scholarly journals Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expenditures

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e049487
Author(s):  
Rose J Geurten ◽  
Arianne M J Elissen ◽  
Henk J G Bilo ◽  
Jeroen N Struijs ◽  
Chantal van Tilburg ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
The Netherlands ◽  
Health System ◽  
Pharmaceutical Care ◽  
Healthcare Utilisation ◽  
Medical Specialist ◽  
Specialist Care ◽  
Policy And Practice ◽  
Claims Database

ObjectivesWe aimed to identify and delineate the Dutch type 2 diabetes population and the distribution of healthcare utilisation and expenditures across the health system from 2016 to 2018 using an all-payer claims database.DesignRetrospective observational cohort study based on an all-payer claims database of the Dutch population.SettingThe Netherlands.ParticipantsThe whole Dutch type 2 diabetes population (n=900 522 in 2018), determined based on bundled payment codes for integrated diabetes care and medication use indicating type 2 diabetes.Outcome measuresAnnual prevalence of type 2 diabetes, comorbidities and characteristics of the type 2 diabetes population, as well as the distribution of healthcare utilisation and expenditures were analysed descriptively.ResultsIn 2018, 900 522 people (6.5% of adults) were identified as having type 2 diabetes. The most common comorbidity in the population was heart disease (12.1%). Additionally, 16.2% and 5.6% of patients received specialised care for microvascular and macrovascular diabetes-related complications, respectively. Most patients with type 2 diabetes received pharmaceutical care (99.1%), medical specialist care (97.0%) and general practitioner consultations (90.5%). In total, €8173 million, 9.4% of total healthcare expenditures, was reimbursed for the type 2 diabetes population. Medical specialist care accounted for the largest share of spending (38.1%), followed by district nursing (12.4%), and pharmaceutical care (11.5%).ConclusionsAll-payer claims databases can be used to delineate healthcare use: this insight can inform health policy and practice and, thereby, support better decisions to promote long-term sustainability of healthcare systems. The healthcare utilisation of the Dutch type 2 diabetes population is distributed across the health system and utilisation of medical specialist care is high. This is likely to be due to presence of concurrent morbidities and complications. Therefore, a shift from a disease-specific approach to a person-centred and integrated care approach could be beneficial in the treatment of type 2 diabetes.

scholarly journals Cardiovascular disease prevalence in type 2 diabetes – an analysis of a large German statutory health insurance database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maximilian Gabler ◽  
Silke Geier ◽  
Lukas Mayerhoff ◽  
Wolfgang Rathmann
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Health System ◽  
Cardiovascular Complications ◽  
Population Based ◽  
Stratified Sample ◽  
Icd 10 ◽  
Definition Of ◽  
Observation Period

Abstract Background The aim of this study was to determine the prevalence of cardiovascular disease in persons with type 2 diabetes mellitus (T2D) in Germany. Methods A claims database with an age- and sex-stratified sample of nearly 4 million individuals insured within the German statutory health system was used. All patients aged ≥18 years with T2D documented between 1 January 2015 and 31 December 2015 and complete retrospective documentation of ≥5 years (continuous enrollment in the German statutory health system) before 2015 were selected based on a validated algorithm. Cardiovascular disease (CVD) events were identified based on ICD-10 and OPS codes according to a previous clinical study (EMPA-REG OUTCOME trial). Results The prevalence of T2D in Germany in 2015 was 9.9% (n = 324,708). Using a narrow definition of CVD, the 6-year observation period prevalence of CVD was estimated as 46.7% [95% CI: 46.52%;46.86%]. Applying a wider CVD definition, the proportion of T2D patients who showed a history of CVD was 57.1% [95% CI: 56.9%;57.24%]. The prevalence of CVD in patients with T2D ranged from 36.3 to 57.1%, depending on the observation period and definition of CVD. Conclusions The results underline the need for a population-based registration of cardiovascular complications in T2D.

scholarly journals Quantifying the Influence of Individual, Community, and Health System Factors on Quality of Life Among Inner-City African Americans With Type 2 Diabetes

2021 ◽  
pp. 014572172199628
Author(s):  
Jennifer A. Campbell ◽  
Alice Yan ◽  
Renee E. Walker ◽  
Lance Weinhardt ◽  
Yang Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
African Americans ◽  
Inner City ◽  
Health System ◽  
Community Sample ◽  
Primary Data ◽  
System Factors

Purpose The purpose of this study is to examine the association of individual, community, and health system factors on quality of life among inner-city African Americans with type 2 diabetes. Methods Primary data from a cross-sectional study with a community sample of 241 inner-city African Americans with type 2 diabetes were analyzed. Paper-based surveys were administered in which the SF-12 was used to capture the physical component (PCS) and mental component (MCS) of quality of life. Four regression approaches (sequential, stepwise with backward and forward selection, and all possible subsets regression) were used to examine the influence of individual, community, and health system factors on PCS and MCS after adjusting for relevant covariates using a conceptual framework. Results In fully adjusted models, having less than a high school education and having major depression were associated with lower quality-of-life scores for MCS across all 4 regression approaches. Being employed was positively associated with better quality-of-life scores for PCS across all 4 regression approaches. PCS was higher across all 4 regression approaches for those reporting a history of trauma. At the health systems level, usual source of care was associated with better PCS across 3 regression approaches. Conclusions These results highlight key factors that influence quality of life among inner-city African Americans with type 2 diabetes that could be targets for interventions in this population. However, additional research is needed to understand existing pathways that may be driving many of these relationships.

scholarly journals The effect of pharmaceutical care in the elderly patients with type 2 diabetes mellitus

2016 ◽  
Vol 11 (1) ◽  
pp. 93-94 ◽  
Author(s):  
Win Myat Maw ◽  
Mi Mi Saw ◽  
Theingi Kyaw ◽  
Khin Ohnmar Kyaing ◽  
Zaw Min Latt ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Elderly Patients ◽  
Pharmaceutical Care ◽  
The Elderly
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