Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Dutch Institute for Clinical Auditing, Leiden, The Netherlands.
BMC Endocr Disord. 2023 Apr 7;23(1):72. doi: 10.1186/s12902-023-01316-3.
Diabetes mellitus is one of the most common chronic diseases in childhood. With more advanced care options including ever-evolving technology, allocation of resources becomes increasingly important to guarantee equal care for all. Therefore, we investigated healthcare resource utilization, hospital costs, and its determinants in Dutch children with diabetes.
We conducted a retrospective, observational analysis with hospital claims data of 5,474 children with diabetes mellitus treated in 64 hospitals across the Netherlands between 2019-2020.
Total hospital costs were €33,002,652 per year, and most of these costs were diabetes-associated (€28,151,381; 85.3%). Mean annual diabetes costs were €5,143 per child, and treatment-related costs determined 61.8%. Diabetes technology significantly increased yearly diabetes costs compared to no technology: insulin pumps € 4,759 (28.7% of children), Real-Time Continuous Glucose Monitoring € 7,259 (2.1% of children), and the combination of these treatment modalities € 9,579 (27.3% of children). Technology use increased treatment costs significantly (5.9 - 15.3 times), but lower all-cause hospitalisation rates were observed. In all age groups, diabetes technology use influenced healthcare consumption, yet in adolescence usage decreased and consumption patterns changed.
These findings suggest that contemporary hospital costs of children with diabetes of all ages are driven primarily by the treatment of diabetes, with technology use as an important additive factor. The expected rise in technology use in the near future underlines the importance of insight into resource use and cost-effectiveness studies to evaluate if improved outcomes balance out these short-term costs of modern technology.
糖尿病是儿童中最常见的慢性疾病之一。随着包括不断发展的技术在内的更先进的护理选择，资源的分配对于保证所有儿童都能得到平等的护理变得越来越重要。因此，我们调查了荷兰儿童糖尿病患者的医疗资源利用、医院费用及其决定因素。
我们对 2019-2020 年期间在荷兰 64 家医院接受治疗的 5474 名糖尿病儿童的医院索赔数据进行了回顾性观察分析。
每年的总医院费用为 3300.2652 万欧元，其中大部分与糖尿病相关（2815.1381 万欧元，占 85.3%）。儿童每年的平均糖尿病费用为 5143 欧元，治疗相关费用占 61.8%。与没有使用技术相比，糖尿病技术显著增加了每年的糖尿病费用：胰岛素泵 4759 欧元（占儿童的 28.7%），实时连续血糖监测 7259 欧元（占儿童的 2.1%），以及这些治疗方式的组合 9579 欧元（占儿童的 27.3%）。技术的使用显著增加了治疗费用（5.9-15.3 倍），但观察到全因住院率降低。在所有年龄组中，糖尿病技术的使用都影响了医疗保健的消费，但在青春期，使用减少，消费模式发生了变化。
这些发现表明，所有年龄段儿童糖尿病患者的当代医院费用主要由糖尿病治疗驱动，技术使用是一个重要的附加因素。在不久的将来，技术使用预计会增加，这凸显了了解资源利用和成本效益研究的重要性，以评估改善结果是否平衡了现代技术的短期成本。
