Health service utilization and related costs attributable to diabetes

O’Neill, Kate N.; McHugh, Sheena; Tracey, Marsha L.; Fitzgerald, Anthony P.; Kearney, Patricia M.

doi:10.1111/dme.13806

Cited by 28 publications

(32 citation statements)

References 29 publications

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“…Diabetes is a chronic disease that requires continuous medical care as well as patient self-management training and support to prevent acute complications and reduce the risk of longterm complications (18). Evidence shows that diabetes is associated with substantial additional health service use and costs, with hospital admissions accounting for more than two-thirds of the cost burden (19). In view of the COVID-19 outbreak in 2020, the prevalence of diabetes may further increase, which will result in a huge burden to the healthcare system (20).…”

Section: Discussionmentioning

confidence: 99%

The effect of the integrated delivery system in rural areas of China

Feng

Shen³

et al. 2021

Ann Palliat Med

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Background: With the continuous development of modern society, the management of chronic diseases has become the focus of the medical community in China. In particular, diabetes is a chronic disease that cannot be ignored. China has built an integrated delivery system to deal with imminent health problems.The purpose of this study is to investigate the effects of integrated rural supply system in China. Methods:We selected 1,061 patients with diabetes from the Zhili Town Health Center's hospital information system. We tracked and studied their outpatient and inpatient expenses, treatment behaviors, incidence of complications, and satisfaction over 5 years. We compared the data collected from 2014 to 2019 to determine the trends of these four factors and the effects of the integrated delivery system for patients with diabetes.Results: We found that the average costs for diabetes patients in outpatient and inpatient departments were increasing slightly every year. The number of patients in tertiary hospitals has decreased significantly, while the number of patients in community hospitals (primary hospitals) has increased, and the number of patients in secondary hospitals has remained relatively unchanged. Meanwhile, the expenses per visit were also lower over this period in hospitals at all levels. Diabetes complications have been increasing marginally, and there is a relatively high degree of satisfaction among patients and doctors in primary hospitals, which is rising.Conclusions: Considering the various needs of people in different stages of life, the integrated delivery system provides and manages continuous services such as health promotion, disease prevention, diagnosis, treatment, rehabilitation, and management through cooperation between institutions at different levels of the health system.

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Section: Discussionmentioning

confidence: 99%

The effect of the integrated delivery system in rural areas of China

Feng

Shen³

et al. 2021

Ann Palliat Med

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“…In the United States, an estimated 28% of older adults live with diabetes, a chronic condition associated with macro-and microvascular complications [1]. Diabetes is associated with more frequent use of emergency and acute care, higher mortality [2,3], longer hospitalizations, and more frequent rehospitalizations [4,5]. For older adults with multiple chronic conditions, post-acute care transitions are a particularly high-risk period for adverse events and rehospitalization [6,7].…”

Section: Introductionmentioning

confidence: 99%

Racial Disparities in Post-Acute Home Health Care Referral and Utilization Among Older Adults with Diabetes

Smith¹,

Jarrín²,

Lin³

et al. 2021

Preprint

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Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.

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“…In Europe and North America, the proportion of health care expenditure on diabetes in 2010 ranges from 6 to 14 per cent (1). In the Republic of Ireland, the incremental cost of additional health service use is estimated to be €89 million annually (2). Health care utilisation and health care costs among those with diabetes are strongly related to diabetic complications; in the UK, 80 per cent of diabetic health care costs are due to complications (3,4).…”

Section: Introductionmentioning

confidence: 99%

A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland

Pierse

Barry

Glynn

et al. 2020

Preprint

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Background: There are social and economic differences between Northern Ireland (NI) and the Republic of Ireland (ROI). There are also differences in the health care systems in the two jurisdictions. The aims of this study are to compare health (prevalence of diabetes and related complications) and health care utilisation (general practitioner, outpatient or accident and emergency utilisation) among older people with diabetes in the NI and ROI. Methods: Large scale comparable surveys of people over 50 years of age in Northern Ireland (NICOLA, wave 1) and the Republic of Ireland (TILDA, wave 1) are used to compare people with diabetes (type I and type II) in the two jurisdictions. The combined data set comprises 1,536 people with diabetes. A coarsened exact matching approach is used to compare health care utilisation among people with diabetes in NI and ROI with equivalent demographic, lifestyle and illness characteristics (age, gender, education, smoking status and self-related health, number of other chronic diseases and number of diabetic complications).Results: The overall prevalence of diabetes in the 50 to 84 years old age group is 3.4 percentage points higher in NI (11.1% in NI, 7.7% ROI, p-value < 0.01). The diabetic population in NI appear sicker – with more diabetic complications and more chronic illnesses. Comparing people with diabetes in the two jurisdictions with similar levels of illness we find that there are no statistically significant differences in GP, outpatient or A&E utilisation.Conclusion: Despite the proximity of NI and ROI there are substantial differences in the prevalence of diabetes and its related complications. Despite differences in the health services in the two jurisdictions the differences in health care utilisation for an equivalent cohort are small.

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Health service utilization and related costs attributable to diabetes

Abstract: Using robust methods, we identified substantially increased service use attributable to diabetes across the health system. Our findings highlight the urgent need to invest in the prevention and management of diabetes.

Cited by 28 publications

References 29 publications

The effect of the integrated delivery system in rural areas of China

The effect of the integrated delivery system in rural areas of China

Racial Disparities in Post-Acute Home Health Care Referral and Utilization Among Older Adults with Diabetes

A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland

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