Le Trong K, Able Stephen L, Lage Maureen J
Eli Lilly and Company, Indianapolis, IN, USA.
Cost Eff Resour Alloc. 2006 Oct 23;4:18. doi: 10.1186/1478-7547-4-18.
Diabetes is often associated with complications and comorbidities. The purpose of this research is to compare medical resources used by patients with the following diagnoses: diabetes mellitus (DM), diabetic neuropathy (DN), and diabetes mellitus combined with comorbid depression (DD).
Adult patients who were diagnosed with DM, DN, or DD were included in the study. There were 55,972 patients in the DM cohort, 2,146 in the DN, and 2,379 in the DD. P values for comparisons between the three mutually exclusive cohorts were conducted using the Tukey-Kramer method. Cost comparisons among the cohorts were conducted using a stepwise multivariate regression that controlled for patient characteristics and comorbid conditions.
Individuals in the DM or DN cohorts were generally more likely to use antidiabetic medications than patients in the DD group. Those diagnosed with DN or DD generally used more pain medications than individuals in the DM cohort. The DM cohort had significantly lower diabetes-related total medical costs ($1,297 v $5,125, p < 0.0001) and lower total medical costs ($4,819 v $24,765, p < 0.0001) than the DN cohort. The DM cohort also had significantly lower diabetes-related total medical costs ($1,297 v $3,264, p < 0.0001) as well as significantly lower total medical costs ($4,819 v $19,298, p < 0.0001) than the DD cohort.
Results from this study indicated significant differences in demographic characteristics, comorbidities, and medication use among individuals diagnosed with DM, DN, or DD. These differences translated into significant cost differences. Patients diagnosed with DN or DD had higher diabetes-related costs than patients diagnosed with DM.
糖尿病常伴有并发症和合并症。本研究的目的是比较患有以下诊断的患者所使用的医疗资源:糖尿病(DM)、糖尿病神经病变(DN)以及合并抑郁症的糖尿病(DD)。
被诊断为DM、DN或DD的成年患者纳入本研究。DM队列中有55972名患者,DN队列中有2146名患者,DD队列中有2379名患者。使用Tukey-Kramer方法对三个相互排斥的队列进行比较的P值。队列间的成本比较使用逐步多元回归进行,该回归控制了患者特征和合并症情况。
DM或DN队列中的个体通常比DD组患者更有可能使用抗糖尿病药物。被诊断为DN或DD的患者通常比DM队列中的个体使用更多的止痛药物。DM队列的糖尿病相关总医疗费用(1297美元对5125美元,p<0.0001)和总医疗费用(4819美元对24765美元,p<0.0001)显著低于DN队列。DM队列的糖尿病相关总医疗费用(1297美元对3264美元,p<0.0001)以及总医疗费用(4819美元对19298美元,p<0.0001)也显著低于DD队列。
本研究结果表明,被诊断为DM、DN或DD的个体在人口统计学特征、合并症和药物使用方面存在显著差异。这些差异转化为显著的成本差异。被诊断为DN或DD的患者比被诊断为DM的患者有更高的糖尿病相关成本。