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加拿大低血糖评估工具项目中 1 型和 2 型糖尿病成人患者低血糖相关直接医疗成本和生产力成本。

Direct Health-Care Costs and Productivity Costs Associated With Hypoglycemia in Adults With Type 1 and Type 2 Diabetes Mellitus That Participated in the Canadian Hypoglycemia Assessment Tool Program.

机构信息

Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Programs for Assessment of Technology in Health (PATH), The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.

Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Programs for Assessment of Technology in Health (PATH), The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.

出版信息

Can J Diabetes. 2018 Dec;42(6):659-663. doi: 10.1016/j.jcjd.2018.01.010. Epub 2018 Jan 31.

Abstract

OBJECTIVES

There is a paucity of information concerning the cost of hypoglycemia events in Canadians with type 1 or type 2 diabetes. The objective of this study was to estimate the direct health-care costs and indirect costs associated with hypoglycemia based on a Canadian cohort of 498 patients from the global Hypoglycemia Assessment Tool (HAT) study.

METHODS

A costing model was developed to estimate the direct costs related to experiencing hypoglycemia by using health-care resources associated with hospital admissions and additional clinical appointments that were prospectively reported 1 month after baseline in the HAT study. Data collected retrospectively on work absenteeism in the year prior to baseline were used to estimate the indirect costs of hypoglycemia events. All costs were annualized and reported in 2016 Canadian dollars.

RESULTS

Of the 403 patients with diabetes who experienced hypoglycemia events in the first month after baseline (81%), 10 (2.5%) patients required hospitalization or clinical appointments. Over 1 year, the mean direct health-care costs were estimated to be C$90,300 (C$1,777 per patient) for hospitalizations and C$14,695 (C$204 per person) for additional clinical appointments. Work absenteeism resulted in a total annual indirect cost of C$20,937 for time off due to sick leave (C$500 per patient), arriving late (C$187 per patient) or leaving work early (C$128 per patient). The annual direct and indirect costs of hypoglycemia events total C$125,932.

CONCLUSIONS

The impact of hypoglycemia events on health-care resource utilization and work productivity leads to substantial direct and indirect costs in Canadian patients with diabetes.

摘要

目的

有关 1 型或 2 型糖尿病加拿大患者低血糖事件成本的信息十分有限。本研究的目的是根据全球低血糖评估工具(HAT)研究中的 498 名加拿大患者队列,估算与低血糖相关的直接医疗保健成本和间接成本。

方法

开发了一种成本估算模型,通过使用与住院和额外临床预约相关的医疗保健资源,估算经历低血糖的直接成本,这些资源是在 HAT 研究的基线后 1 个月前瞻性报告的。回顾性收集基线前 1 年的工作缺勤数据,用于估算低血糖事件的间接成本。所有成本均按年计算,并以 2016 年加元报告。

结果

在基线后第一个月经历低血糖事件的 403 名糖尿病患者中(81%),有 10 名(2.5%)患者需要住院或临床预约。在 1 年期间,预计直接医疗保健成本的平均值为因住院而产生的 90,300 加元(每位患者 1,777 加元)和因额外临床预约而产生的 14,695 加元(每位患者 204 加元)。由于病假(每位患者 500 加元)、迟到(每位患者 187 加元)或早退(每位患者 128 加元)而导致的工作缺勤,导致间接总成本每年为 20,937 加元。低血糖事件的直接和间接年度总成本为 125,932 加元。

结论

低血糖事件对医疗资源利用和工作生产力的影响导致加拿大糖尿病患者的直接和间接成本大幅增加。

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