Weng Wayne, Tian Ye, Kong Sheldon X, Ganguly Rahul, Hersloev Malene, Brett Jason, Hobbs Todd
Novo Nordisk Inc., 800 Scudders Mill Road, Plainsboro, NJ 08536 USA.
Clin Diabetes Endocrinol. 2020 Mar 4;6:5. doi: 10.1186/s40842-019-0090-y. eCollection 2020.
This study evaluated the impact of atherosclerotic cardiovascular disease (ASCVD) on healthcare resource utilization and costs in patients with type 2 diabetes mellitus (T2DM).
This study was a retrospective, cross-sectional study using US claims data. Adult patients with T2DM were stratified by presence or absence of ASCVD and compared regarding annual (2015) healthcare resource utilization and associated costs. Subgroup analyses were conducted for three age groups (18-44, 45-64, and ≥ 65 years).
Among 1,202,596 eligible patients with T2DM, 45.2% had documented ASCVD. The proportions of patients with inpatient and ER-based resource utilization during 2015 were three-to-four times greater in the ASCVD cohort as compared to the non-ASCVD cohort for the categories of inpatient visits (15.6% vs 4.4% of patients), outpatient ER visits (18.4% vs 5.2% of patients), and inpatient ER visits (4.3% vs 0.9% of patients). Outpatient utilization also was higher among patients with ASCVD as compared to those without ASCVD (mean number of annual office visits per patient, 9.1 vs 5.6), and more than twice as many patients with ASCVD had ≥ 9 office visits (43.5% vs 19.8%). Average per-patient total healthcare cost was $22,977 for ASCVD vs $9735 for non-ASCVD, with medical costs primarily driving the difference ($17,849 vs $6079); the difference in pharmacy costs was smaller ($5128 vs $3656). In the 18-44, 45-64, and ≥ 65 age subgroups respectively, total annual healthcare costs were 143, 127, and 114% higher in ASCVD vs non-ASCVD patients.
These findings indicate significantly higher healthcare resource utilization and associated costs in patients having T2DM with ASCVD compared to T2DM without ASCVD.
本研究评估了动脉粥样硬化性心血管疾病(ASCVD)对2型糖尿病(T2DM)患者医疗资源利用和成本的影响。
本研究是一项使用美国索赔数据的回顾性横断面研究。成年T2DM患者按是否存在ASCVD进行分层,并比较2015年的年度医疗资源利用情况及相关成本。对三个年龄组(18 - 44岁、45 - 64岁和≥65岁)进行亚组分析。
在1,202,596例符合条件的T2DM患者中,45.2%有ASCVD记录。2015年,ASCVD队列中住院和基于急诊的资源利用患者比例在住院就诊(患者比例为15.6% vs 4.4%)、门诊急诊就诊(患者比例为18.4% vs 5.2%)和住院急诊就诊(患者比例为4.3% vs 0.9%)类别中是非ASCVD队列的三到四倍。与无ASCVD的患者相比,ASCVD患者的门诊利用率也更高(每位患者每年平均门诊就诊次数,9.1次 vs 5.6次),且ASCVD患者中门诊就诊≥9次的人数是无ASCVD患者的两倍多(43.5% vs 19.8%)。ASCVD患者的人均总医疗成本为22,977美元,而非ASCVD患者为9735美元,主要是医疗成本导致了差异(17,849美元 vs 6079美元);药房成本差异较小(5128美元 vs 3656美元)。在18 - 44岁、45 - 64岁和≥65岁年龄亚组中,ASCVD患者的年度总医疗成本分别比非ASCVD患者高143%、127%和114%。
这些发现表明,与无ASCVD的T2DM患者相比,合并ASCVD的T2DM患者的医疗资源利用和相关成本显著更高。