An accessible approach to estimate the direct medical costs of type 2 Diabetes mellitus for the Brazilian National Health System

Introduction: This was a retrospective cross-sectional study to assess the impact of chronic kidney disease (CKD) and its severity in Type 2 diabetes mellitus (T2DM) on direct medical costs, and the effects of economic burden on CKD related complications in T2DM in Singapore. Methods: A total of 1,275 T2DM patients were recruited by the diabetes centre at Khoo Teck Puat Hospital from 2011–2014. CKD stages were classified based on improving global outcome (KDIGO) categories, namely the estimated glomerular filtration rate (eGFR) and albuminuria kidney disease. Medical costs were extracted from the hospital administrative database. Results: CKD occurred in 57.3% of patients. The total mean cost ratio for CKD relative to non-CKD was 2.2 (P<0.001). Mean (median) baseline annual unadjusted costs were significantly higher with increasing CKD severity—S$1,523 (S$949), S$2,065 (S$1,198), S$3,502 (S$1,613), and S$5,328 (S$2,556) for low, moderate, high, and very high risk respectively (P<0.001). CKD (P<0.001), age at study entry (P=0.001), Malay ethnicity (P=0.035), duration of diabetes mellitus (DM; P<0.001), use of statins/fibrates (P=0.021), and modified Diabetes Complications Severity Index (DCSI) (P<0.001) were positively associated with mean annual direct medical costs in the univariate analysis. In the fully adjusted model, association with mean annual total costs persisted for CKD, CKD severity and modified DCSI. Conclusion: The presence and increased severity of CKD is significantly associated with higher direct medical costs in T2DM patients. Actively preventing the occurrence and progression in DM-induced CKD may significantly reduce healthcare resource consumption and healthcare costs. Keywords: Chronic kidney disease, costs, endocrinology, nephrology

Download Full-text

Five-year direct medical costs and comorbidities after bariatric surgery of obese patients with type 2 diabetes mellitus: A population-based propensity score-matched study

10.21203/rs.3.rs-16320/v1 ◽

2020 ◽

Author(s):

Tingting Wu ◽

Simon Kin Hung Wong ◽

Betty Tsz Ting Law ◽

Eleanor Grieve ◽

Olivia Wu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Type 2 Diabetes Mellitus ◽

Medical Costs ◽

Population Based ◽

Surgical Patients ◽

Obese Patients ◽

Direct Medical Costs

Abstract Background: Bariatric surgery is effective in weight reduction and diabetes remission. This study aimed to estimate direct medical costs and changes of comorbidities after bariatric surgery up to five years among obese patients with type 2 diabetes mellitus. Methods: A population-based retrospective cohort of obese type 2 diabetes patients from Hong Kong Hospital Authority between 2006 and 2017 was assembled. One-to-five propensity score matching method was applied to match 401 eligible surgical patients with 1,894 non-surgical patients. Frequency of healthcare service utilization and dispense of diabetes medication were collected for both groups to estimate the direct medical costs from baseline to up to 60 months; Charlson Comorbidity Index (CCI) and number of comorbidities were measured to compare the changes of comorbidities between two groups over the 5 years. Results: Direct medical costs were US$40,889 for surgical patients and US$6,163 for controls in the index year (p<0.001), with incremental costs of US$34,726. Bariatric surgery and hospitalization were the main cost drivers for surgical patients in the year of surgery. Although surgical patients had significantly lower annual costs than control patients in the subsequent four years, five-year cumulative costs incurred by surgical patients were significantly greater than controls (US$60,174 vs US$33,374, p<0.001), regardless of subgroups. Surgical patients had better profile of comorbidities than controls, as they had significantly lower CCI after baseline and fewer percentages of them proceeded to higher CCI categories. Conclusions: Over 5 years, bariatric surgery was associated with increased medical costs in the year of surgery and cumulative costs. Although bariatric surgery is not cost-saving for type 2 diabetes patients at 5 years, it is associated with improved comorbidity profile.

Download Full-text

Estimates of direct medical costs for microvascular and macrovascular complications resulting from type 2 diabetes mellitus in the United States in 2000

Clinical Therapeutics ◽

10.1016/s0149-2918(03)80122-4 ◽

2003 ◽

Vol 25 (3) ◽

pp. 1017-1038 ◽

Cited By ~ 77

Author(s):

Judith A. O'Brien ◽

Amanda R. Patrick ◽

Jaime Caro

Keyword(s):

Diabetes Mellitus ◽

United States ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Medical Costs ◽

The United States ◽

Macrovascular Complications ◽

Direct Medical Costs ◽

Microvascular And Macrovascular Complications

Download Full-text

Estimating direct medical costs of type 2 diabetes mellitus in the Philippines: a protocol

BMJ Open ◽

10.1136/bmjopen-2018-025696 ◽

2020 ◽

Vol 10 (7) ◽

pp. e025696

Author(s):

Junice Yi Siu Ng ◽

Ivan John Clement ◽

Cecilia Jimeno ◽

Rosa Allyn Sy ◽

Roberto Mirasol ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Research Ethics ◽

Medical Costs ◽

The Philippines ◽

Direct Medical Costs ◽

Research Ethics Board ◽

The Cost

IntroductionDiabetes and its complications are a major cause of morbidity and mortality in the Philippines. The prevalence of diabetes in the Philippines has increased from 3.4 million in 2010 to 3.7 million in 2017. The government has formulated strategies to control this increase, for example, through its non-communicable disease prevention and control plan. However, there is scarce research on the financial burden of diabetes. Filling this gap may further help policymakers to make informed decisions while developing and implementing resource planning for relevant interventions. The primary objective of the current study is to estimate the direct medical costs associated with type 2 diabetes mellitus (T2DM).Methods and analysisThis is a 1-year retrospective cohort study of patients with T2DM in 2016. Data will be collected from: (1) hospital databases from public institutions to estimate the cost of diabetes treatment and (2) physician interviews to estimate the cost of management of diabetes in outpatient care. We will perform descriptive and comparative analyses on direct medical costs and healthcare resource utilisation, stratified by the presence of diabetes-associated complications.Ethics and disseminationResearch ethics board approval has been obtained from the Department of Health Single Joint Research Ethics Board and Cardinal Santos Medical Center Research Ethics Review Committee. Findings from the study will be reported in peer-reviewed scientific journals and local researcher meetings.

Download Full-text

Analisis Estimasi Biaya Langsung Medis Penderita Rawat Jalan Diabetes Mellitus Tipe 2 di RSUD Dr. Abdul Aziz Singkawang Tahun 2013

Jurnal Ekonomi Kesehatan Indonesia ◽

10.7454/eki.v1i2.1770 ◽

2017 ◽

Vol 1 (2) ◽

Author(s):

Mursalin 1976 ◽

Prastuti Soewondo

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Outpatient Care ◽

Secondary Data ◽

Medical Costs ◽

Cost Of Care ◽

Direct Medical Costs ◽

Significant Difference

AbstrakDiabetes Mellitus merupakan penyakit epidemik yang menjadi ancaman global. Selain tingkat morbiditas dan mortalitas yang tinggi, juga menyebabkan sebagian besar negara di dunia mengeluarkan anggaran kesehatan yang besar. Penelitian ini bertujuan untuk menghitung besarnya biaya langsung medis dan faktor-faktor yang mempengaruhinya pada penderita rawat jalan diabetes mellitus tipe 2. Penelitian dilaksanakan pada bulan Januari – Februari 2015 di RSUD dr. Abdul Aziz Singkawang, Kalimantan Barat. Jenis penelitian ini adalah kuantitatif analitik dengan menggunakan data sekunder yang dikumpulkan secara retrospektif berdasarkan data tahun 2013 dengan jumlah sampel sebanyak 200. Hasil analisis multivariat, terdapat perbedaan yang signifikan biaya langsung medis pada setiap tipe penatalaksanaan, lama sakit dan komplikasi yang dialami penderita. Upaya promotif dan preventif perlu ditingkatkan untuk mencapai efektivitas dan efisiensi pengobatan dan meningkatkan kualitas hidup penderita. AbstractDiabetes mellitus has epidemic diseases that seriously global threated. Except, hight level of morbidity and mortality, its also caused most countries in the world spend a lot of money for health care. This study purpose to count direct medical costs and factors of influence on type 2 diabetes mellitus outpatient care. This study conduct on January to February 2015 in RSUD dr. Abdul Aziz Singkawang at West Kalimantan. Design study used cuantitative analysis by secondary data that retrospectively collected on 2013 data and number of samples are 200. Result of multivariate analysis, there were significant difference means of direct medical costs of type 2 diabetes mellitus outpatient care on type of care, diseases duration, and complication. Health promotion and prevention on type 2 diabetes mellitus intervention must be increasingly to achieve effective and efficient cost of care and to increase patient’s quality of life.

Download Full-text