Center for Health Economics and Policy Studies, Universitas Indonesia, Jawa Barat, Indonesia.
Endocrine and Metabolic Division of Internal Medicine Department, Faculty of Medicine Brawijaya University-Saiful Anwar Hospital, Malang, Indonesia.
Value Health Reg Issues. 2022 Mar;28:82-89. doi: 10.1016/j.vhri.2021.04.006. Epub 2021 Nov 25.
To estimate the direct medical cost of type 2 diabetes mellitus (T2DM) and its complications in the Indonesian population from a payer perspective using a prevalence-based approach.
The direct medical costs in 2016 were estimated using the database of Indonesia's National Health Insurance, known as Jaminan Kesehatan Nasional, which included diagnosis-related group costs and unbundled costs for patients accessing advanced care. The study population included people aged 30 years or older having a diagnosis of T2DM. T2DM and its related complications were identified using the International Classification of Diseases, 10th Revision, code. Hypoglycemia and all complications listed in the Diabetes Severity Complications Index were included. Descriptive analysis was conducted. Costs were converted to 2016 US dollar equivalent.
Of the 18.9 million Jaminan Kesehatan Nasional members who accessed secondary and tertiary care, 812 204 (4%) were identified with T2DM, of which 57% had complications. The most common complication was cardiovascular diseases (24%). The total direct medical cost was US $576 million, with 56% spent on hospitalization, 38% on specialist visits, 4% on unbundled non-diabetes-related medication, and 2% on unbundled anti-hyperglycemic medications. Approximately 74% of the total costs was used for the management of people with complications. People with complications (US $930/person/year ± US $1480/person/year) incurred twice the cost of those without complications (US $421/person/year ± US $745/person/year).
The direct medical cost for management of people with T2DM in Indonesia was high. Early diagnosis and optimal management of T2DM to prevent complications may reduce the costly sequelae and have a possibility of cost savings.
从支付者角度出发，采用基于患病率的方法，估算印度尼西亚人群 2 型糖尿病（T2DM）及其并发症的直接医疗费用。
使用印度尼西亚国家医疗保险（Jaminan Kesehatan Nasional）数据库，即全民健康保险，来估算 2016 年的直接医疗费用。该数据库包含按诊断相关组计算的费用和接受高级护理的患者的非捆绑费用。研究人群包括年龄在 30 岁及以上、患有 T2DM 诊断的人群。使用国际疾病分类，第 10 版，代码识别 T2DM 及其相关并发症。包括低血糖和糖尿病严重程度并发症指数中列出的所有并发症。进行描述性分析。费用转换为 2016 年美元等价物。
在接受二级和三级保健的 1890 万全民健康保险成员中，有 812204 人（4%）被诊断为 T2DM，其中 57%有并发症。最常见的并发症是心血管疾病（24%）。直接医疗总费用为 5.76 亿美元，其中 56%用于住院治疗，38%用于专科就诊，4%用于非糖尿病相关药物的非捆绑费用，2%用于非捆绑抗高血糖药物。大约 74%的总费用用于管理有并发症的人群。有并发症的人（每年每人 930 美元±1480 美元）的费用是没有并发症的人的两倍（每年每人 421 美元±745 美元）。
印度尼西亚 T2DM 患者的管理直接医疗费用很高。早期诊断和优化 T2DM 管理以预防并发症可能会减少昂贵的后果，并有可能节省成本。
