Impact of Continuous Care on Health Outcomes and Cost for Type 2 Diabetes Mellitus: Analysis Using National Health Insurance Cohort Database

Background and Objectives: People living with diabetes mellitus are at risk of developing many serious and life-threatening complications. The present study aimed to determine the occurrence of microvascular complications, peripheral artery disease, and mortality in patients with type 2 diabetes mellitus (T2DM), in 2 Lithuanian counties. Materials and Methods: The data on residents aged ≥ 18 years, who were diagnosed for the first time in 2004 with uncomplicated T2DM, were obtained from the National Health Insurance Fund database. The occurrence of T2DM microvascular complications, peripheral artery disease, and mortality during the period from 2004 to 2016 were assessed by gender and age groups (<65 and ≥65 years). Results: During the 13 years, 46.9% of the patients developed T2DM complications. More men than women developed at least 1 T2DM complication (50.8% vs. 44.8%, p = 0.035). The mean time for developing any T2DM complication was 9.2 years. The probability of occurrence of any complication was 0.07 in the second year and increased to 0.59 in the thirteenth year of living with diabetes. Within the 13 years, 38.2% of the patients died. More men (43.1%) than women (35.5%) died during the analysis period (p = 0.036). Mortality was higher among older patients (60.7%) than among younger patients (22.2%) (p < 0.001). Conclusions: The results of this study provide a comprehensive picture of microvascular complications, peripheral artery disease, and mortality among patients with T2DM of two Lithuanian counties. Information about the occurrence of T2DM complications and mortality will assist further studies in estimating the burden of T2DM and in performing economic evaluations of T2DM prevention and treatment in Lithuania.

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Validation of economic and health outcomes simulation model of type 2 diabetes mellitus (ECHO-T2DM)

Journal of Medical Economics ◽

10.3111/13696998.2013.809352 ◽

2013 ◽

Vol 16 (8) ◽

pp. 1007-1021 ◽

Cited By ~ 20

Author(s):

Michael Willis ◽

Christian Asseburg ◽

Jianming He

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Health Outcomes ◽

Simulation Model

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Comparing the Cohort and Micro-Simulation Modeling Approaches in Cost-Effectiveness Modeling of Type 2 Diabetes Mellitus: A Case Study of the IHE Diabetes Cohort Model and the Economics and Health Outcomes Model of T2DM

PharmacoEconomics ◽

10.1007/s40273-020-00922-6 ◽

2020 ◽

Vol 38 (9) ◽

pp. 953-969 ◽

Cited By ~ 2

Author(s):

Michael Willis ◽

Adam Fridhammar ◽

Jens Gundgaard ◽

Andreas Nilsson ◽

Pierre Johansen

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cost Effectiveness ◽

Health Outcomes ◽

Simulation Modeling ◽

Cohort Model ◽

Micro Simulation

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Validation of the Economic and Health Outcomes Model of Type 2 Diabetes Mellitus (ECHO-T2DM)

PharmacoEconomics ◽

10.1007/s40273-016-0471-3 ◽

2016 ◽

Vol 35 (3) ◽

pp. 375-396 ◽

Cited By ~ 11

Author(s):

Michael Willis ◽

Pierre Johansen ◽

Andreas Nilsson ◽

Christian Asseburg

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Health Outcomes

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Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients

Scientific Reports ◽

10.1038/s41598-020-76546-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Inmaculada Guerrero Fernández de Alba ◽

Antonio Gimeno-Miguel ◽

Beatriz Poblador-Plou ◽

Luis Andrés Gimeno-Feliu ◽

Ignatios Ioakeim-Skoufa ◽

...

Keyword(s):

Mental Health ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Substance Use ◽

Type 2 Diabetes Mellitus ◽

Health Outcomes ◽

Substance Use Disorder ◽

Emergency Room Visit ◽

Mental Health Problems

Abstract Type 2 diabetes mellitus (T2D) is often accompanied by chronic diseases, including mental health problems. We aimed at studying mental health comorbidity prevalence in T2D patients and its association with T2D outcomes through a retrospective, observational study of individuals of the EpiChron Cohort (Aragón, Spain) with prevalent T2D in 2011 (n = 63,365). Participants were categorized as having or not mental health comorbidity (i.e., depression, anxiety, schizophrenia, and/or substance use disorder). We performed logistic regression models, controlled for age, sex and comorbidities, to analyse the likelihood of 4-year mortality, 1-year all-cause hospitalization, T2D-hospitalization, and emergency room visit. Mental health comorbidity was observed in 19% of patients. Depression was the most frequent condition, especially in women (20.7% vs. 7.57%). Mortality risk was higher in patients with mental health comorbidity (odds ratio 1.24; 95% confidence interval 1.16–1.31), especially in those with substance use disorder (2.18; 1.84–2.57) and schizophrenia (1.82; 1.50–2.21). Mental health comorbidity also increased the likelihood of all-cause hospitalization (1.16; 1.10–1.23), T2D-hospitalization (1.51; 1.18–1.93) and emergency room visit (1.26; 1.21–1.32). These results suggest that T2D healthcare management should include specific strategies for the early detection and treatment of mental health problems to reduce its impact on health outcomes.

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