López-Bastida Julio, López-Siguero Juan Pedro, Oliva-Moreno Juan, Perez-Nieves Magaly, Villoro Renata, Dilla Tatiana, Merino María, Jiang Dingfeng, Aranda-Reneo Isaac, Reviriego Jesús, Vázquez Luis Alberto
University of Castilla-La Mancha, Avda. Real Fábrica de Seda, s/n, 45600 Talavera de la Reina, Toledo, Spain.
Pediatric Endocrinology Department, Regional University Hospital, Avda Arroyo de los Ángeles s/n, 29011 Málaga, Spain.
Diabetes Res Clin Pract. 2017 May;127:59-69. doi: 10.1016/j.diabres.2017.02.033. Epub 2017 Mar 7.
To estimate the social-economic costs of Type 1 Diabetes Mellitus (T1DM) in patients aged 0-17years in Spain from a social perspective.
We conducted a cross-sectional observational study in 2014 of 275 T1DM pediatric outpatients distributed across 12 public health centers in Spain. Data on demographic and clinical characteristics, healthcare utilization and informal care were collected from medical records and questionnaires completed by clinicians and patients' caregivers.
A valid sample of 249 individuals was analyzed. The average annual cost for a T1DM patient was €27,274. Direct healthcare costs were €4070 and direct non-healthcare cost were €23,204. Informal (familial) care represented 83% of total cost, followed by medical material (8%), outpatient and primary care visits (3.1%) and insulin (2.1%). Direct healthcare cost per patient statistically differed by glycated haemoglobin (HbA1c) level [mean cost €4704 in HbA1c ≥7.5% (≥58mmol/mol) group vs. €3616 in HbA1c<7.5% (<58mmol/mol) group)]; and by the presence or absence of complications and comorbidities (mean cost €5713 in group with complications or comorbidities vs. €3636 in group without complications or comorbidities).
T1DM amongst pediatric patients incurs in considerable societal costs. Informal care represents the largest cost category.
从社会角度估算西班牙0至17岁1型糖尿病（T1DM）患者的社会经济成本。
2014年，我们对分布在西班牙12个公共卫生中心的275名T1DM儿科门诊患者进行了横断面观察研究。从病历以及临床医生和患者护理人员填写的问卷中收集了有关人口统计学和临床特征、医疗保健利用情况及非正式护理的数据。
对249名个体的有效样本进行了分析。一名T1DM患者的年均成本为27274欧元。直接医疗成本为4070欧元，直接非医疗成本为23204欧元。非正式（家庭）护理占总成本的83%，其次是医疗材料（8%）、门诊和初级保健就诊（3.1%）以及胰岛素（2.1%）。每位患者的直接医疗成本在统计学上因糖化血红蛋白（HbA1c）水平而异[HbA1c≥7.5%（≥58mmol/mol）组的平均成本为4704欧元，而HbA1c<7.5%（<58mmol/mol）组为3616欧元]；也因是否存在并发症和合并症而异（有并发症或合并症组的平均成本为5713欧元，无并发症或合并症组为3636欧元）。
儿科患者的T1DM会产生相当大的社会成本。非正式护理是最大的成本类别。
