUSIONSPrevious models have assigned costs to specific diabetes-related health states (17)(18)(19)(20). This approach is most appropriate for acute health states where interactions with other conditions are absent or clearly identifiable and of limited duration (21). A complex chronic disease like diabetes impacts many other apparently unrelated health problems and the resources used in their treatment. Therefore, it is important to extend the scope of a cost model beyond the direct complications of diabetes to include total direct medical costs. Only in this way can the true economic burden of diabetes be assessed. RESEARCH DESIGN AND METHODS -The study was reviewed and approved by the University of Michigan Institutional Review Board. All subjects were enrolled in commercial, Medicare, or Medicaid managed care programs offered by a large Michigan health maintenance organization (HMO). Subjects thus represented ...

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Excess costs of medical care 1 and 8 years after diagnosis of diabetes: estimates from young and middle-aged incidence cohorts in Sweden

Cited by 21 publications

References 18 publications

The cost burden of diabetes mellitus: the evidence from Germany—the CoDiM Study

The cost burden of diabetes mellitus: the evidence from Germany—the CoDiM Study

Increasing Expenditure on Health Care Incurred by Diabetic Subjects in a Developing Country

The Direct Medical Cost of Type 2 Diabetes

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