Ministry of Health, Manama, Kingdom of Bahrain.
Associate professor, Arabian Gulf University, Manama, Kingdom of Bahrain.
BMC Health Serv Res. 2019 Dec 5;19(1):939. doi: 10.1186/s12913-019-4795-5.
Type 2 diabetes is a growing health challenge in the Kingdom of Bahrain, and the disease exerts significant pressure on the healthcare system. The aim of this study was to assess the annual costs and understand the drivers of those costs in the country.
A sample of 628 patients diagnosed with type 2 diabetes were randomly selected from primary healthcare diabetes clinics, and the direct medical and indirect costs due to type 2 diabetes were analysed for a one-year period. The study used patients' medical records, interviews and standardised frequency questionnaires to obtain data on demographic and clinical characteristics, complication status, treatment profile, healthcare resource utilisation and absenteeism due to diabetes. The indirect costs were estimated by using the human capital approach. The direct medical and indirect costs attributable to type 2 diabetes were extrapolated to the type 2 diabetes population in Bahrain.
In 2015, the total direct medical cost of type 2 diabetes was 104.7 million Bahraini dinars (BHD), or 277.9 million US dollars (USD), and the average unit cost per person with type 2 diabetes (1162 BHD, or 3084 USD) was more than three times higher than for a person without the condition (372 BHD, or 987 USD). The healthcare costs for patients with both micro- and macrovascular complications were more than three times higher than for patients without complications. Thus, 9% of the patients consumed 21% of the treatment costs due to complications. Complications often lead to hospital admission, and 20% of the patients consumed almost 60% of the healthcare costs attributable to type 2 diabetes due to hospital admissions. The indirect cost due to absenteeism was 1.23 million BHD (3.26 million USD).
Type 2 diabetes exerts significant pressure on Bahrain's healthcare system - primarily due to costly diabetes-related complications. It is therefore important to optimise the management and control of type 2 diabetes, thereby reducing the risk of disabling and expensive complications.
2 型糖尿病是巴林王国日益严重的健康挑战，这种疾病给医疗保健系统带来了巨大压力。本研究旨在评估该国的年度成本，并了解这些成本的驱动因素。
从初级保健糖尿病诊所中随机抽取了 628 名 2 型糖尿病患者作为样本，分析了为期一年的 2 型糖尿病直接医疗和间接成本。本研究使用患者的病历、访谈和标准化频率问卷来获取人口统计学和临床特征、并发症状况、治疗概况、医疗资源利用情况以及因糖尿病而缺勤的数据。间接成本使用人力资本法进行估算。将归因于 2 型糖尿病的直接医疗和间接成本外推到巴林的 2 型糖尿病人群中。
2015 年，2 型糖尿病的总直接医疗费用为 1.047 亿巴林第纳尔（BHD），即 2.779 亿美元（USD），每例 2 型糖尿病患者的平均单位成本（1162 BHD，即 3084 USD）是无该病患者的三倍多（372 BHD，即 987 USD）。患有微血管和大血管并发症的患者的医疗费用是无并发症患者的三倍多。因此，9%的患者消耗了 21%的并发症治疗费用。并发症常常导致住院治疗，20%的患者因住院治疗而消耗了近 60%的 2 型糖尿病医疗费用。因缺勤导致的间接成本为 123 万 BHD（3260 万美元）。
2 型糖尿病给巴林的医疗保健系统带来了巨大压力——主要是由于昂贵的糖尿病相关并发症。因此，优化 2 型糖尿病的管理和控制非常重要，从而降低导致残疾和昂贵并发症的风险。
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