The direct medical cost of type 2 diabetes
The direct medical cost of type 2 diabetes
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DOI：
10.2337/diacare.26.8.2300
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发表时间：
2003-08-01
期刊：
影响因子：
16.2
通讯作者：
Herman, WH
中科院分区：
文献类型：
--
作者：
Brandle, M;Zhou, HH;Herman, WH
目的-描述与2型糖尿病相关的直接医疗费用，以及其治疗，并发症，和comorbidity.Research设计和方法-我们研究了随机抽样的1,364例2型糖尿病患者谁是密歇根州的健康维护组织的成员。通过调查和病历审查评估人口统计学特征、糖尿病病程、糖尿病治疗、血糖控制、并发症和合并症。每年的资源利用和费用是使用健康保险索赔进行评估的。对数转换后的年度直接医疗费用通过多元线性回归拟合到人口统计学、治疗、血糖控制、并发症和合并症的指标变量。结果-饮食控制的2型糖尿病患者，BMI 30 kg/m2，无微血管、神经病变或心血管并发症的患者，白色男性的年度直接医疗费用中位数为1，700美元，白色女人100块。BMI增加10 kg/m2、口服抗糖尿病或抗高血压药物、糖尿病肾病、脑血管疾病和外周血管疾病的治疗费用均增加10-30%。胰岛素治疗、心绞痛和心肌梗死均与费用增加60-90%相关。透析与成本增加11倍有关。结论-胰岛素治疗和糖尿病并发症对2型糖尿病的直接医疗费用有重大影响。该模型中的估计值可用于分析2型糖尿病干预措施的成本效益。
OBJECTIVE - To describe the direct medical costs associated with type 2 diabetes, as well as its treatments, complications, and comorbidities.RESEARCH DESIGN AND METHODS - We studied a random sample of 1,364 subjects with type 2 diabetes who were members of a Michigan health maintenance organization. Demographic characteristics, duration of diabetes, diabetes treatments, glycemic control, complications, and comorbidities were assessed by surveys and medical chart reviews. Annual resource utilization and costs were assessed using health insurance claims. The log-transformed annual direct medical costs were fitted by multiple linear regression to indicator variables for demographics, treatments, glycemic control, complications, and comorbidities.RESULTS - The median annual direct medical costs for subjects with diet-controlled type 2 diabetes, BMI 30 kg/m(2), and no microvascular, neuropathic, or cardiovascular complications were $1,700 for white men and $2, 100 for white women. A 10-kg/m(2) increase in BMI, treatment with oral antidiabetic or antihypertensive agents, diabetic kidney disease, cerebrovascular disease, and peripheral vascular disease were each associated with 10-30% increases in cost. Insulin treatment, angina, and MI were each associated with 60-90% increases in cost. Dialysis was associated with an 11-fold increase in cost.CONCLUSIONS - insulin treatment and diabetes complications have a substantial impact on the direct medical costs of type 2 diabetes. The estimates presented in this model may be used to analyze the cost-effectiveness of interventions for type 2 diabetes.