Huber Carola A, Schwenkglenks Matthias, Rapold Roland, Reich Oliver
Department of Health Sciences, Helsana Insurance Group, P,O, Box, Zürich, Switzerland.
BMC Endocr Disord. 2014 Jun 3;14:44. doi: 10.1186/1472-6823-14-44.
Quantifying the burden of diabetes mellitus is fundamental for managing patients in health service delivery systems and improves the understanding of the importance of prevention and early intervention of diabetes. In Switzerland, epidemiological data on diabetes are very scarce. In this study we provide a first national overview of the current situation of diabetes mellitus in Switzerland as well as the development of the prevalence, incidence, mortality and costs between 2006 and 2011.
Using health care claims data of a large health insurance group, current epidemiology and costs were determined from a sample of adult enrollees in 2011. The identification of patients with diabetes was based on prescription data of diabetes related drugs using the Anatomical Therapeutic Chemical Classification as proxy for clinical diagnosis. We further evaluated changes in epidemiology and costs between 2006 and 2011. All results were weighted with census data to achieve an extrapolation to the Swiss general population level.
A total of 920'402 patients were enrolled in 2011 and 49'757 (5.4%) were identified as diabetes cases. The extrapolated overall prevalence of diabetes in Switzerland was 4.9% (2006, 3.9%). The incidence was 0.58% in 2011 (2007, 0.63%). The extrapolated mortality rate was 2.6% with no significant change over time. Annual diabetes costs to the mandatory health insurance increased from EUR 5,036 per patient in 2006 to EUR 5'331 per patient in 2011.
This study shows a high medical and economic burden of diabetes. The prevalence and costs of diabetes in Switzerland increased substantially over time. Findings stress the need for public health strategies to manage patients with chronic conditions and optimize resource allocation in health service delivery systems.
量化糖尿病负担对于卫生服务提供系统中的患者管理至关重要，且有助于加深对糖尿病预防和早期干预重要性的理解。在瑞士，有关糖尿病的流行病学数据非常匮乏。在本研究中，我们首次提供了瑞士糖尿病现状的全国性概述，以及2006年至2011年间患病率、发病率、死亡率和成本的变化情况。
利用一个大型健康保险集团的医疗保健理赔数据，从2011年成年参保者样本中确定当前的流行病学情况和成本。糖尿病患者的识别基于糖尿病相关药物的处方数据，使用解剖治疗化学分类作为临床诊断的替代指标。我们进一步评估了2006年至2011年间流行病学和成本的变化。所有结果均根据人口普查数据进行加权，以推断至瑞士总人口水平。
2011年共有920402名患者参保，其中49757名（5.4%）被确定为糖尿病病例。瑞士糖尿病的推断总体患病率为4.9%（2006年为3.9%）。2011年发病率为0.58%（2007年为0.63%）。推断死亡率为2.6%，随时间无显著变化。强制性医疗保险的年度糖尿病成本从2006年的每位患者5036欧元增加到2011年的每位患者5331欧元。
本研究表明糖尿病具有很高的医疗和经济负担。瑞士糖尿病的患病率和成本随时间大幅增加。研究结果强调需要制定公共卫生策略来管理慢性病患者，并优化卫生服务提供系统中的资源分配。
