Trends in Health Care Expenditure in U.S. Adults With Diabetes: 2002–2011

Abstract

OBJECTIVEDirect medical cost of diabetes in the U.S. has been estimated to be 2.3 times higher relative to individuals without diabetes. This study examines trends in health care expenditures by expenditure category in U.S. adults with diabetes between 2002 and 2011.RESEARCH DESIGN AND METHODSWe analyzed 10 years of data representing a weighted population of 189,013,514 U.S. adults aged ≥18 years from the Medical Expenditure Panel Survey. We used a novel two-part model to estimate adjusted mean and incremental medical expenditures by diabetes status, while adjusting for demographics, comorbidities, and time.RESULTSRelative to individuals without diabetes ($5,058 [95% CI 4,949–5,166]), individuals with diabetes ($12,180 [11,775–12,586]) had more than double the unadjusted mean direct expenditures over the 10-year period. After adjustment for confounders, individuals with diabetes had $2,558 (2,266–2,849) significantly higher direct incremental expenditures compared with those without diabetes. For individuals with diabetes, inpatient expenditures rose initially from $4,014 in 2002/2003 to $4,183 in 2004/2005 and then decreased continuously to $3,443 in 2010/2011, while rising steadily for individuals without diabetes. The estimated unadjusted total direct expenditures for individuals with diabetes were $218.6 billion/year and adjusted total incremental expenditures were approximately $46 billion/year.CONCLUSIONSOur findings show that compared with individuals without diabetes, individuals with diabetes had significantly higher health expenditures from 2002 to 2011 and the bulk of the expenditures came from hospital inpatient and prescription expenditures.

Health service utilization and related costs attributable to diabetes

“…Almost 70% of the health service costs associated with diabetes resulted from hospital admissions. Numerous studies report hospital admissions as the main driver of costs associated with diabetes and our findings highlight the need to provide effective interventions for the management of diabetes and related complications [22,23]. Increased risk of hospitalization in people with diabetes is attributable to macrovascular and microvascular complications [19,24].…”

Trends in health care expenditure among US adults with heart failure: The Medical Expenditure Panel Survey 2002-2011

“…Recent studies showed that socio demographic and binary indicators of disease are important covariates that affect medical expenditures 15 and that binary indicators of disease are more effective in accounting for disease burden. 16–18 Covariates are age, sex, race/ethnicity, marital status, educational level, health insurance, metropolitan statistical area (MSA), region, poverty/income ratio (income level), calendar year, and comorbidities – diabetes, hypertension, cardiovascular diseases (CVD), emphysema, joint pain, arthritis and asthma.…”

Direct medical cost of diabetes in rural China using electronic insurance claims data and diabetes management data

“…Evidence from previous studies suggests that diabetes imposes a substantial economic burden on affected individuals, their families and communities, as well as on healthcare systems due to its growing prevalence and chronic nature [3][4][5][6] . A recent study estimated that among adults in China, the overall prevalence of diabetes was 10.9% 2 .…”