Excess costs of medical care for patients with diabetes in a managed care population
Excess costs of medical care for patients with diabetes in a managed care population
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DOI：
10.2337/diacare.20.9.1396
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发表时间：
1997-09-01
期刊：
影响因子：
16.2
通讯作者：
Colby, CJ
中科院分区：
文献类型：
--
作者：
Selby, JV;Ray, GT;Colby, CJ
研究设计和方法-比较北方加州凯萨医疗机构糖尿病登记处的85，209名成员和1994年的85，209名成员的医疗保健费用，209名年龄和性别匹配的非糖尿病对照受试者。成本从自动化程序数据库中获得。明确了与治疗糖尿病急性和长期并发症有关的费用，并计算了糖尿病患者每种并发症的超额费用。结果-糖尿病患者的超额费用总计2.827亿美元，即每人3,494美元。糖尿病患者的人均支出是对照组的2.4倍。总超额费用的最大比例是医疗保健组织内的住院费用（38.5%）。近38%的总过剩是用于治疗糖尿病的长期并发症，主要是冠心病和终末期肾病diseases.CONCLUSIONS -糖尿病是一种昂贵的条件，凭借其高患病率和高人均成本。这些费用中有很大一部分与治疗糖尿病并发症有关。现有证据表明，几种措施可以降低并发症发生率。因此，旨在预防并发症的有效疾病管理计划可能会在管理式护理环境中节省成本。
OBJECTIVE - To estimate the excess costs of medical care for patients with diabetes in a managed care population and to determine the proportion of costs spent on treating the complications of diabetes.RESEARCH DESIGN AND METHODS - A comparison of 1-year (1994) costs of medical care in the 85,209 members of the diabetes registry of Kaiser Permanente, Northern California, and in 85,209 age-and sex-matched nondiabetic control subjects. Costs were obtained from automated program databases. Costs specifically related to treating acute and long-term complications of diabetes were identified, and the excess costs attributable to each complication in individuals with diabetes were calculated.RESULTS - Excess expenditures in individuals with diabetes totaled $282.7 million, or $3,494 per person. Per person expenditures for members with diabetes were 2.4 times those for matched control subjects. The largest proportion of total excess costs was for hospitalizations within the health maintenance organization (38.5%). Nearly 38% of the total excess was spent treating the long-term complications of diabetes, predominantly coronary heart disease and end-stage renal disease.CONCLUSIONS - Diabetes is a costly condition by Virtue of its high prevalence and high per person costs. A large proportion of these costs are related to treating complications of diabetes. Available evidence indicates that several measures can reduce complication rates. Thus, effective disease management programs that aim to prevent complications could potentially lead to cost savings in managed care settings.