Chodick Gabriel, Heymann Anthony D, Wood Francis, Kokia Ehud
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur J Health Econ. 2005 Jun;6(2):166-71. doi: 10.1007/s10198-004-0269-7.
Diabetes mellitus is an important chronic disease with a growing prevalence that absorbs an ever increasing investment of resources. This population-based study evaluated the direct medical costs of diabetes mellitus in an HMO setting. We evaluated both the total cost of diabetic patients and their added cost in comparison to other HMO members (diabetes-related costs). Data were obtained for the years 1999-2001 in a cohort of 24,632 diabetic patients followed up for 3 years drawn from the computerized medical administrative database of a large HMO in Israel, insuring around 25% of the population. The mean direct cost of the medical treatment of a diabetic patient rose 29% from US $2,017 in 1999 to $2,601 in 2001 (in 2001 terms) in comparison to a 19.7% rise (from $1,246 to $1,492). Hospitalizations, medication, and physician visits account for 39%, 29%, and 21% of the total diabetic patient costs, respectively. Dialysis, insulin intake, impaired creatinine, and elevated HbA1c were associated with increased expenditures. According to our results, the total national medical cost of diabetes alone in 2001 was $317 million and that of diabetic patients was $564 million, 6.9% and 12.4% of the total Israeli HMO budget, respectively. The study presents the use of a population-based computerized database to comprehensively assess the economic burden of disease and the potential savings from prevention. The study data suggest a rise in the cost of diabetes which has implications for prevention and treatment policies.
糖尿病是一种重要的慢性疾病，其患病率不断上升，消耗的资源投入也日益增加。这项基于人群的研究评估了健康维护组织（HMO）环境下糖尿病的直接医疗成本。我们评估了糖尿病患者的总成本以及与其他HMO成员相比他们的额外成本（糖尿病相关成本）。数据取自1999 - 2001年，从以色列一家大型HMO的计算机化医疗管理数据库中抽取了24632名糖尿病患者组成队列，进行了3年的随访，该HMO承保了约25%的人口。糖尿病患者医疗治疗的平均直接成本从1999年的2017美元（按2001年价格计算）升至2001年的2601美元，涨幅为29%，而相比之下，其他患者的成本从1246美元升至1492美元，涨幅为19.7%。住院、药物治疗和看医生分别占糖尿病患者总成本的39%、29%和21%。透析、胰岛素摄入、肌酐受损和糖化血红蛋白（HbA1c）升高与支出增加有关。根据我们的研究结果，2001年仅糖尿病的全国医疗总成本为3.17亿美元，糖尿病患者的总成本为5.64亿美元，分别占以色列HMO总预算的6.9%和12.4%。该研究展示了利用基于人群的计算机化数据库全面评估疾病的经济负担以及预防可能带来的节省。研究数据表明糖尿病成本上升，这对预防和治疗政策具有启示意义。
