School of Public Health and Center of Migrant Health Policy, Sun Yat-sen University, Guangzhou 510080, PR China.
Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Diabetes Res Clin Pract. 2015 May;108(2):223-34. doi: 10.1016/j.diabres.2015.02.016. Epub 2015 Feb 20.
This research presents a comprehensive picture of medical spending associated with diabetes in the United States, accounting for important population characteristics.
The Household Component (HC) of the 2010 Medical Expenditure Panel Survey (MEPS) was used for this study. Regression analysis was used to compare medical spending between individuals with and without diabetes. The dependent variables of interest were total and out-of-pocket expenditures related to medical care, hospital use, physician office visits, and prescription drug use.
This study reveals that individuals with diabetes experience significantly greater medical, hospital, physician office, and prescription drug expenditures compared to those without diabetes. Even after controlling for predisposing, enabling, and need factors, adults with diabetes spent $1843 more on total medical expenditures and $353 more on out-of-pocket medical expenditures than those without diabetes. Significant disparities were found in total and out-of-pocket expenditures by age, gender, education, race/ethnicity, and insurance status.
Comprehensive interventions that focus on education and prevention should target individuals and communities at high-risk for diabetes and its complications. Our findings suggest that programs should focus on older Americans and those with poor health and mental health status.
本研究全面描述了美国与糖尿病相关的医疗支出情况，考虑了重要的人口特征。
本研究使用了 2010 年医疗支出调查（MEPS）的家庭部分（HC）。回归分析用于比较有和没有糖尿病的个体之间的医疗支出。感兴趣的因变量包括与医疗保健、医院使用、医生办公室就诊和处方药使用相关的总支出和自付支出。
本研究表明，与没有糖尿病的个体相比，患有糖尿病的个体在医疗、医院、医生办公室和处方药方面的支出明显更多。即使控制了倾向因素、促成因素和需求因素，患有糖尿病的成年人在总医疗支出上比没有糖尿病的成年人多支出 1843 美元，在自付医疗支出上多支出 353 美元。在总支出和自付支出方面，年龄、性别、教育程度、种族/民族和保险状况存在显著差异。
应针对有糖尿病和其并发症高风险的个人和社区，开展以教育和预防为重点的综合干预措施。我们的研究结果表明，这些计划应针对美国老年人以及健康和心理健康状况较差的人群。
