Objectives:
Patterns of healthcare resource utilization (HRU) among patients with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) are not well studied in large epidemiological studies. Using a large US population-based study, SHIELD, this study quantified the HRU over 3 and 5 years among adults with T2DM at high risk for CVD.
Methods:
SHIELD is a 5-year (2004-2009) prospective survey-based study of adults with and without T2DM. Respondents with T2DM were stratified into 2 cohorts: (1) established CVD with age ≥40 years, prior MI, prior stroke, atherosclerosis, or peripheral vascular disease, and (2) multiple risk factors (men ≥55 years and women ≥60 years and ≥1 risk factors of hyperlipidemia, hypertension, currently smoking, without prior history of CVD). Number of hospitalizations, emergency room (ER) visits, and physician office visits were tabulated for respondents who did and did not report a new CVD event (MI, stroke, angioplasty, or heart bypass surgery) in each cohort for up to 3 and 5 years of follow-up.
Results:
Frequencies of hospitalization, ER visit, and physician visit within 3 and 5 years of follow-up were significantly higher among those who reported a new CVD event over 3 and 5 years for both cohorts compared with respondents without a new CVD event, p <0.05 (Table). Median number of hospitalizations, ER visits, and physician visits were significantly higher for respondents reporting a new CVD event compared with respondents with no new CVD events for both cohorts, p <0.01 (Table).
Conclusions:
CVD events among T2DM patients continue to represent a very high economic burden on the healthcare system. HRU is very high among adults with T2DM at-risk of CVD events and significantly higher among those who had a new CVD event within 3 and 5 years compared with those who did not have a new CVD event.
Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areas
