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A retrospective study on the impact of comorbid depression or anxiety on healthcare resource use and costs among diabetic neuropathy patients.

Boulanger L, Zhao Y, Bao Y, Russell MW - BMC Health Serv Res (2009)

Bottom Line: Patients' clinical characteristics over pre-index period were compared.We identified 16,831 DN-only and 1,699 DN-DA patients in the Medicare supplemental cohort, as well as 17,205 and 3,105 in the commercially insured.Factors associated with increased costs included insurance type, geographical region, diabetes-related comorbidities, and insulin therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Economic Research and Quality of Life Evaluation, Abt Bio-Pharma Solutions, Inc, Lexington, MA, USA. luke.boulanger@abtbiopharma.com

ABSTRACT

Background: Diabetic neuropathy (DN) is a common complication of diabetes that has significant economic burden, especially for patients with comorbid depression or anxiety. This study examines and quantifies factors associated with healthcare costs among patients diagnosed with diabetic neuropathy (DN) with or without a comorbid diagnosis of depression or anxiety (DA) using retrospective administrative claims data. No study has examined the differences in economic outcomes depending on the presence of comorbid DA disorders.

Methods: Over-age-18 individuals with 1+ diagnosis of DN in 2005 were selected. The first observed DN claim was considered the "index date." All individuals had a 12-month pre-index and follow-up period. For both under-age-65 commercially insured and over-age-65 individuals with employer-sponsored Medicare supplemental insurance, we constructed 2 subgroups for individuals with DA (DN-DA) or without (DN-only). Patients' clinical characteristics over pre-index period were compared. Multivariate regressions were performed to assess whether DN-DA patients had higher utilization of healthcare resources and costs than DN-only patients, controlling for demographic and clinical characteristics.

Results: We identified 16,831 DN-only and 1,699 DN-DA patients in the Medicare supplemental cohort, as well as 17,205 and 3,105 in the commercially insured. DN-DA patients had higher prevalence of diabetes-related comorbidities for cardiovascular disease, cerebrovascular/peripheral vascular disease, nephropathy, obesity, and hypoglycemic events than DN-only patients (all p < 0.05). Controlling for differences in demographic and clinical characteristics, DN-DA patients had $9,235 (p < 0.05) higher total healthcare costs than patients with DN-only among those with Medicare supplemental coverage ($26,718 vs. $17,483), and $10,389 (p < 0.05) more total costs among commercially insured ($29,775 vs. $19,386). Factors associated with increased costs included insurance type, geographical region, diabetes-related comorbidities, and insulin therapy.

Conclusion: These findings indicate that the healthcare costs were significantly higher for DN patients with depression or anxiety relative to those without such comorbid disorders.

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Related in: MedlinePlus

Sample size of study population.
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Figure 1: Sample size of study population.

Mentions: Figure 1 illustrates how sample size was attained for both commercially insured and Medicare supplemental covered patients. Patients diagnosed with diabetes mellitus and diabetic neuropathy in 2005 were included in the study. Commercial patients age 18–64 years and Medicare patients 65 years and older were required to be continuously eligible from the 12 months prior through the 12 months after the index date. Furthermore, patients were classified based on whether or not they were diagnosed with depression or anxiety in the 12 months pre- or post-index period.


A retrospective study on the impact of comorbid depression or anxiety on healthcare resource use and costs among diabetic neuropathy patients.

Boulanger L, Zhao Y, Bao Y, Russell MW - BMC Health Serv Res (2009)

Sample size of study population.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2719623&req=5

Figure 1: Sample size of study population.
Mentions: Figure 1 illustrates how sample size was attained for both commercially insured and Medicare supplemental covered patients. Patients diagnosed with diabetes mellitus and diabetic neuropathy in 2005 were included in the study. Commercial patients age 18–64 years and Medicare patients 65 years and older were required to be continuously eligible from the 12 months prior through the 12 months after the index date. Furthermore, patients were classified based on whether or not they were diagnosed with depression or anxiety in the 12 months pre- or post-index period.

Bottom Line: Patients' clinical characteristics over pre-index period were compared.We identified 16,831 DN-only and 1,699 DN-DA patients in the Medicare supplemental cohort, as well as 17,205 and 3,105 in the commercially insured.Factors associated with increased costs included insurance type, geographical region, diabetes-related comorbidities, and insulin therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Economic Research and Quality of Life Evaluation, Abt Bio-Pharma Solutions, Inc, Lexington, MA, USA. luke.boulanger@abtbiopharma.com

ABSTRACT

Background: Diabetic neuropathy (DN) is a common complication of diabetes that has significant economic burden, especially for patients with comorbid depression or anxiety. This study examines and quantifies factors associated with healthcare costs among patients diagnosed with diabetic neuropathy (DN) with or without a comorbid diagnosis of depression or anxiety (DA) using retrospective administrative claims data. No study has examined the differences in economic outcomes depending on the presence of comorbid DA disorders.

Methods: Over-age-18 individuals with 1+ diagnosis of DN in 2005 were selected. The first observed DN claim was considered the "index date." All individuals had a 12-month pre-index and follow-up period. For both under-age-65 commercially insured and over-age-65 individuals with employer-sponsored Medicare supplemental insurance, we constructed 2 subgroups for individuals with DA (DN-DA) or without (DN-only). Patients' clinical characteristics over pre-index period were compared. Multivariate regressions were performed to assess whether DN-DA patients had higher utilization of healthcare resources and costs than DN-only patients, controlling for demographic and clinical characteristics.

Results: We identified 16,831 DN-only and 1,699 DN-DA patients in the Medicare supplemental cohort, as well as 17,205 and 3,105 in the commercially insured. DN-DA patients had higher prevalence of diabetes-related comorbidities for cardiovascular disease, cerebrovascular/peripheral vascular disease, nephropathy, obesity, and hypoglycemic events than DN-only patients (all p < 0.05). Controlling for differences in demographic and clinical characteristics, DN-DA patients had $9,235 (p < 0.05) higher total healthcare costs than patients with DN-only among those with Medicare supplemental coverage ($26,718 vs. $17,483), and $10,389 (p < 0.05) more total costs among commercially insured ($29,775 vs. $19,386). Factors associated with increased costs included insurance type, geographical region, diabetes-related comorbidities, and insulin therapy.

Conclusion: These findings indicate that the healthcare costs were significantly higher for DN patients with depression or anxiety relative to those without such comorbid disorders.

Show MeSH
Related in: MedlinePlus