How do type 2 diabetes mellitus (T2DM)-related complications and socioeconomic factors impact direct medical costs? A cross-sectional study in rural Southeast China

ObjectiveTo evaluate type 2 diabetes mellitus (T2DM)-related direct medical costs by complication type and complication number, and to assess the impacts of complications as well as socioeconomic factors on direct medical costs.DesignA cross-sectional study using data from the region’s diabetes mana...

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Bibliographic Details
Published in:BMJ open Vol. 8; no. 11; p. e020647
Main Authors: Wu, Haibin, Eggleston, Karen N, Zhong, Jieming, Hu, Ruying, Wang, Chunmei, Xie, Kaixu, Chen, Yiwei, Chen, Xiangyu, Yu, Min
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 01.11.2018
BMJ Publishing Group
Subjects:
Adult
Aged
Aging
China - epidemiology
Cost of Illness
Costs
Cross-Sectional Studies
Diabetes
Diabetes Complications - economics
Diabetes Complications - epidemiology
Diabetes Mellitus, Type 2 - economics
Diabetes Mellitus, Type 2 - epidemiology
Diabetic nephropathy
Epidemiology
Female
GDP
Gross Domestic Product
Health care expenditures
Health Economics
Health Expenditures - statistics & numerical data
Humans
Insurance - classification
Insurance - statistics & numerical data
Insurance claims
Male
Middle Aged
Older people
Primary care
Public health
Registries
Socioeconomic Factors
China
epidemiology
general diabetes
health economics
ISSN:2044-6055, 2044-6055
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Summary:ObjectiveTo evaluate type 2 diabetes mellitus (T2DM)-related direct medical costs by complication type and complication number, and to assess the impacts of complications as well as socioeconomic factors on direct medical costs.DesignA cross-sectional study using data from the region’s diabetes management system, social security system and death registry system, 2015.SettingTongxiang, China.ParticipantsIndividuals diagnosed with T2DM in the local diabetes management system, and who had 2015 insurance claims in the social security system. Patients younger than 35 years and patients whose insurance type changed in the year 2015 were excluded.Main outcome measuresThe mean of direct medical costs by complication type and number, and the percentage increase of direct medical costs relative to a reference group, considering complications and socioeconomic factors.ResultsA total of 19 015 eligible individuals were identified. The total cost of patients with one complication was US$1399 at mean, compared with US$248 for patients without complications. The mean total cost for patients with 2 and 3+ complications was US$1705 and US$2994, respectively. After adjustment for socioeconomic confounders, patients with one complication had, respectively, 83.55% and 38.46% greater total costs for inpatient and outpatient services than did patients without complications. The presence of multiple complications was associated with a significant 44.55% adjusted increase in total outpatient costs, when compared with one complication. Acute complications, diabetic foot, stroke, ischaemic heart disease and diabetic nephropathy were the highest cost complications. Gender, age, education level, insurance type, T2DM duration and mortality were significantly associated with increased expenditures of T2DM.ConclusionsComplications significantly aggravated expenditures on T2DM. Specific kinds of complications and the presence of multiple complications are correlated with much higher expenditures. Proper management and the prevention of related complications are urgently needed to reduce the growing economic burden of diabetes.
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2017-020647