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- Title
The Effects of Diagnostic Definitions in Claims Data on Healthcare Cost Estimates: Evidence from a Large-Scale Panel Data Analysis of Diabetes Care in Japan.
- Authors
Fukuda, Haruhisa; Ikeda, Shunya; Shiroiwa, Takeru; Fukuda, Takashi
- Abstract
<bold>Background: </bold>Inaccurate estimates of diabetes-related healthcare costs can undermine the efficiency of resource allocation for diabetes care. The quantification of these costs using claims data may be affected by the method for defining diagnoses.<bold>Objectives: </bold>The aims were to use panel data analysis to estimate diabetes-related healthcare costs and to comparatively evaluate the effects of diagnostic definitions on cost estimates.<bold>Research Design: </bold>Monthly panel data analysis of Japanese claims data.<bold>Subjects: </bold>The study included a maximum of 141,673 patients with type 2 diabetes who received treatment between 2005 and 2013.<bold>Measures: </bold>Additional healthcare costs associated with diabetes and diabetes-related complications were estimated for various diagnostic definition methods using fixed-effects panel data regression models.<bold>Results: </bold>The average follow-up period per patient ranged from 49.4 to 52.3 months. The number of patients identified as having type 2 diabetes varied widely among the diagnostic definition methods, ranging from 14,743 patients to 141,673 patients. The fixed-effects models showed that the additional costs per patient per month associated with diabetes ranged from US$180 [95 % confidence interval (CI) 178-181] to US$223 (95 % CI 221-224). When the diagnostic definition excluded rule-out diagnoses, the diabetes-related complications associated with higher additional healthcare costs were ischemic heart disease with surgery (US$13,595; 95 % CI 13,568-13,622), neuropathy/extremity disease with surgery (US$4594; 95 % CI 3979-5208), and diabetic nephropathy with dialysis (US$3689; 95 % CI 3667-3711).<bold>Conclusions: </bold>Diabetes-related healthcare costs are sensitive to diagnostic definition methods. Determining appropriate diagnostic definitions can further advance healthcare cost research for diabetes and its applications in healthcare policies.
- Subjects
JAPAN; MEDICAL care costs; COST estimates; TREATMENT of diabetes; DIAGNOSIS of diabetes; DIABETES complications; THERAPEUTICS; PANEL analysis; TYPE 2 diabetes diagnosis; TYPE 2 diabetes treatment; TYPE 2 diabetes; DATABASES; LONGITUDINAL method; REGRESSION analysis; TIME; STATISTICAL models; ECONOMICS
- Publication
PharmacoEconomics, 2016, Vol 34, Issue 10, p1005
- ISSN
1170-7690
- Publication type
journal article
- DOI
10.1007/s40273-016-0402-3