Social economic costs of type 1 diabetes mellitus in pediatric patients in Spain: CHRYSTAL observational study

López-Bastida, Julio; López-Siguero, Juan Pedro; Oliva‐Moreno, Juan; Pérez-Nieves, Magaly; Villoro, Renata; Dilla, Tatiana; Merino, María; Jiang, Dongjie; Aranda-Reneo, Isaac; Reviriego, Jesús; Vázquez, Luis Alberto

doi:10.1016/j.diabres.2017.02.033

Cited by 22 publications

(13 citation statements)

References 31 publications

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“…69% of the children reported a diabetic complication. Poor glycaemic control may cause episodes of hypoglycaemia which can affect developing nervous system and children with diabetes mellitus who are aged less than 7 years are at risk of cognitive dysfunction (10). In this study 74% of the children who had HbA1c had a result ≥7.5% indicating poor metabolic control which is contrary to a study in Spain where 60% of the children had a HbA1c < 7.5% (López-Bastida et al, 2017).…”

Section: Discussioncontrasting

confidence: 69%

Cost of Paediatric Diabetes Mellitus Treatment on Carers of Diabetic Children Attending Three Hospital Out-Patient Clinics in Zimbabwe

Machingura¹

2017

TIJPH

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There is paucity of information on the economic impact of diabetes mellitus in low and middle income countries, including Zimbabwe. The study sought to determine the patient treatment cost of paediatric diabetes mellitus on families of diabetic children attending Parirenyatwa, Harare and Chitungwiza hospital outpatient clinics in Zimbabwe. A cross sectional study was conducted at Parirenyatwa, Harare and Chitungwiza hospitals between 10 May 2017 and 27 September 2017 in which all paediatric diabetic patients and carers were given the information on the study. A questionnaire was administered on all carers of paediatric diabetic patients' who consented to participate in the study. Only (36/85) 42% of the carers of paediatric diabetes mellitus children, who had attended the outpatient clinic in the year preceding the study at least once at Parirenyatwa, Harare and Chitungwiza hospital were accessed. Only 53% of the 36 children had a measure of glycaemic control, of whom 74% had HbA1c ≥7.5% indicating poor glycaemic control. Cash was the mode of payment used by the majority of the carers for child treatment, and the monthly expenditure was almost half of the family total income. This study indicates a considerable portion of the family income is spent in child care of diabetic children and loss of productive time due to child care. Only a small proportion of the children was accessed during the study population which can be attributed to financial problems limiting clinic attendance. There was poor diabetic control amongst the paediatric diabetic patients who had HbA1c results.

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Section: Discussioncontrasting

confidence: 69%

Cost of Paediatric Diabetes Mellitus Treatment on Carers of Diabetic Children Attending Three Hospital Out-Patient Clinics in Zimbabwe

Machingura¹

2017

TIJPH

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“…Because of the rapid developments in the innovation of the treatment of T1DM [ 19 – 22 ] with an increasing use of high-tech devices, the costs of treating T1DM in children are likely to increase further in the coming years. Data from adults with diabetes suggest that more expenditure is needed for general care not directly related to diabetes compared to diabetes related care [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Healthcare reimbursement costs of children with type 1 diabetes in the Netherlands, a observational nationwide study (Young Dudes-4)

et al. 2018

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BackgroundType 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in children. Studies on costs related to T1DM are scarce and focused primarily on the costs directly related to diabetes. We aimed to investigate both the overall healthcare costs and the more specific costs related to the management of diabetes.MethodsThis is a retrospective and observational, nationwide cohort study of all Dutch children (aged 0–18 years) with T1DM. Data were collected from the national registry for healthcare reimbursement, in which all Dutch insurance companies combine their reimbursement data. In the Netherlands for all Dutch citizens health care is covered by law and all children are treated by hospital-based paediatricians.ResultsWe analysed 6710 children distributed over 81 hospitals: 475 children in 6 university hospitals and 6235 children in 75 general hospitals. Total reimbursement for all children with T1DM over the period 2009 to 2011 was € 167,494,732 corresponding to an annual mean of € 55,831,577 of total costs and € 8326 euros per child. When comparing small (between 26 and 54 patients), medium (57–84 patients) and large (88–248 patients) general hospitals, costs per patient were highest in the hospitals with the highest number of T1DM patients. The costs for devices, secondary care and pharmaceutics had most impact on total expenditures. Over the study period, there was a slight decrease in per person costs.ConclusionThe overall health expenditure of a child with T1DM is more than € 8000 per patient per annum. Given the move towards more device-intensive multidisciplinary care for these patients, the costs of treating T1DM in children are likely to increase further in the coming years.

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“…We randomly selected 12 centers across Spain and the researchers randomly selected patients fulfilling the inclusion criteria. More information about the study population selection can be found in L opez-Bastida and co-authors 22 .…”

Section: Study Populationmentioning

confidence: 99%

Health-related quality of life in type 1 diabetes mellitus pediatric patients and their caregivers in Spain: an observational cross-sectional study

López-Bastida

López-Siguero

Oliva‐Moreno

et al. 2019

Current Medical Research and Opinion

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Objectives: This study assessed the health-related quality of life (HRQOL) of pediatric patients with type 1 diabetes mellitus (T1DM) and their caregivers. Methods: CHRYSTAL was an observational cross-sectional study conducted in Spain in 2014 on 275 patients under 18 years old diagnosed with T1DM. Patient/caregiver pairs were stratified by patients' HbA1c level (7.5% versus <7.5%) and by presence or absence of T1DM complications and/or comorbidities. EQ-5D and PedsQL questionnaires were administered to patients and caregivers. Results: On the EQ-5D, according to caregivers' perception, 17.7% of children experienced moderate pain or discomfort, 9.7% suffered problems performing usual activities, and 13.2% demonstrated moderate anxiety or depression. Mean EQ-5D index score was 0.95 and mean visual analog scale (VAS) score was 86.1. By HbA1c level (7.5% versus <7.5%), mean index scores were 0.94 and 0.95, and mean VAS scores were 82.8 and 89.2, respectively. Mean index scores were 0.91 for children with complications and/or comorbidities and 0.96 for children without. Mean VAS scores were 83.7 and 87.2, respectively. HRQOL per the PedsQL tool ranged from 68.1 (ages 2-4) to 73.1 (ages 13-18). EQ-5D index and VAS scores were significantly correlated (rho ¼ 0.29-0.43) with several age groups of the PedsQL. EQ-5D scales showed significant moderate correlation between EQ-5D-Y and EQ-5D-3L proxy VAS score (rho ¼ 0.45; p < .001). Conclusions: Patients with few complications and controlled HbA1c reported a relatively high HRQOL.The results suggest that parent-proxy EQ-5D ratings are valid for use as part of an overall health outcomes assessment in clinical studies of T1DM in pediatric patients. ARTICLE HISTORY

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Social economic costs of type 1 diabetes mellitus in pediatric patients in Spain: CHRYSTAL observational study

Abstract: T1DM amongst pediatric patients incurs in considerable societal costs. Informal care represents the largest cost category.

Cited by 22 publications

References 31 publications

Cost of Paediatric Diabetes Mellitus Treatment on Carers of Diabetic Children Attending Three Hospital Out-Patient Clinics in Zimbabwe

Cost of Paediatric Diabetes Mellitus Treatment on Carers of Diabetic Children Attending Three Hospital Out-Patient Clinics in Zimbabwe

Healthcare reimbursement costs of children with type 1 diabetes in the Netherlands, a observational nationwide study (Young Dudes-4)

Health-related quality of life in type 1 diabetes mellitus pediatric patients and their caregivers in Spain: an observational cross-sectional study

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