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- Title
Health service utilization and related costs attributable to diabetes.
- Authors
O'Neill, K. N.; McHugh, S. M.; Tracey, M. L.; Fitzgerald, A. P.; Kearney, P. M.
- Abstract
Aims: To estimate the health service use and direct healthcare costs attributable to diabetes using best available data and methods. Methods: A nationally representative sample of adults aged ≥50 years was analysed (n=8107). Health service use in the previous 12 months included the number of general practitioner visits, outpatient department visits, hospital admissions, and accident and emergency department attendances. Multivariable negative binomial regression was used to estimate the associations between diabetes and frequency of visits. Average marginal effects were applied to unit costs for each health service and extrapolated to the total population, calculating the incremental costs associated with diabetes. Results: The prevalence of diabetes was 8.0% (95% CI: 7.4, 8.6). In fully adjusted models, diabetes was associated with additional health service use. Compared to those without diabetes, people with diabetes have, on average, 1.49 (95% CI: 1.10, 1.88) additional general practitioner visits annually. Diabetes was associated with an 87% increase in outpatient visits, a 52% increase in hospital admissions and a 33% increase in accident and emergency department attendances (P<0.001). The incremental cost of this additional service use, nationally, is an estimated €88,894,421 annually, with hospital admissions accounting for 67% of these costs. Conclusion: 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. What's new?: Addressing many of the limitations of previous studies, our paper is one of the first European studies to quantify the excess health service use and costs independently attributable to diabetes.After accounting for important determinants of health service use, diabetes was associated with substantial additional health service use and costs across the health system. Hospital admissions account for two‐thirds of the cost burden.We provide informative estimates for policy‐makers, identifying the costs that can be directly targeted by diabetes prevention and management interventions and by highlighting areas for potential cost savings in the context of finite healthcare resources.
- Subjects
DIABETES; CONFIDENCE intervals; ECONOMIC aspects of diseases; HOSPITAL admission &; discharge; HOSPITAL emergency services; OUTPATIENT services in hospitals; MEDICAL appointments; MEDICAL care use; MEDICAL care costs; PATIENTS; GENERAL practitioners; MULTIPLE regression analysis; DISEASE prevalence; ECONOMICS
- Publication
Diabetic Medicine, 2018, Vol 35, Issue 12, p1727
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.13806