Köster I, von Ferber L, Ihle P, Schubert I, Hauner H
PMV Research Group, University of Cologne, Herderstrasse 52-54, 50931, Cologne, Germany.
Diabetologia. 2006 Jul;49(7):1498-504. doi: 10.1007/s00125-006-0277-5. Epub 2006 May 11.
AIMS/HYPOTHESIS: The aim of this study was to identify the health care costs of diabetic patients in Germany in 2001, focusing on the influence of age, sex, and type of treatment.
Annual direct costs of medical care and indirect costs of inability to work and early retirement in diabetic subjects were compared with costs of age- and sex-matched non-diabetic control subjects. The analysis was based on routine health care data from a random sample (18.75%) taken from a database of 1.9 million insured persons. Incremental differences in medical and national expenditure between subjects with and without diabetes were calculated.
Annual direct mean costs per diabetic patient were 5,262 Euro, and indirect costs were 5,019 Euro. In the control group, mean direct and indirect costs were 2,755 Euro and 3,691 Euro, respectively. Analysis of cost components revealed that the high costs associated with the care of diabetic patients could be largely attributed to inpatient care and overall medication costs. Hypoglycaemic drugs amounted to only one-quarter of the medication costs. The total health care costs were correlated with the type of treatment. Direct excess costs increased with increasing age in insulin-treated patients, but were unaffected by age in patients receiving other types of treatment.
CONCLUSIONS/INTERPRETATION: The Costs of Diabetes Mellitus (CoDiM) study is the first comprehensive study to provide estimates of costs associated with diabetes care in Germany. Direct costs of diabetic patients account for 14.2% of total health care costs, which includes the proportion that specifically accounts for diabetes-related costs (6.8%).
目的/假设：本研究旨在确定2001年德国糖尿病患者的医疗保健费用，重点关注年龄、性别和治疗类型的影响。
将糖尿病患者的年度医疗直接费用以及无法工作和提前退休的间接费用与年龄和性别匹配的非糖尿病对照对象的费用进行比较。分析基于从190万参保人员数据库中随机抽取的样本（18.75%）的常规医疗保健数据。计算了糖尿病患者与非糖尿病患者之间医疗和国家支出的增量差异。
每位糖尿病患者的年度直接平均费用为5262欧元，间接费用为5019欧元。在对照组中，直接和间接平均费用分别为2755欧元和3691欧元。成本构成分析显示，糖尿病患者护理相关的高成本在很大程度上可归因于住院护理和总体药物费用。降糖药物仅占药物费用的四分之一。总医疗保健费用与治疗类型相关。胰岛素治疗患者的直接额外费用随年龄增长而增加，但接受其他类型治疗的患者不受年龄影响。
结论/解读：糖尿病成本（CoDiM）研究是第一项全面估算德国糖尿病护理相关成本的研究。糖尿病患者的直接费用占总医疗保健费用的14.2%，其中包括专门用于糖尿病相关费用的比例（6.8%）。
