David I Feldman1, Javier Valero-Elizondo2, Joseph A Salami3, Jamal S Rana4, Oluseye Ogunmoroti3, Chukwuemeka U Osondu3, Erica S Spatz5, Salim S Virani6, Ron Blankstein7, Michael J Blaha8, Emir Veledar3, Khurram Nasir9. 1. University of Miami Miller School of Medicine, Miami, FL, USA; The Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA. 2. Tecnologico de Monterrey, Catedra de Cardiologia y Medicina Vascular, Nuevo Leon, Mexico; Center for Healthcare Advancement and Outcomes Research, BHSF, Miami, FL, USA. 3. Center for Healthcare Advancement and Outcomes Research, BHSF, Miami, FL, USA. 4. Division of Cardiology and Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. 5. Center for Outcomes Research and Evaluation, Yale New Haven Hospital, Yale University, New Haven, CT, USA. 6. Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. 7. Non-Invasive Cardiovascular Imaging Program, Department of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA, USA. 8. The Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA. 9. Center for Healthcare Advancement and Outcomes Research, BHSF, Miami, FL, USA; The Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA. Electronic address: KhurramN@baptisthealth.net.
Abstract
BACKGROUND AND AIMS: Given the prevalence and economic burden of diabetes mellitus (DM), we studied the impact of a favorable cardiovascular risk factor (CRF) profile on healthcare expenditures and resource utilization among individuals without cardiovascular disease (CVD), by DM status. METHODS: 25,317 participants were categorized into 3 mutually-exclusive strata: "Poor", "Average" and "Optimal" CRF profiles (≥4, 2-3, 0-1 CRF, respectively). Two-part econometric models were utilized to study cost data. RESULTS: Mean age was 45 (48% male), with 54% having optimal, 39% average, and 7% poor CRF profiles. Individuals with DM were more likely to have poor CRF profile vs. those without DM (OR 7.7, 95% CI 6.4, 9.2). Individuals with DM/poor CRF profile had a mean annual expenditure of $9,006, compared to $6,461 among those with DM/optimal CRF profile (p < 0.001). CONCLUSIONS: A favorable CRF profile is associated with significantly lower healthcare expenditures and utilization in CVD-free individuals across DM status, suggesting that these individuals require aggressive individualized prescriptions targeting lifestyle modifications and therapeutic treatments.
BACKGROUND AND AIMS: Given the prevalence and economic burden of diabetes mellitus (DM), we studied the impact of a favorable cardiovascular risk factor (CRF) profile on healthcare expenditures and resource utilization among individuals without cardiovascular disease (CVD), by DM status. METHODS: 25,317 participants were categorized into 3 mutually-exclusive strata: "Poor", "Average" and "Optimal" CRF profiles (≥4, 2-3, 0-1 CRF, respectively). Two-part econometric models were utilized to study cost data. RESULTS: Mean age was 45 (48% male), with 54% having optimal, 39% average, and 7% poor CRF profiles. Individuals with DM were more likely to have poor CRF profile vs. those without DM (OR 7.7, 95% CI 6.4, 9.2). Individuals with DM/poor CRF profile had a mean annual expenditure of $9,006, compared to $6,461 among those with DM/optimal CRF profile (p < 0.001). CONCLUSIONS: A favorable CRF profile is associated with significantly lower healthcare expenditures and utilization in CVD-free individuals across DM status, suggesting that these individuals require aggressive individualized prescriptions targeting lifestyle modifications and therapeutic treatments.
Authors: Andi Shahu; Victor Okunrintemi; Martin Tibuakuu; Safi U Khan; Martha Gulati; Francoise Marvel; Roger S Blumenthal; Erin D Michos Journal: Am J Prev Cardiol Date: 2021-11-06
Authors: Gowtham R Grandhi; Javier Valero-Elizondo; Reed Mszar; Eric J Brandt; Amarnath Annapureddy; Rohan Khera; Anshul Saxena; Salim S Virani; Ron Blankstein; Nihar R Desai; Michael J Blaha; Faisal H Cheema; Farhaan S Vahidy; Khurram Nasir Journal: Am J Prev Cardiol Date: 2020-07-13