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Estimating the prevalence of comorbid conditions and their effect on health care costs in patients with diabetes mellitus in Switzerland.

Huber CA, Diem P, Schwenkglenks M, Rapold R, Reich O - Diabetes Metab Syndr Obes (2014)

Bottom Line: Generalized linear models with negative binomial distribution were used to analyze the effect of comorbidities on health care costs.Costs were significantly higher in patients with diabetes and comorbid cardiovascular disease (US$4,788), hyperlipidemia (US$2,163), hyperacidity disorders (US$8,753), and pain (US$8,324) compared with in those without the given disease.Interestingly, hyperacidity disorders and pain were the most costly conditions.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Sciences, Helsana Group, Zürich, Switzerland.

ABSTRACT

Background: Estimating the prevalence of comorbidities and their associated costs in patients with diabetes is fundamental to optimizing health care management. This study assesses the prevalence and health care costs of comorbid conditions among patients with diabetes compared with patients without diabetes. Distinguishing potentially diabetes- and nondiabetes-related comorbidities in patients with diabetes, we also determined the most frequent chronic conditions and estimated their effect on costs across different health care settings in Switzerland.

Methods: Using health care claims data from 2011, we calculated the prevalence and average health care costs of comorbidities among patients with and without diabetes in inpatient and outpatient settings. Patients with diabetes and comorbid conditions were identified using pharmacy-based cost groups. Generalized linear models with negative binomial distribution were used to analyze the effect of comorbidities on health care costs.

Results: A total of 932,612 persons, including 50,751 patients with diabetes, were enrolled. The most frequent potentially diabetes- and nondiabetes-related comorbidities in patients older than 64 years were cardiovascular diseases (91%), rheumatologic conditions (55%), and hyperlipidemia (53%). The mean total health care costs for diabetes patients varied substantially by comorbidity status (US$3,203-$14,223). Patients with diabetes and more than two comorbidities incurred US$10,584 higher total costs than patients without comorbidity. Costs were significantly higher in patients with diabetes and comorbid cardiovascular disease (US$4,788), hyperlipidemia (US$2,163), hyperacidity disorders (US$8,753), and pain (US$8,324) compared with in those without the given disease.

Conclusion: Comorbidities in patients with diabetes are highly prevalent and have substantial consequences for medical expenditures. Interestingly, hyperacidity disorders and pain were the most costly conditions. Our findings highlight the importance of developing strategies that meet the needs of patients with diabetes and comorbidities. Integrated diabetes care such as used in the Chronic Care Model may represent a useful strategy.

No MeSH data available.


Related in: MedlinePlus

Mean total health care costs in patients with and without diabetes by comorbidity status.
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f1-dmso-7-455: Mean total health care costs in patients with and without diabetes by comorbidity status.

Mentions: The patient characteristics and health care costs categorized by diabetes and comorbidity status are presented in Tables 2 and 3. Of the 50,751 patients with diabetes, almost all persons had at least one concurrent condition (96%). Furthermore, there were higher proportions of men in the diabetes sample. Among the patients without diabetes (n=881,861), a total of 530,320 (60%) had at least one chronic condition other than diabetes, with a higher percentage of women. The majority of the persons with one or two chronic conditions were younger than 64 years old; comorbid patients with more than two conditions were equally represented in both age groups. The mean total health care costs in 2011 varied substantially between the comorbidity status in patients with diabetes, ranging from US$3,203 in patients with only diabetes to US$14,223 in patients with more than two concurrent conditions. Annual costs of both the outpatient setting (US$1,403 versus $5,577) and the inpatient setting (US$553 versus $4,764), as well as the cost of prescription drugs (US$857 versus $3,726), were highest in patients with diabetes and at least three comorbidities. Overall, the total health care costs are significantly higher in patients with diabetes and comorbidities than in patients with diabetes only. Among persons without diabetes, the mean total health care costs were highest in multimorbid patients with more than two chronic conditions (US$10,429 versus $928). The costs varied across the different health care settings, from US$4,535 in the outpatient setting and US$3,488 in the inpatient setting for patients without diabetes and with at least three chronic diseases. After splitting the cost estimates into two age groups (18–64 years and older than 64 years), we could still observe higher average health care costs in all categories, with the exception of older patients in the nondiabetes-only compared with the diabetes-only group (Figure 1).


Estimating the prevalence of comorbid conditions and their effect on health care costs in patients with diabetes mellitus in Switzerland.

Huber CA, Diem P, Schwenkglenks M, Rapold R, Reich O - Diabetes Metab Syndr Obes (2014)

Mean total health care costs in patients with and without diabetes by comorbidity status.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4199853&req=5

f1-dmso-7-455: Mean total health care costs in patients with and without diabetes by comorbidity status.
Mentions: The patient characteristics and health care costs categorized by diabetes and comorbidity status are presented in Tables 2 and 3. Of the 50,751 patients with diabetes, almost all persons had at least one concurrent condition (96%). Furthermore, there were higher proportions of men in the diabetes sample. Among the patients without diabetes (n=881,861), a total of 530,320 (60%) had at least one chronic condition other than diabetes, with a higher percentage of women. The majority of the persons with one or two chronic conditions were younger than 64 years old; comorbid patients with more than two conditions were equally represented in both age groups. The mean total health care costs in 2011 varied substantially between the comorbidity status in patients with diabetes, ranging from US$3,203 in patients with only diabetes to US$14,223 in patients with more than two concurrent conditions. Annual costs of both the outpatient setting (US$1,403 versus $5,577) and the inpatient setting (US$553 versus $4,764), as well as the cost of prescription drugs (US$857 versus $3,726), were highest in patients with diabetes and at least three comorbidities. Overall, the total health care costs are significantly higher in patients with diabetes and comorbidities than in patients with diabetes only. Among persons without diabetes, the mean total health care costs were highest in multimorbid patients with more than two chronic conditions (US$10,429 versus $928). The costs varied across the different health care settings, from US$4,535 in the outpatient setting and US$3,488 in the inpatient setting for patients without diabetes and with at least three chronic diseases. After splitting the cost estimates into two age groups (18–64 years and older than 64 years), we could still observe higher average health care costs in all categories, with the exception of older patients in the nondiabetes-only compared with the diabetes-only group (Figure 1).

Bottom Line: Generalized linear models with negative binomial distribution were used to analyze the effect of comorbidities on health care costs.Costs were significantly higher in patients with diabetes and comorbid cardiovascular disease (US$4,788), hyperlipidemia (US$2,163), hyperacidity disorders (US$8,753), and pain (US$8,324) compared with in those without the given disease.Interestingly, hyperacidity disorders and pain were the most costly conditions.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Sciences, Helsana Group, Zürich, Switzerland.

ABSTRACT

Background: Estimating the prevalence of comorbidities and their associated costs in patients with diabetes is fundamental to optimizing health care management. This study assesses the prevalence and health care costs of comorbid conditions among patients with diabetes compared with patients without diabetes. Distinguishing potentially diabetes- and nondiabetes-related comorbidities in patients with diabetes, we also determined the most frequent chronic conditions and estimated their effect on costs across different health care settings in Switzerland.

Methods: Using health care claims data from 2011, we calculated the prevalence and average health care costs of comorbidities among patients with and without diabetes in inpatient and outpatient settings. Patients with diabetes and comorbid conditions were identified using pharmacy-based cost groups. Generalized linear models with negative binomial distribution were used to analyze the effect of comorbidities on health care costs.

Results: A total of 932,612 persons, including 50,751 patients with diabetes, were enrolled. The most frequent potentially diabetes- and nondiabetes-related comorbidities in patients older than 64 years were cardiovascular diseases (91%), rheumatologic conditions (55%), and hyperlipidemia (53%). The mean total health care costs for diabetes patients varied substantially by comorbidity status (US$3,203-$14,223). Patients with diabetes and more than two comorbidities incurred US$10,584 higher total costs than patients without comorbidity. Costs were significantly higher in patients with diabetes and comorbid cardiovascular disease (US$4,788), hyperlipidemia (US$2,163), hyperacidity disorders (US$8,753), and pain (US$8,324) compared with in those without the given disease.

Conclusion: Comorbidities in patients with diabetes are highly prevalent and have substantial consequences for medical expenditures. Interestingly, hyperacidity disorders and pain were the most costly conditions. Our findings highlight the importance of developing strategies that meet the needs of patients with diabetes and comorbidities. Integrated diabetes care such as used in the Chronic Care Model may represent a useful strategy.

No MeSH data available.


Related in: MedlinePlus