PDB46 ELEVATED ANNUAL HEALTHCARE UTILIZATION AND DIRECT MEDICAL COSTS ASSOCIATED WITH DIABETES MELLITUS PATIENTS WITH OSTEOPOROSIS IN CHINA

Objectives: To compare healthcare utilization and medical costs between patients with seronegative (SN) and seropositive (SP) rheumatoid arthritis (RA). Methods: We conducted a nationwide population study using the Korean health insurance claims database in 2016. We divided patients with RA into SN and SP groups and compared healthcare utilization including medications, medical utilization, and direct medical costs for 1 year between the groups in a cross-sectional analysis. Differences in costs between patients with SPRA and SNRA were assessed using the quantile regression model. We performed longitudinal analysis using data from 2012 and 2016 to examine changes over time. Results: A total of 103,815 SPRA and 75,809 SNRA patients were included in the analyses. The SPRA group used significantly more methotrexate (73.2% versus 30.3%) and biologic agents (7.9% versus 2.9%) than the SNRA group. The number of RA-related outpatient visits [6.0 ± 3.7 versus 4.4 ± 4.0 times/year, standardized difference (SD) = 0.41] and annual medical costs per patient ($1027 versus $450/year, SD = 0.25) were higher in the SPRA group than the SNRA group. Quantile regression results indicated that the incremental cost of seropositivity on total medical costs of RA patients gradually increased as medical costs approached the upper quantile. The annual direct medical costs for each patient between 2012 and 2016 increased in both groups: by 25.1% in the SPRA group and 37.6% in the SNRA group. Conclusion: Annual RA-related direct medical costs and RA-related healthcare utilization per patient are higher in patients with SPRA than those with SNRA.

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Estimation and determinants of direct medical costs of ischaemic heart disease, stroke and hypertensive heart disease: evidence from two major hospitals in Cameroon

BMC Health Services Research ◽

10.1186/s12913-021-06146-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Leopold Ndemnge Aminde ◽

Anastase Dzudie ◽

Yacouba N. Mapoure ◽

Jacques Cabral Tantchou ◽

J. Lennert Veerman

Keyword(s):

Diabetes Mellitus ◽

Heart Disease ◽

Ischaemic Stroke ◽

Ischaemic Heart Disease ◽

Economic Burden ◽

Hypertensive Heart Disease ◽

Haemorrhagic Stroke ◽

Medical Costs ◽

Communicable Diseases ◽

Direct Medical Costs

Abstract Background Cardiovascular disease (CVD) is the largest contributor to the non-communicable diseases (NCD) burden in Cameroon, but data on its economic burden is lacking. Methods A prevalence-based cost-of-illness study was conducted from a healthcare provider perspective and enrolled patients with ischaemic heart disease (IHD), ischaemic stroke, haemorrhagic stroke and hypertensive heart disease (HHD) from two major hospitals between 2013 and 2017. Determinants of cost were explored using multivariate generalized linear models. Results Overall, data from 850 patients: IHD (n = 92, 10.8%), ischaemic stroke (n = 317, 37.3%), haemorrhagic stroke (n = 193, 22.7%) and HHD (n = 248, 29.2%) were analysed. The total cost for these CVDs was XAF 676,694,000 (~US$ 1,224,918). The average annual direct medical costs of care per patient were XAF 1,395,200 (US$ 2400) for IHD, XAF 932,700 (US$ 1600) for ischaemic stroke, XAF 815,400 (US$ 1400) for haemorrhagic stroke, and XAF 384,300 (US$ 700) for HHD. In the fully adjusted models, apart from history of CVD event (β = − 0.429; 95% confidence interval − 0.705, − 0.153) that predicted lower costs in patients with IHD, having of diabetes mellitus predicted higher costs in patients with IHD (β = 0.435; 0.098, 0.772), ischaemic stroke (β = 0.188; 0.052, 0.324) and HHD (β = 0.229; 0.080, 0.378). Conclusions This study reveals substantial economic burden due to CVD in Cameroon. Diabetes mellitus was a consistent driver of elevated costs across the CVDs. There is urgent need to invest in cost-effective primary prevention strategies in order to reduce the incidence of CVD and consequent economic burden on a health system already laden with the impact of communicable diseases.

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Assessment of the Direct Medical Costs of Type 2 Diabetes Mellitus and its Complications in Turkey

Turkish Journal of Endocrinology and Metabolism ◽

10.4274/tjem.2441 ◽

2014 ◽

Vol 18 (2) ◽

pp. 39-43 ◽

Cited By ~ 5

Author(s):

Simten Malhan ◽

Ergun Öksüz ◽

Steven M Babineaux ◽

Ali Ertekin ◽

James P Palmer

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Medical Costs ◽

Direct Medical Costs

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Direct medical costs attributable to type 2 diabetes mellitus: a population-based study in Catalonia, Spain

The European Journal of Health Economics ◽

10.1007/s10198-015-0742-5 ◽

2015 ◽

Vol 17 (8) ◽

pp. 1001-1010 ◽

Cited By ~ 46

Author(s):

Manel Mata-Cases ◽

Marc Casajuana ◽

Josep Franch-Nadal ◽

Aina Casellas ◽

Conxa Castell ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Medical Costs ◽

Population Based ◽

Population Based Study ◽

Direct Medical Costs

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PDB18 Direct Medical Costs of Diabetes Mellitus in China: Annual Cost of Illness and Long-Term Projections Using a Validated Diabetes Model

Value in Health ◽

10.1016/j.jval.2012.08.349 ◽

2012 ◽

Vol 15 (7) ◽

pp. A662 ◽

Cited By ~ 1

Author(s):

J.L. Palmer ◽

J. Caputo ◽

V. Foos ◽

D. Grant ◽

M. Lamotte ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cost Of Illness ◽

Annual Cost ◽

Medical Costs ◽

Direct Medical Costs ◽

Diabetes Model

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

Value in Health ◽

10.1016/j.jval.2015.03.1493 ◽

2015 ◽

Vol 18 (3) ◽

pp. A256

Author(s):

C.M. Aquino ◽

R.C. Lima ◽

M.G. Marinho ◽

I.M. Sousa ◽

E.Â. Cesse ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Health System ◽

National Health ◽

National Health System ◽

Medical Costs ◽

Direct Medical Costs

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Medical Costs Associated with Severity of Chronic Kidney Disease in Type 2 Diabetes Mellitus in Singapore

Annals of the Academy of Medicine, Singapore ◽

10.47102/annals-acadmedsg.202032 ◽

2020 ◽

Vol 49 (10) ◽

pp. 731-741

Author(s):

Gwyneth J Lim ◽

Yan Lun Liu ◽

Serena Low ◽

Keven Ang ◽

Subramaniam Tavintharan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Type 2 Diabetes Mellitus ◽

Kidney Disease ◽

Medical Costs ◽

Direct Medical Costs ◽

Disease Costs ◽

The Impact

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

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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.

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