Morsanutto Andrea, Berto Patrizia, Lopatriello Stefania, Gelisio Renzo, Voinovich Dario, Cippo Paola Perelli, Mantovani Lorenzo Giovanni
Centro di Farmacoeconomia, Università degli Studi di Milano, Milano, Italy.
J Diabetes Complications. 2006 May-Jun;20(3):163-9. doi: 10.1016/j.jdiacomp.2005.06.011.
Type 2 diabetes mellitus is a common, chronic, and costly disease, and its prevalence is increasing in major industrialized countries. Diabetes has indeed a high social impact mainly because of its chronic complications.
The aim of this study was to analyze the direct medical costs attributable to Type 2 diabetes mellitus and its determinants, as assessed in a diabetologic center (DC) in Italy.
We conducted a retrospective longitudinal cost of care study; Type 2 diabetic patients who visited between January 2001 and August 2002 were randomly selected from the database of the DC of Portogruaro. Cost data collected included hospitalizations, visits, diagnostics, and pharmacological therapies and were quantified and analyzed in the perspective of the National Health Service (NHS).
Two hundred ninety-nine diabetic patients were extracted, with a mean/patient follow up of 476 days. Mean age was 67.5 years and males represented 67.2% of the sample. The average annual health care cost was found to be euro1909.67 per patient; pharmacological therapies accounted for the greatest proportion of direct medical costs (52%), followed by hospitalization (28%) and diagnostic exams (11%). Annual costs increased with the number of diabetes related comorbidities, from euro1039 to 3141 per patient in participants with none or more than two complications, respectively.
Long-term complications carry a considerable impact on total annual medical cost. Our study demonstrates that an increase in the number of comorbidities is directly associated with an increase of Type 2 diabetes cost. Strategies aimed at preventing the onset of diabetic complications are likely to reduce medical costs in the long run, while improving patients' health.
2型糖尿病是一种常见的慢性疾病，治疗成本高昂，在主要工业化国家的患病率正在上升。糖尿病因其慢性并发症而具有很高的社会影响。
本研究旨在分析意大利一家糖尿病中心评估的2型糖尿病直接医疗成本及其决定因素。
我们进行了一项回顾性纵向护理成本研究；从波尔托格鲁阿罗糖尿病中心数据库中随机选取2001年1月至2002年8月期间就诊的2型糖尿病患者。收集的成本数据包括住院、就诊、诊断和药物治疗，并从国家卫生服务（NHS）的角度进行量化和分析。
提取了299名糖尿病患者，平均每位患者随访476天。平均年龄为67.5岁，男性占样本的67.2%。发现每位患者的平均年度医疗保健成本为1909.67欧元；药物治疗占直接医疗成本的最大比例（52%），其次是住院（28%）和诊断检查（11%）。年度成本随着糖尿病相关合并症的数量增加而增加，无并发症或并发症超过两种的参与者中，每位患者的年度成本分别从1039欧元增加到3141欧元。
长期并发症对年度总医疗成本有相当大的影响。我们的研究表明，合并症数量的增加与2型糖尿病成本的增加直接相关。从长远来看，旨在预防糖尿病并发症发生的策略可能会降低医疗成本，同时改善患者健康。
