Type 2 diabetes: Incremental medical care costs during the first 8 years after diagnosis
Type 2 diabetes: Incremental medical care costs during the first 8 years after diagnosis
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DOI：
10.2337/diacare.22.7.1116
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发表时间：
1999-07-01
期刊：
影响因子：
16.2
通讯作者：
Bakst, AW
中科院分区：
文献类型：
--
作者：
Brown, JB;Nichols, GA;Bakst, AW
目的 - 描述和分析 2 型糖尿病引起的医疗费用的时间进程，从诊断时到诊断后的前 8 年。 研究设计和方法 - 根据电子健康维护组织 (HMO) 记录，我们确定了 1988 年至 1995 年间新诊断的所有 2 型糖尿病成员的持续医疗费用。为了隔离增量费用（由糖尿病诊断引起的费用），我们从患有糖尿病的会员的费用中减去单独匹配的没有糖尿病的 HMO 会员的费用。 结果 - 从诊断时起，糖尿病的经济负担立即显而易见。第一年，糖尿病患者的总医疗费用是非糖尿病患者的 2.1 倍。在诊断后的前 8 年里，与糖尿病相关的增量成本（2 型糖尿病成本减去非糖尿病患者的匹配成本）平均为每名 2 型糖尿病患者每年 2,257 美元。在此期间，年度增量费用变化相对较小，但在第 1 年、第 7 年和第 8 年较高，因为糖尿病或其并发症以外的其他原因导致的住院费用较高。结论 - 在糖尿病诊断后的前 8 年中，2 型糖尿病患者的费用明显高于匹配的非糖尿病患者；但这些高成本基本保持不变。一旦因普遍老龄化而导致的成本增长得到控制，糖尿病并发症似乎不会像人们普遍认为的那样增加增量成本。需要进行更多研究来更好地了解糖尿病及其诊断在较长时间内如何影响医疗费用。
OBJECTIVE - To describe and analyze the time course of medical care costs caused by type 2 diabetes, from the rime of diagnosis through the first 8 postdiagnostic years.RESEARCH DESIGN AND METHODS - From electronic health maintenance organization (HMO) records, we ascertained the ongoing medical care costs for all members with type 2 diabetes who were newly diagnosed between 1988 and 1995. To isolate incremental costs (costs caused by the diagnosis of diabetes), we subtracted the costs of individually matched HMO members without diabetes from costs of members with diabetes.RESULTS - The economic burden of diabetes is immediately apparent from the time of diagnosis. In year 1, total medical costs were 2.1 times higher for patients with diabetes compared with those without diabetes. Diabetes-associated incremental costs (type 2 diabetic costs minus matched costs for people without diabetes) averaged $2,257 per ripe 2 diabetic patient per year during the first 8 postdiagnostic years. Annual incremental costs varied relatively little over the period but were higher during years 1, 7, and 8 because of higher-cost hospitalizations for causes other than diabetes or its complications.CONCLUSIONS - For the first 8 years after diabetes diagnosis, patients with type 2 diabetes incurred substantially higher costs than matched nondiabetic patients; but those high costs remained largely flat. Once the growth in costs due to general aging is controlled for, it appears that diabetic complications do not increase incremental costs as early as is commonly believed. Additional research is needed to better understand how diabetes and its diagnosis affect medical care costs over longer periods of time.