Resource consumption and costs in Dutch patients with Type 2 diabetes mellitus. Results from 29 general practices

Redekop, William K.; Koopmanschap, M A; Rutten, G. E. H. M.; Wolffenbuttel, Bruce H. R.; Stolk, Ronald P.; Niessen, Louis

doi:10.1046/j.1464-5491.2002.00654.x

Cited by 37 publications

(40 citation statements)

References 8 publications

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“…Data from the United States and Europe indicate that the health care expenditure for patients with diabetes mellitus is significantly higher than for comparable patients without this disease [1][2][3][4][5]. These and other studies [6][7][8][9] also suggest that the majority of such 'excess' costs can be attributed to diabetes-related complications.…”

Section: Introductionmentioning

confidence: 77%

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

et al. 2006

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Section: Introductionmentioning

confidence: 77%

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

et al. 2006

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“…Most of the previously reported models explained Ͻ10% of the variation in costs (15,25). It is likely that our model predicted more of the variation in costs because we assessed exposures more rigorously by assessing demographic characteristics, treatments, and complications by both survey and medical chart review.…”

Section: Discussionmentioning

confidence: 99%

“…Not unexpectedly, direct medical costs during the first year after the onset of acute MI, stroke, and amputation were high (Table 3). Only a few studies have provided patient level estimates of the direct medical costs of diabetes (11,14,15). O'Brien et al (11) developed an economic model to estimate the direct medical costs of 15 diabetes complications.…”

Section: Discussionmentioning

confidence: 99%

“…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). 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.…”

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confidence: 99%

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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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“…2,3 Studies have also shown that people with diabetes-related complications have a reduced HRQoL compared to those without complications. [4][5][6] There is limited information available on changes in HRQoL associated with prediabetes or the development of type 2 diabetes (T2D). A cross-sectional study examined the association of HRQoL with glucose tolerance status in an Australian population.…”

Section: Introductionmentioning

confidence: 99%

Impact of Lifestyle Intervention and Metformin on Health-Related Quality of Life: the Diabetes Prevention Program Randomized Trial

et al. 2012

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BACKGROUND: Adults at high risk for diabetes may have reduced health-related quality of life (HRQoL). OBJECTIVE: To assess changes in HRQoL after interventions aimed at diabetes risk reduction. DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial, the Diabetes Prevention Program, was conducted in 27 centers in the United States, in 3,234 non-diabetic persons with elevated fasting and postload plasma glucose, mean age 51 years, mean BMI 34 Kg/m²; 68 % women, and 45 % members of minority groups. INTERVENTIONS: Intensive lifestyle (ILS) program with the goals of at least 7 % weight loss and 150 min of physical activity per week, metformin (MET) 850 mg twice daily, or placebo (PLB). MEASUREMENTS: HRQoL using the 36-Item ShortForm (SF-36) health survey to evaluate health utility index (SF-6D), physical component summaries (PCS) and mental component summaries (MCS). A minimally important difference (MID) was met when the mean of HRQoL scores between groups differed by at least 3 %. RESULTS: After a mean follow-up of 3.2 years, there were significant improvements in the SF-6D (+0.008, p=0.04) and PCS (+1.57, p<0.0001) scores in ILS but not in MET participants (+0.002 and +0.15, respectively, p=0.6) compared to the PLB group. ILS participants showed improvements in general health (+3.2, p< 0.001), physical function (+3.6, p<0.001), bodily pain (+1.9, p= 0.01), and vitality (+2.1, p= 0.01) domain scores. Treatment effects remained significant after adjusting sequentially for baseline demographic factors, and for medical and psychological comorbidities. Increased physical activity and weight reduction mediated these ILS treatment effects. Participants who experienced weight gain had significant worsening on the same HRQoL specific domains when compared to those that had treatment-related (ILS or MET) weight loss. No benefits with ILS or MET were observed in the MCS score. CONCLUSION: Overweight/obese adults at high risk for diabetes show small improvement in most physical HRQoL and vitality scores through the weight loss and increased physical activity achieved with an ILS intervention.KEY WORDS: quality of life; lifestyle; metformin; diabetes risk; weight loss.

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Resource consumption and costs in Dutch patients with Type 2 diabetes mellitus. Results from 29 general practices

Abstract: Independent determinants of the medical costs of Type 2 diabetes in The Netherlands include age, complications, insulin use and hyperlipidaemia.

Cited by 37 publications

References 8 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

The Direct Medical Cost of Type 2 Diabetes

Impact of Lifestyle Intervention and Metformin on Health-Related Quality of Life: the Diabetes Prevention Program Randomized Trial

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