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2型糖尿病管理的经济负担:来自马来西亚一家教学医院的分析。

Economic burden of managing Type 2 diabetes mellitus: Analysis from a Teaching Hospital in Malaysia.

作者信息

Ismail Aniza, Suddin Leny Suzana, Sulong Saperi, Ahmed Zafar, Kamaruddin Nor Azmi, Sukor Norlela

机构信息

Associate Professor and Dr, Department of Community Health, Universiti Kebangsaan , Selangor, Malaysia.

Dr, Discipline of Population Health and Preventive Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.

出版信息

Indian J Public Health. 2017 Oct-Dec;61(4):243-247. doi: 10.4103/ijph.IJPH_24_16.

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a chronic disease that consumes a large amount of health-care resources. It is essential to estimate the cost of managing T2DM to the society, especially in developing countries. Economic studies of T2DM as a primary diagnosis would assist efficient health-care resource allocation for disease management.

OBJECTIVE

This study aims to measure the economic burden of T2DM as the primary diagnosis for hospitalization from provider's perspective.

METHODS

A retrospective prevalence-based costing study was conducted in a teaching hospital. Financial administrative data and inpatient medical records of patients with primary diagnosis (International Classification Disease-10 coding) E11 in the year 2013 were included in costing analysis. Average cost per episode of care and average cost per outpatient visit were calculated using gross direct costing allocation approach.

RESULTS

Total admissions for T2DM as primary diagnosis in 2013 were 217 with total outpatient visits of 3214. Average cost per episode of care was RM 901.51 (US$ 286.20) and the average cost per outpatient visit was RM 641.02 (US$ 203.50) from provider's perspective. The annual economic burden of T2DM for hospitalized patients was RM 195,627.67 (US$ 62,104) and RM 2,061,520.32 (US$ 654,450) for those being treated in the outpatient setting.

CONCLUSIONS

Economic burden to provide T2DM care was higher in the outpatient setting due to the higher utilization of the health-care service in this setting. Thus, more focus toward improving T2DM outpatient service could mitigate further increase in health-care cost from this chronic disease.

摘要

背景

2型糖尿病(T2DM)是一种消耗大量医疗资源的慢性疾病。估算T2DM对社会的管理成本至关重要,尤其是在发展中国家。将T2DM作为主要诊断的经济研究将有助于为疾病管理进行高效的医疗资源分配。

目的

本研究旨在从医疗机构的角度衡量将T2DM作为住院主要诊断的经济负担。

方法

在一家教学医院进行了一项基于患病率的回顾性成本核算研究。2013年主要诊断(国际疾病分类-10编码)为E11的患者的财务行政数据和住院病历被纳入成本分析。使用直接总成本分配方法计算每次护理的平均成本和每次门诊就诊的平均成本。

结果

2013年以T2DM作为主要诊断的总住院人数为217人,总门诊就诊次数为3214次。从医疗机构的角度来看,每次护理的平均成本为901.51马来西亚林吉特(286.20美元),每次门诊就诊的平均成本为641.02马来西亚林吉特(203.50美元)。住院患者的T2DM年度经济负担为195,627.67马来西亚林吉特(62,104美元),门诊治疗患者的年度经济负担为2,061,520.32马来西亚林吉特(654,450美元)。

结论

由于门诊环境中医疗服务利用率较高,提供T2DM护理的经济负担在门诊环境中更高。因此,更多地关注改善T2DM门诊服务可以减轻这种慢性病医疗成本的进一步增加。

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