Change in Medical Spending Attributable to Diabetes: National Data From 1987 to 2011
Change in Medical Spending Attributable to Diabetes: National Data From 1987 to 2011
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DOI：
10.2337/dc14-1687
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发表时间：
2015-04-01
期刊：
影响因子：
16.2
通讯作者：
Gregg, Edward W.
中科院分区：
文献类型：
--
作者：
Zhuo, Xiaohui;Zhang, Ping;Gregg, Edward W.
糖尿病护理在过去的20年里发生了巨大的变化。研究设计和方法利用1987年全国医疗支出调查和2000-2001年和2010-2011年的医疗支出小组调查，我们比较了18岁以上有或无糖尿病的成年人在三个时间点的人均医疗支出和使用。医疗服务的类型包括住院护理、急诊室（ER）就诊、门诊就诊、处方药等。我们还检查了单位成本的变化，单位成本由每次医疗服务的支出定义。（95%CI，2，265美元至3，104美元），4，205美元（3，746美元至4，920美元）和5，378美元（5，129美元至5，688美元）。在增加的2，790美元中，处方药占55%;住院治疗占24%;门诊治疗占15%;急诊和其他医疗支出占6%。处方药支出的增长是由于使用量和单位成本的增加，而门诊支出的增加几乎完全是由更多的访问驱动的。相比之下，住院和急诊室支出的增加是由单位costs.CONCLUSIONSIn过去的20年，管理糖尿病已变得更加昂贵，主要是由于更高的药物支出。需要进行进一步的研究，以评估增加药物支出的成本效益。
OBJECTIVEDiabetes care has changed substantially in the past 2 decades. We examined the change in medical spending and use related to diabetes between 1987 and 2011.RESEARCH DESIGN AND METHODSUsing the 1987 National Medical Expenditure Survey and the Medical Expenditure Panel Surveys in 2000-2001 and 2010-2011, we compared per person medical expenditures and uses among adults 18 years of age with or without diabetes at the three time points. Types of medical services included inpatient care, emergency room (ER) visits, outpatient visits, prescription drugs, and others. We also examined the changes in unit cost, defined by the expenditure per encounter for medical services.RESULTSThe excess medical spending attributed to diabetes was $2,588 (95% CI, $2,265 to $3,104), $4,205 ($3,746 to $4,920), and $5,378 ($5,129 to $5,688) per person, respectively, in 1987, 2000-2001, and 2010-2011. Of the $2,790 increase, prescription medication accounted for 55%; inpatient visits accounted for 24%; outpatient visits accounted for 15%; and ER visits and other medical spending accounted for 6%. The growth in prescription medication spending was due to the increase in both the volume of use and unit cost, whereas the increase in outpatient expenditure was almost entirely driven by more visits. In contrast, the increase in inpatient and ER expenditures was caused by the rise of unit costs.CONCLUSIONSIn the past 2 decades, managing diabetes has become more expensive, mostly due to the higher spending on drugs. Further studies are needed to assess the cost-effectiveness of increased spending on drugs.