Economic Burden in Chinese Patients with Diabetes Mellitus Using Electronic Insurance Claims Data.
Economic Burden in Chinese Patients with Diabetes Mellitus Using Electronic Insurance Claims Data.
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DOI：
10.1371/journal.pone.0159297
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Chen W
中科院分区：
文献类型：
--
作者：
Huang Y;Vemer P;Zhu J;Postma MJ;Chen W
在中国，使用电子健康数据关注日常护理的经济负担的研究很少。本研究的目的是描述2009 - 2011年中国一个样本城市糖尿病患者的经济负担的发展，使用患者的索赔记录的电子数据。本研究是一项在中国糖尿病患者开放队列中进行的回顾性纵向研究。患者人群由居住在中国东部省会城市的人组成，由省级城镇职工基本医疗保险（UEBMI）覆盖。我们纳入了在2009-2011年的一个日历年内至少有一次明确的糖尿病诊断或在至少一次登记的门诊访视或住院治疗中接受降血糖药物治疗的任何患者。对不同类型的费用、糖尿病并发症和相关疾病的患病率、药物使用情况进行横断面描述，并使用卡方检验或非参数Kruskal-Wallis H检验比较3年之间的差异。我们的研究结果显示，在研究期间，糖尿病患者的总医疗费用（从2，383美元增加到2，780美元，p = 0.032）和糖尿病相关费用（从1，655美元增加到1，857美元）呈上升趋势。糖尿病经济负担与并发症及相关疾病患病率显著相关（P<0.001）。糖尿病相关访视期间的总体药物费用也增加（从1，335美元增加到1，383美元，p = 0.021）。但糖尿病相关药物的使用模式和费用在研究期间没有显着变化。中国城市糖尿病的经济负担显着增加。提高糖尿病的预防和治疗水平对中国医疗体系的可持续发展至关重要。
There is a paucity of studies that focus on the economic burden in daily care in China using electronic health data. The aim of this study is to describe the development of the economic burden of diabetic patients in a sample city in China from 2009 to 2011 using electronic data of patients’ claims records. This study is a retrospective, longitudinal study in an open cohort of Chinese patients with diabetes. The patient population consisted of people living in a provincial capital city in east China, covered by the provincial urban employee basic medical insurance (UEBMI). We included any patient who had at least one explicit diabetes diagnosis or received blood glucose lowering medication in at least one registered outpatient visit or hospitalization during a calendar year in the years 2009–2011. Cross-sectional descriptions of different types of costs, prevalence of diabetic complications and related diseases, medication use were performed for each year separately and differences between three years were compared using a chi-square test or the non-parametric Kruskal-Wallis H test. Our results showed an increasing trend in total medical cost (from 2,383 to 2,780 USD, p = 0.032) and diabetes related cost (from 1,655 to 1,857 USD) for those diabetic patients during the study period. The diabetes related economic burden was significantly related to the prevalence of complications and related diseases (p<0.001). The overall medication cost during diabetes related visits also increased (from 1,335 to 1,383 USD, p = 0.021). But the use pattern and cost of diabetes-related medication did not show significant changes during the study period. The economic burden of diabetes increased significantly in urban China. It is important to improve the prevention and treatment of diabetes to contribute to the sustainability of the Chinese health-care system.
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