Manel Mata-Cases1,2,3, Beatriz Rodríguez-Sánchez4, Dídac Mauricio5,3,6, Jordi Real2,3, Bogdan Vlacho2, Josep Franch-Nadal5,3,7, Juan Oliva4. 1. Centre d'Atenció Primària La Mina, Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain. 2. DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain. 3. CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain. 4. Department of Economic Analysis and Finance, Faculty of Law and Social Sciences, University of Castilla-La Mancha, Toledo, Spain. 5. DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain josep.franch@gmail.com didacmauricio@gmail.com. 6. Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 7. Centre d'Atenció Primària Raval Sud, Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain.
Abstract
OBJECTIVE: To analyze the differences in health care costs according to glycemic control in people with type 2 diabetes. RESEARCH DESIGN AND METHODS: Data on health care resource utilization from 100,391 people with type 2 diabetes were extracted from the electronic database used at the Catalan Health Institute. Multivariate regression models were carried out to test the impact of glycemic control (HbA1c) on total health care, hospital admission, and medication costs; model 1 adjusted for a variety of covariates, and model 2 also included micro- and macrovascular complications. Glycemic control was classified as good for HbA1c <7%, fair for ≥7% to <8%, poor for ≥8% to <10%, and very poor for ≥10%. RESULTS: Mean per patient annual direct medical costs were €3,039 ± SD €6,581. Worse glycemic control was associated with higher total health care costs: compared with good glycemic control, health care costs increased by 18% (€509.82) and 23% (€661.35) in patients with very poor and poor glycemic control, respectively, when unadjusted and by €428.3 and €395.1, respectively, in model 2. Medication costs increased by 12% in patients with fair control and by 28% in those with very poor control (model 2). Patients with poor control had a higher probability of hospitalization than those with good control (5% in model 2) and a greater average cost when hospitalization occurred (€811). CONCLUSIONS: Poor glycemic control was directly related to higher total health care, hospitalization, and medication costs. Preventive strategies and good glycemic control in people with type 2 diabetes could reduce the economic impact associated with this disease.
OBJECTIVE: To analyze the differences in health care costs according to glycemic control in people with type 2 diabetes. RESEARCH DESIGN AND METHODS: Data on health care resource utilization from 100,391 people with type 2 diabetes were extracted from the electronic database used at the Catalan Health Institute. Multivariate regression models were carried out to test the impact of glycemic control (HbA1c) on total health care, hospital admission, and medication costs; model 1 adjusted for a variety of covariates, and model 2 also included micro- and macrovascular complications. Glycemic control was classified as good for HbA1c <7%, fair for ≥7% to <8%, poor for ≥8% to <10%, and very poor for ≥10%. RESULTS: Mean per patient annual direct medical costs were €3,039 ± SD €6,581. Worse glycemic control was associated with higher total health care costs: compared with good glycemic control, health care costs increased by 18% (€509.82) and 23% (€661.35) in patients with very poor and poor glycemic control, respectively, when unadjusted and by €428.3 and €395.1, respectively, in model 2. Medication costs increased by 12% in patients with fair control and by 28% in those with very poor control (model 2). Patients with poor control had a higher probability of hospitalization than those with good control (5% in model 2) and a greater average cost when hospitalization occurred (€811). CONCLUSIONS: Poor glycemic control was directly related to higher total health care, hospitalization, and medication costs. Preventive strategies and good glycemic control in people with type 2 diabetes could reduce the economic impact associated with this disease.
Authors: Robert L Ferrer; Carolina Gonzalez Schlenker; Inez Cruz; Polly Hitchcock Noël; Raymond F Palmer; Ramin Poursani; Carlos Roberto Jaén Journal: Ann Fam Med Date: 2022 Sep-Oct Impact factor: 5.707
Authors: Sanjeev N Mehta; Liane J Tinsley; Davida Kruger; Bruce Bode; Jennifer E Layne; Lauren M Huyett; Kate Dryga; Bonnie Dumais; Trang T Ly; Lori M Laffel Journal: Clin Diabetes Date: 2021-01