Xilin Zhou1, Sundar S Shrestha2, Elizabeth Luman2, Guijing Wang3, Ping Zhang2. 1. Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: kqt5@cdc.gov. 2. Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia. 3. Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
INTRODUCTION: The coexistence of diabetes among people with acute myocardial infarction (AMI) or acute ischemic stroke (AIS) is common. However, little is known about the extent of excess medical expenditures associated with having diabetes among AMI and AIS patients. METHODS: Data on 3,307 AMI patients and 2,460 AIS patients aged ≥18 years from the 2008 to 2014 Medical Expenditure Panel Survey were analyzed. Per capita annual medical expenditures associated with diabetes were separately estimated by healthcare components with generalized linear models and two-part models. Excess expenditure associated with diabetes is the difference between estimated expenditure conditional on having both diabetes and AMI (or AIS) and the estimated expenditure conditional on having AMI (or AIS) but not diabetes. All expenditures were adjusted to 2014 U.S. dollars. The analysis was conducted in 2017. RESULTS: Per capita annual total excess expenditures associated with diabetes were $5,117 (95% CI=$4,989, $5,243) for AMI patients and $5,734 (95% CI=$5,579, $5,887) for AIS patients. Of the total excess expenditures, prescription drugs accounted for 40% among AMI patients and 42% among AIS patients. Higher expenditures associated with diabetes were explained more by higher volume of utilization than higher per unit expenditures. CONCLUSIONS: Excess expenditures associated with diabetes were substantial among both AMI and AIS patients. These results highlight the needs for both prevention and better management of diabetes among AMI and AIS patients, which in turn may lower the financial burden of treating these conditions. Published by Elsevier Inc.
INTRODUCTION: The coexistence of diabetes among people with acute myocardial infarction (AMI) or acute ischemic stroke (AIS) is common. However, little is known about the extent of excess medical expenditures associated with having diabetes among AMI and AISpatients. METHODS: Data on 3,307 AMI patients and 2,460 AISpatients aged ≥18 years from the 2008 to 2014 Medical Expenditure Panel Survey were analyzed. Per capita annual medical expenditures associated with diabetes were separately estimated by healthcare components with generalized linear models and two-part models. Excess expenditure associated with diabetes is the difference between estimated expenditure conditional on having both diabetes and AMI (or AIS) and the estimated expenditure conditional on having AMI (or AIS) but not diabetes. All expenditures were adjusted to 2014 U.S. dollars. The analysis was conducted in 2017. RESULTS: Per capita annual total excess expenditures associated with diabetes were $5,117 (95% CI=$4,989, $5,243) for AMI patients and $5,734 (95% CI=$5,579, $5,887) for AISpatients. Of the total excess expenditures, prescription drugs accounted for 40% among AMI patients and 42% among AISpatients. Higher expenditures associated with diabetes were explained more by higher volume of utilization than higher per unit expenditures. CONCLUSIONS: Excess expenditures associated with diabetes were substantial among both AMI and AISpatients. These results highlight the needs for both prevention and better management of diabetes among AMI and AISpatients, which in turn may lower the financial burden of treating these conditions. Published by Elsevier Inc.
Authors: Viera Ivanková; Rastislav Kotulič; Jaroslav Gonos; Martin Rigelský Journal: Int J Environ Res Public Health Date: 2019-10-11 Impact factor: 3.390