Direct and indirect costs among employees with diabetic retinopathy in the United States

ABSTRACT Objective: To examine, from the employer perspective, the direct (healthcare) and indirect (workloss) costs of employees with diabetic retinopathy (DR) compared to control non-DR employees with diabetes, and within DR subgroups. Methods: Compared annual costs using claims data from 17 large...

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Veröffentlicht in:Current medical research and opinion Jg. 24; H. 5; S. 1549 - 1559
Hauptverfasser: Lee, Lauren J., Yu, Andrew P., Cahill, Kevin E., Oglesby, Alan K., Tang, Jackson, Qiu, Ying, Birnbaum, Howard G.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Informa UK Ltd 01.05.2008
Taylor & Francis
Informa Healthcare
Schlagworte:
Adult
Age Factors
Case-Control Studies
Chi-Square Distribution
Cost of Illness
Diabetic macular edema
Diabetic retinopathy
Diabetic Retinopathy - diagnosis
Diabetic Retinopathy - economics
Diabetic Retinopathy - therapy
Direct Service Costs - statistics & numerical data
Employer Health Costs - statistics & numerical data
Evaluation Studies as Topic
Female
Health Benefit Plans, Employee - economics
Health care costs
Humans
Male
Middle Aged
Photocoagulation
Reference Values
Risk Assessment
Severity of Illness Index
Sex Factors
Sick Leave - economics
Sick Leave - statistics & numerical data
Statistics, Nonparametric
United States
Vitrectomy
Workers' Compensation - economics
Workers' Compensation - statistics & numerical data
United States
ISSN:0300-7995, 1473-4877, 1473-4877
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Zusammenfassung:ABSTRACT Objective: To examine, from the employer perspective, the direct (healthcare) and indirect (workloss) costs of employees with diabetic retinopathy (DR) compared to control non-DR employees with diabetes, and within DR subgroups. Methods: Compared annual costs using claims data from 17 large companies (1999-2004). 'DR employees' (n = 2098) had ≥ 1 DR (International Classification of Disease, 9th Revision [ICD‑9]) diagnosis; DR subgroups included employees with diabetic macular edema (DME), proliferative DR (PDR), and employees receiving photo­coagulation or vitrectomy procedures. Descriptive and multivariate tests were performed. Results: DR employee annual direct costs were $18 218 (indirect = $3548) compared to $11 898 (indirect = $2374) for controls (Δ = $2032 (adjusted); p < 0.0001). Costs differences were larger across DR employee subgroups: DME/non-DME ($28 606/$16 363); PDR/non-PDR ($30 135/$13 445; p < 0.0001); DR with/without photocoagulation ($34 539/$16 041; p < 0.0001); and DR with/without vitrectomy ($63 933/$17 239; p < 0.0001). Limitations: This study examined the incremental costs of treating DR employees, which may be higher than the incremental costs of DR itself. Some measures of diabetes severity (e.g., duration of diabetes) were not available in the claims data, and were therefore not included in the multivariate models. The cost of photocoagulation and vitrectomy procedures pertain to individuals who underwent these procedures, and not the cost of the procedures themselves. Conclusion: DR employees had significantly higher costs than controls, and larger differences existed within DR subgroups. Indirect costs accounted for about 20% of total cost.
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ISSN:0300-7995
1473-4877
1473-4877
DOI:10.1185/030079908X297303