Icks Andrea, Rosenbauer Joachim, Rathmann Wolfgang, Haastert Burkhard, Gandjour Afschin, Giani Guido
Department of Biometrics and Epidemiology, German Diabetes Research Institute at Heinrich-Heine-University, Düsseldorf, Germany.
J Pediatr Endocrinol Metab. 2004 Nov;17(11):1551-9. doi: 10.1515/jpem.2004.17.11.1551.
Prospective population-based cost-of-illness study to evaluate diabetes mellitus (DM)-related direct costs in German pediatric DM care in the early course after onset (perspective: statutory health insurers).
573 patients with DM <15 years of age were followed for up to 2 years after onset. DM-related hospitalization and ambulatory care, insulin and self-testing regimen were ascertained. Costs per patient-year were estimated (2000 prices). Using multivariate regression, associations between costs and families' socioeconomic status was evaluated.
Mean total costs per patient-year were 7,069 euro (interquartile range 5,414-8,127). Onset hospitalization accounted for the majority of costs (4,908 euro, 3,728-6,213). Within post-onset costs, most were attributable to blood glucose self measurement and hospitalization (36% and 32%). Costs were significantly higher in children from families with lower compared to highest educated parents and in children from non-German families (p <0.01).
Among the direct medical costs of childhood DM in the early course after onset, the greatest economic burden was due to hospitalization, in particular at onset. Blood glucose self measurement accounted for the majority of the post-onset costs. Costs were associated with the socio-economic status. It is recommended to evaluate the cost-effectiveness of outpatient programs targeting children from families with lower social status.
基于人群的前瞻性疾病成本研究，以评估德国儿童糖尿病（DM）发病初期（视角：法定健康保险公司）与糖尿病相关的直接成本。
对573例15岁以下的糖尿病患者发病后随访长达2年。确定与糖尿病相关的住院和门诊护理、胰岛素及自我检测方案。估算每位患者每年的成本（2000年价格）。采用多变量回归分析评估成本与家庭社会经济地位之间的关联。
每位患者每年的平均总成本为7069欧元（四分位间距5414 - 8127欧元）。发病时的住院费用占成本的大部分（4908欧元，3728 - 6213欧元）。在发病后的成本中，大部分归因于血糖自我检测和住院（分别为36%和32%）。与父母受教育程度最高的家庭相比，父母受教育程度较低家庭的儿童以及非德裔家庭的儿童成本显著更高（p <0.01）。
在儿童糖尿病发病初期的直接医疗成本中，最大的经济负担归因于住院，尤其是发病时。血糖自我检测占发病后成本的大部分。成本与社会经济地位相关。建议评估针对社会地位较低家庭儿童的门诊项目的成本效益。
