Köster I, Huppertz E, Hauner H, Schubert I
PMV Research Group at the Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Germany.
Niedererbach, Germany.
Exp Clin Endocrinol Diabetes. 2014 Oct;122(9):510-6. doi: 10.1055/s-0034-1375675. Epub 2014 Jun 11.
To identify direct health care costs of patients with diabetes in Germany in 2010, with focus on costs of treating hyperglycaemia and costs caused by diabetes complications, and to compare findings with results from the CoDiM study 2001.
The cost analysis was based on administrative data (18.75% random sample of 1.5 million insured persons). Medical costs covered by statutory health insurance and costs covered by nursing care insurance were included. Incremental differences in costs of patients with diabetes (n=30 987) and age and sex-matched subjects without a diagnosis of diabetes (controls) were estimated according to the number and type of complications. Costs were standardised to the German population.
In 2010, incremental medical costs attributed to diabetes were € 2 391 (95% confidence interval: 2 257-2 524) per patient with diabetes. Of that amount, 26.5% were spent for the management of hyperglycaemia (€ 633 (622-644)) and 73.5% for the treatment of comp-lications (€ 1 758 (1 627-1 889)). Nursing care contributed incremental costs of € 289 (249-330), of which 98.8% was due to complications. From 2001 to 2010 the incremental per-capita costs for medical and nursing care decreased by 4.8% (controls: +3.9%), the per-capita costs for treating hyperglycaemia increased by 2.0% and the per-capita costs for complications decreased by 7.0%.
Cost for diabetes is largely caused by management of complications. It is important to prevent complications by consequent management of diabetes as well as by primary prevention of its onset.
确定2010年德国糖尿病患者的直接医疗保健成本,重点关注高血糖治疗成本和糖尿病并发症所致成本,并将研究结果与2001年CoDiM研究的结果进行比较。
成本分析基于行政数据(150万参保人的18.75%随机样本)。纳入法定医疗保险涵盖的医疗成本和护理保险涵盖的成本。根据并发症的数量和类型,估算糖尿病患者(n = 30987)与年龄和性别匹配的未诊断为糖尿病的受试者(对照组)的成本增量差异。成本按德国人口进行标准化。
2010年,每位糖尿病患者归因于糖尿病的增量医疗成本为2391欧元(95%置信区间:2257 - 2524欧元)。其中,26.5%用于高血糖管理(633欧元(622 - 644欧元)),73.5%用于并发症治疗(1758欧元(1627 - 1889欧元))。护理产生的增量成本为289欧元(249 - 330欧元),其中98.8%归因于并发症。从2001年到2010年,医疗和护理的人均增量成本下降了4.8%(对照组:增长3.9%),高血糖治疗的人均成本增长了2.0%,并发症的人均成本下降了7.0%。
糖尿病成本主要由并发症管理所致。通过对糖尿病的持续管理以及对其发病的一级预防来预防并发症很重要。