The health care costs of diabetic peripheral neuropathy in the US
The health care costs of diabetic peripheral neuropathy in the US
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DOI：
10.2337/diacare.26.6.1790
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发表时间：
2003-06-01
期刊：
影响因子：
16.2
通讯作者：
Tobian, JA
中科院分区：
文献类型：
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作者：
Gordois, A;Scuffham, P;Tobian, JA
周围神经病变在糖尿病患者中很常见，可导致足部溃疡和截肢。本研究的目的是量化美国1型和2型糖尿病患者周围神经病变及其并发症的年度医疗费用。研究设计和方法-疾病成本模型用于估计美国患有糖尿病周围神经病变（DPN）和/或神经性足溃疡的糖尿病个体的数量（没有深部感染和伴有蜂窝组织炎或骨髓炎的患者），和/或一年内脚趾、脚或腿截肢。患病率和发病率是根据已发表的研究估计的，并适用于美国普通人群。所有费用都是以2001年美元估计的。在敏感性分析中，我们改变了并发症的发生率，以评估成本估计的稳健性。结果-DPN及其并发症在美国的年成本分别为8亿美元（1型糖尿病），101亿美元（2型糖尿病）和109亿美元（总）。考虑到并发症发生率的点估计值的不确定性，成本范围在3亿美元至10亿美元之间（1型糖尿病），43亿美元和127亿美元（2型糖尿病），46亿美元和137亿美元结论-在美国，DPN及其并发症的年度总费用估计在46亿至137亿美元之间。高达27%的糖尿病直接医疗费用可归因于DPN。
OBJECTIVE - Peripheral neuropathy is common among people with diabetes and can result in foot ulceration and amputation. The aim of this study was to quantify the annual medical costs of peripheral neuropathy and its complications among people with type 1 and type 2 diabetes in the U.S.RESEARCH DESIGN AND METHODS - A cost-of-illness model was used to estimate the numbers of diabetic individuals in the U.S. who have diabetic peripheral neuropathy (DPN) and/or neuropathic foot ulcers (both those with no deep infection and those accompanied by cellulitis or osteomyelitis) at a given point in time, and/or a toe, foot, or leg amputation during a year. Prevalence and incidence rates were estimated from published studies and applied to the general U.S. population. All costs were estimated in 2001 U.S. dollars. In, a sensitivity analysis, we varied the rates of complications to assess the robustness of the cost estimates.RESULTS - The annual costs of DPN and its complications in the U.S. were $0.8 billion (type 1 diabetes), $10.1 billion (type 2 diabetes), and $10.9 billion (total). After allowing for uncertainty in the point estimates of complication rates, the range of costs were between $0.3 and $1.0 billion (type 1 diabetes), $4.3b and $12.7 billion (type 2 diabetes), and $4.6 and $13.7 billion (type 1 and type 2 diabetes).CONCLUSIONS - The total annual cost of DPN and its complications in the U.S. was estimated to be between $4.6 and $13.7 billion. Up to 27% of the direct medical cost of diabetes may be attributed to DPN.