Health Economics Research Group, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Department of Pharmacology, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen University, Thai Nguyen, Vietnam.
Diabet Med. 2024 Oct;41(10):e15417. doi: 10.1111/dme.15417. Epub 2024 Aug 2.
To estimate the direct costs during the prenatal, delivery and postpartum periods in mothers with diabetes in pregnancy, compared to those without.
This study used a population-based dataset from 2004 to 2017, including 57,090 people with diabetes and 114,179 people without diabetes in Tasmania, Australia. Based on diagnostic codes, delivery episodes with gestational diabetes mellitus (GDM) were identified and matched with delivery episodes without diabetes in pregnancy. A group of delivery episodes with pre-existing diabetes was identified for comparison. Hospitalisation, emergency department and pathology costs of these groups were calculated and adjusted to 2020-2021 Australian dollars.
There were 2774 delivery episodes with GDM, 2774 delivery episodes without diabetes and 237 delivery episodes with pre-existing diabetes identified. Across the 24-month period, the pre-existing diabetes group required the highest costs, totalling $23,536/person. This was followed by the GDM ($13,210/person), and the no diabetes group ($11,167/person). The incremental costs of GDM over the no diabetes group were $890 (95% CI 635; 1160) in the year preceding delivery; $812 (616; 1031) within the delivery period and $341 (110; 582) in the year following delivery (p < 0.05). Within the year preceding delivery, the incremental costs in the prenatal period were $803 (579; 1058) (p < 0.05). Within the year following delivery, the incremental costs in the postpartum period were $137 (55; 238) (p < 0.05).
Our results emphasised the importance of proper management of diabetes in pregnancy in the prenatal and postpartum periods and highlighted the significance of screening and preventative strategies for diabetes in pregnancy.
评估妊娠糖尿病母亲在产前、分娩和产后期间的直接成本，与无糖尿病母亲进行比较。
本研究使用了 2004 年至 2017 年的基于人群的数据集，包括澳大利亚塔斯马尼亚州的 57090 名糖尿病患者和 114179 名无糖尿病患者。基于诊断代码，确定了妊娠糖尿病（GDM）分娩病例，并与无妊娠糖尿病的分娩病例相匹配。还确定了一组患有糖尿病前期的分娩病例进行比较。计算了这些组别的住院、急诊和病理费用，并调整为 2020-2021 年澳大利亚元。
共确定了 2774 例 GDM 分娩病例、2774 例无糖尿病分娩病例和 237 例糖尿病前期分娩病例。在 24 个月的时间里，糖尿病前期组的费用最高，总计每人 23536 澳元。其次是 GDM（每人 13210 澳元）和无糖尿病组（每人 11167 澳元）。GDM 组比无糖尿病组在分娩前一年的增量成本为 890 澳元（95%CI635;1160）；分娩期间为 812 澳元（616;1031）；分娩后一年为 341 澳元（110;582）（p<0.05）。在分娩前一年，产前期间的增量成本为 803 澳元（579;1058）（p<0.05）。分娩后一年，产后期间的增量成本为 137 澳元（55;238）（p<0.05）。
我们的结果强调了妊娠糖尿病患者在产前和产后期间进行适当管理的重要性，并突出了妊娠糖尿病筛查和预防策略的重要性。
