Healthcare Costs Associated with Complications in Patients with Type 2 Diabetes among 1.85 Million Adults in Beijing, China

Wu, Junhui; Wu, Yao; Wang, Zijing; Wu, Yiqun; Wu, Tao; Wang, Meng-Ying; Wang, Xiaowen; Wang, Siyue; Wang, Jiating; Yu, Huan; Hu, Yonghua

doi:10.3390/ijerph18073693

Cited by 9 publications

(9 citation statements)

References 35 publications

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“…The results of our study confirmed that hospitalization and complications play a decisive role in the diabetes-related direct medical costs of diabetic patients, which is consistent with previous studies (15, [23][24][25][26][27][28]. Hospitalization is essentially a reflection of the severity of a diabetic patient's condition and a manifestation of poor control and management of diabetes (29).…”

Section: Discussionsupporting

confidence: 92%

“…In terms of complications, our research shows that the number and types of complications in patients with diabetes have a direct impact on their diabetes-related direct medical costs. This result highlights evidence from other studies that the medical costs caused by complications contribute to a high economic burden for patients with diabetes (15, [23][24][25][26][27][28]. The results of this study showed that the proportion of both patients with at least one complication and patients with multiple complications increased significantly from 2014 to 2019.…”

Section: Discussionsupporting

confidence: 85%

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Trends in economic burden of type 2 diabetes in China: Based on longitudinal claim data

Liu

Zhang

Chen

2023

Front. Public Health

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ObjectiveDiabetes is a major health issue in China that has a significant economic burden on society. Understanding the economic impact of diabetes can help policymakers make informed decisions about healthcare spending and priorities. This study aims to estimate the economic burden of patients with diabetes in an urban setting in China and to identify the impact of hospitalization and complications on health care costs for people with diabetes.MethodsThe study was conducted in a sample city located in eastern China. All patients diagnosed with diabetes before January 2015 were identified from the official health management information system, and their social demographics and records of their health care uses and costs were extracted from the claim database from 2014 to 2019. Six groups of complications were identified according to ICD-10 codes. The diabetes-related direct medical cost (DM cost) was described for patients in stratified groups. A multiple linear regression model was applied to identify the effect of hospitalization and complications on the DM cost of diabetic patients.ResultsOur research included 44,994 patients with diabetes, the average annual DM costs for diabetic patients increased from 1,292.72 USD in 2014 to 2,092.87 USD in 2019. The costs of diabetes are closely related to hospitalizations and the type and number of complications. The average annual DM cost of patients who were hospitalized was 2.23 times that of those without hospitalization, and it rose as the number of complications increased. Cardiovascular complications and nephropathic complications were the complications that had the greatest impact on patients’ DM costs, increasing by an average of 65 and 54%, respectively.ConclusionThe economic burden of diabetes in urban China has increased significantly. Hospitalization and the type and number of complications have significant impacts on the economic burden of patients with diabetes. Efforts should be made to prevent the development of long-term complications in the population with diabetes.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 85%

Trends in economic burden of type 2 diabetes in China: Based on longitudinal claim data

Liu

Zhang

Chen

2023

Front. Public Health

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“…Previous research performed elsewhere reported high costs for care of acute diabetes complications [ 21 , 22 ] and higher costs per episode of hospitalization for acute diabetes complications as compared to those without [ 23 ]. In an analysis performed by Javor et al [ 23 ], it was shown that diabetes ketoacidosis triples the costs of hospital care for patients with type 1 diabetes in the US (USD 13,096 per hospitalization episode for diabetes ketoacidosis versus USD 4907 per hospitalization episode without ketoacidosis).…”

Section: Discussionmentioning

confidence: 99%

Length of Hospital Stay, Hospitalization Costs, and Their Drivers in Adults with Diabetes in the Romanian Public Hospital System

Bala

Rusu

Ciobanu

et al. 2022

IJERPH

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The aim of this analysis was to assess the costs associated with the hospitalizations of persons with diabetes in a Romanian public hospital. We performed a retrospective “top-down” cost analysis of all adult patients discharged from a tertiary care hospital with an ICD-10 primary or secondary code of diabetes mellitus (type 1, type 2, or specific forms) between 1 January 2015 and 31 December 2018. All costs were adjusted with the annual inflation rates and converted to EUR. We included 16,868 patients with diabetes and 28,055 episodes of hospitalization. The total adjusted hospitalization cost in the analyzed period was EUR 26,418,126.8 and the adjusted median cost/episode of hospitalization was EUR 596.5. The mean length of a hospital stay/episode was 7.3 days. In the multivariate regression analysis, higher adjusted average costs/episodes of hospitalization and longer lengths of hospital stays were associated with increasing age, the presence of cardiovascular diseases, chronic kidney disease, and foot ulcerations. Moreover, a significant association between the average cost/episode of hospitalization and the length of hospital stay was observed (β = 0.704, p < 0.001). This study shows the burden on Romanian public hospitals of inpatient diabetes care and the main drivers of the costs.

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“…Details of the Beijing Medical Claim Data for Employees (BMCDE) database have been previously described elsewhere. 17,18 Briefly, anonymous medical claim data, such as demographic characteristics, clinical diagnosis, medication and reimbursement information, of all active or retired employees enrolled in basic medical insurance in Beijing (nearly 90% of Beijing’s permanent population) were registered into the database. Because the data we used were retrospective information encrypted for administrative purposes, our research was exempt from ethics committee review.…”

Section: Methodsmentioning

confidence: 99%

Is statin therapy after ischaemic stroke associated with increased intracerebral hemorrhage? The association may be dependent on intensity of statin therapy

Yang

et al. 2023

International Journal of Stroke

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Background: There has been concern that statin therapy may be associated with an increased risk of intracerebral hemorrhage (ICH). We investigated whether statin therapy intensity and type of statin therapy instituted after ischemic stroke (IS) and was associated with risk of with future intracerebral hemorrhage (ICH) in a region of northern China with a high incidence of stroke. Methods: Newly diagnosed IS patients who were not treated with lipid-lowering drugs in the Beijing Employee Medical Claims Data database from 2010 to 2017 were included. The primary exposure variable was any statin prescription within 1 month of the first documented stroke diagnosis. High-intensity statin therapy was defined as atorvastatin ≥80 mg, simvastatin ≥80 mg, pravastatin ≥40 mg, rosuvastatin ≥20 mg per day or equivalent combination. An adjusted Cox proportional hazards model was used to estimate the hazard ratio for ICH during follow-up in groups exposed and not exposed to statins. Results Of 62,252 participants with IS, 628 ICH readmissions were recorded during a median follow-up of 3.17 years. The risk of ICH among statin users (N=43,434) was similar to that among nonusers (N=18,818), with an adjusted hazard ratio (HR) and 95% confidence interval (CI) of 0.86 (0.73, 1.02). Compared with non-statin therapy, patients with low/moderate-intensity therapy had a lower risk of ICH (0.62: 0.52, 0.75), while patients with high-intensity therapy had a substantially higher risk (2.12: 1.72, 2.62). For patients with different types of statin therapy, adherence to rosuvastatin had the lowest risk of ICH compared to adherence to atorvastatin (0.46: 0.34, 0.63), followed by simvastatin (0.60: 0.45, 0.81). Conclusions: In patients with IS any statin therapy was not assoicted with an increased risk of ICH. However there appeared to be differnetial risk according to the dose of statin with high-intensity statin therapy being associated with an increased risk of ICH, while low/moderate-intensity therapy was associated with a lower risk.

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Healthcare Costs Associated with Complications in Patients with Type 2 Diabetes among 1.85 Million Adults in Beijing, China

Cited by 9 publications

References 35 publications

Trends in economic burden of type 2 diabetes in China: Based on longitudinal claim data

Trends in economic burden of type 2 diabetes in China: Based on longitudinal claim data

Length of Hospital Stay, Hospitalization Costs, and Their Drivers in Adults with Diabetes in the Romanian Public Hospital System

Is statin therapy after ischaemic stroke associated with increased intracerebral hemorrhage? The association may be dependent on intensity of statin therapy

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