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糖尿病患者在死亡当年及其前一年的直接医疗费用。

Direct medical costs of diabetes mellitus in the year of mortality and year preceding the year of mortality.

机构信息

Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong.

Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK.

出版信息

Diabetes Obes Metab. 2018 Jun;20(6):1470-1478. doi: 10.1111/dom.13253. Epub 2018 Mar 11.

Abstract

AIM

To report the health resource use and estimate the direct medical costs among patients with diabetes mellitus (DM) in the year of mortality and the year preceding the year of mortality.

MATERIALS AND METHODS

We analysed data from a population-based, retrospective cohort study including all adults with a DM diagnosis in Hong Kong between 2009 and 2013, and who died between January 1, 2010 and December 31, 2013. The annual direct medical costs in the year of mortality and the year preceding the year of mortality were determined by summing the costs of health services utilized within the respective year. The costs were analysed by gender, the presence of comorbidities, diabetic complications and primary cause of death.

RESULTS

A total of 10 649 patients met the eligibility criteria for analysis. On average, the direct medical costs in the year of death were 1.947 times higher than those in the year before death. Men and women with DM incurred similar costs in the year preceding the year of mortality and in the mortality year. Patients with any diabetic complications incurred greater costs in the year of mortality and the year before mortality than those without.

CONCLUSIONS

This analysis provides new evidence on incorporating additional direct medical costs in the mortality year, and refining the structure of total cost estimates for use in costing and cost-effectiveness analyses of interventions for DM.

摘要

目的

报告糖尿病(DM)患者在死亡当年和死亡前一年的健康资源利用情况,并估算其直接医疗费用。

材料与方法

我们分析了一项基于人群的回顾性队列研究的数据,该研究纳入了 2009 年至 2013 年间香港所有被诊断为 DM 的成年人,以及 2010 年 1 月 1 日至 2013 年 12 月 31 日期间死亡的患者。通过汇总当年所利用的医疗服务费用来确定死亡当年和死亡前一年的年度直接医疗费用。基于性别、合并症、糖尿病并发症和主要死因对费用进行分析。

结果

共有 10649 名患者符合分析标准。平均而言,死亡当年的直接医疗费用是死亡前一年的 1.947 倍。男性和女性 DM 患者在死亡前一年和死亡当年的费用相似。有任何糖尿病并发症的患者在死亡当年和死亡前一年的费用都高于无并发症的患者。

结论

本分析为将额外的直接医疗费用纳入死亡当年提供了新证据,并为 DM 干预措施的成本和成本效益分析中的总费用估算结构提供了更准确的信息。

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