The purpose of this report is to estimate diabetes prevalence and annual health care costs for people with diabetes in 1992, compare average annual costs for diabetics and nondiabetics, and estimate the portion of total U.S. health care expenditures incurred by people with the disease. Data from the 1987 National Medical Expenditure Survey were used to estimate diabetes prevalence and health care expenditures for diabetics in 1992. Diabetics were identified based on self-reports of a physician diagnosis of diabetes, a history of taking diabetic medications, or an encounter with the health care system specifically related to diabetes. Identified diabetics were classified as confirmed if they had a history of taking diabetic medications, had a diabetes-specific encounter with the health care system, or purchased diabetic equipment. Estimates of diabetes prevalence and health care expenditures were calculated separately for identified and confirmed diabetics using the National Medical Expenditure Survey database. Total health care expenditures included costs associated with inpatient hospital care, outpatient hospital care, office visits to a physician or other provider, emergency room visits, home health care, prescription drugs, dental care, and durable medical equipment purchases. We estimate that percapita annual health care expenditures in 1992 were more than three times greater for diabetics ($9,493) than for nondiabetics ($2,604). Percapita expenditures for confirmed diabetics ($11,157) were more than four times greater than for nondiabetics. In 1992, diabetics constituted 4.5% of the U.S. population but accounted for 14.6% of total U.S. health care expenditures ($105 billion). Confirmed diabetics constituted 3.1% of the U.S. population but accounted for 11.9% of total U.S. health care expenditures ($85 billion). This study found that health care expenditures for people with diabetes constituted about one in seven health care dollars spent in 1992. Health care reform and insurers should take note of these findings and structure benefit packages to promote care likely to reduce the costs of caring for diabetics.

Coronavirus disease 2019 (COVID‐19) has led to a surge of patients requiring post‐acute care. In order to support federal, state and corporate planning, we offer a four‐stage regionally oriented approach to achieving optimal systemwide resource allocation across a region's post‐acute service settings and providers over time. In the first stage, the post‐acute care system must, to the extent possible, help relieve acute hospitals of non‐COVID‐19 patients to create as much inpatient capacity as possible over the surge period. In the second stage after the initial surge as subsided, post‐acute providers must protect vulnerable populations from COVID‐19, prepare treat‐in‐place protocols for non‐COVID‐19 admissions, and create and formalize COVID‐19 specific settings. In the third stage after a vaccine has been developed or an effective prophylactic option is available, post‐acute care providers must assist with distribution and administration of vaccinations and prophylaxis, develop strategies to deliver non‐COVID‐19 related medical care, and begin to transition to the post‐COVID‐19 landscape. In the final stage, we must create health advisory bodies to review post‐acute sector's response, identify opportunities to improve performance going forward, and develop a pandemic response plan for post‐acute care providers. J Am Geriatr Soc 68:1150–1154, 2020.

No abstract

No abstract

No abstract