Trogdon Justin G, Hylands Thomas
RTI International, Research Triangle Park, North Carolina, USA.
Diabetes Care. 2008 Dec;31(12):2307-11. doi: 10.2337/dc08-1375.
This study provides nationally representative estimates for the U.S. of medical expenditures associated with diabetes by years since initial diagnosis.
Expenditures are estimated using cross-sectional regression analysis on the 2000-2004 Medical Expenditure Panel Survey linked to the 1998-2003 National Health Interview Survey (n = 46,203). The primary variables of interest are an indicator for self-reported diabetes and the years since diabetes diagnosis.
Under the base specification, a 50-year-old person just diagnosed with diabetes has medical expenditures that are 4,174 USD higher than an identical person without diabetes. On average, each additional year with diabetes increases annual medical expenditures by $158 (standard error = $38) above and beyond increases in medical expenditures due to aging. Conditional on diabetes complications, each additional year with diabetes increases annual medical expenditures by $75 (standard error = $55). Diabetes increases medical expenditures at any age, and the cumulative effect grows over time.
The results show the expected trajectory of medical expenditures after diagnosis of diabetes, highlighting the benefits of prevention and control as well as informing cost-effectiveness models of diabetes interventions.
本研究提供了美国自糖尿病初次诊断以来各年份与糖尿病相关的医疗支出的全国代表性估计值。
利用对2000 - 2004年医疗支出面板调查与1998 - 2003年国家健康访谈调查进行关联分析(n = 46,203)的横断面回归分析来估计支出。主要关注变量是自我报告的糖尿病指标以及糖尿病诊断后的年份。
在基本规范下,一名刚被诊断出患有糖尿病的50岁患者的医疗支出比没有糖尿病的相同患者高出4174美元。平均而言,糖尿病患者每多患病一年,年度医疗支出比因衰老导致的医疗支出增加额高出158美元(标准误差 = 38美元)。在患有糖尿病并发症的情况下,糖尿病患者每多患病一年,年度医疗支出增加75美元(标准误差 = 55美元)。糖尿病在任何年龄段都会增加医疗支出,且累积效应会随着时间增长。
结果显示了糖尿病诊断后医疗支出的预期轨迹,突出了预防和控制的益处,并为糖尿病干预措施的成本效益模型提供了信息。